Lung infarction: symptoms, causes, complications
The content of the article:
- What is it - a lung infarction?
- Lung infarction symptoms
- Diagnostics
- Treatment tactics
- Consequences of lung infarction and prognosis
- Video
Lung infarction is one of the most dangerous forms of the disease. It is characterized by the rapid death of organ cells due to the sudden interruption of blood circulation. The disease begins suddenly, progresses rapidly and is fraught with serious complications.
Cessation of blood flow along the branch of the pulmonary artery leads to the development of pulmonary infarction
What is it - a lung infarction?
Violation of blood flow through the pulmonary artery due to its compression or blockage leads to oxygen starvation of the cells of the lung area, and subsequently their death. The lungs have one of the most developed vascular networks in the body and need a lot of blood flow. Blocking the inflow in one of the vessels leads to systemic disorders of the cardiovascular system, causes an increase in pressure in the pulmonary circulation, and may be complicated by pulmonary hemorrhage and pneumonia. The lung is one of the shock organs, that is, the most susceptible to damage during shock, terminal states.
What happens to the lung tissue when it receives less oxygen and nutrients? Alveolocytes, lung cells, begin to die off, and a necrosis focus is formed. The immune system reacts to it, stimulating the production of antibodies. As a result, necrosis is complicated by autoimmune inflammation, which involves a portion of the lung tissue, which is associated with complications of an already severe disease.
A heart attack is ischemic, that is, caused by ischemia - an insufficient supply of blood to the tissue, and hemorrhagic, associated with hemorrhage into the lung parenchyma, as a result of compression of the lung tissue.
The following causes of lung infarction are distinguished:
- heart failure - if the heart does not have time to pump the required amount of blood per unit of time, the residual volume remains in the vessels, including the lungs. The result is pulmonary edema, vasoconstriction, heart attack;
- blood clots - the lumen of a vessel can be blocked by a blood clot, a dense blood clot. This is often due to vascular surgery, such as the veins of the lower extremities and the pelvis, because they have low blood flow rates and large blood volumes. An acute variant of the development of the disease is BODY - pulmonary embolism;
- prolonged lying position - in this case, pulmonary edema, which leads to compression of the surrounding vessels, develops due to stagnation of blood. This pathology occurs in patients who are paralyzed after a stroke;
- embolism - caused by gas bubbles circulating in the blood, fat drops, foreign bodies. They enter the systemic circulation during surgical interventions, after fractures of large tubular bones, such as the femur;
- labor and the postpartum period are dangerous as thromboembolic complications, and the risk of massive hemorrhage, the development of shock conditions;
- taking combined oral contraceptives and drugs that increase blood clotting, etc.
Lung infarction symptoms
Clinically, a pulmonary infarction can manifest itself in a wide range - from intense pain in the chest to latent leaks. The severity of symptoms depends on the depth of the lesion, the localization of the affected area, the type of heart attack.
Even in the absence of pain, the first signs of the disease can be observed, which will prompt the need for emergency hospitalization: acute respiratory failure develops. The patient suddenly feels worse, suffocation appears - he complains of a lack of air, may ask to open the windows in the room or go outside. These measures are of little help in this case, since the pathogenesis of shortness of breath is associated with pulmonary insufficiency due to a heart attack.
After a while, pronounced cyanosis of the lips, the tip of the nose, fingers appears - this is due to an increase in the amount of venous blood in the bloodstream. Another characteristic sign is a drop in blood pressure, a deterioration in the characteristics of the pulse wave. When checking the pulse of such a person, one should pay attention to its low amplitude and low strength.
Later symptoms include:
- painful sensations - sharp pain in the chest and / or diffuse pain in the back, in the armpit, which intensifies during inhalation or exhalation. Depending on whether the right lung or the left lung is affected, the localization and intensity of pain changes;
- moist, productive cough. Heart failure leads to stagnation of blood in the lungs, leaking into the pulmonary vesicles (alveoli), which causes coughing. Sputum may contain streaks of scarlet blood;
- portal hypertension - an increase in pressure in the vena cava develops. At the same time, the liver enlarges, becomes hard and painful on palpation, and free fluid (ascites) may appear in the abdominal cavity.
Other signs are clammy cold sweat, chills, tension and congestion of the superficial veins of the neck, and loss of consciousness.
Diagnostics
The diagnosis is made in the clinic by a cardiologist and a pulmonologist. During a general examination, they note the degree of cyanosis, shortness of breath, the inclusion of additional muscles in the act of breathing. During auscultation, attention is paid to wheezing in the lungs, weakened vesicular breathing, changes in the heart - murmurs characteristic of heart failure. A preliminary diagnosis is made based on the physical examination data.
The diagnosis is established on the basis of instrumental examination
The most informative diagnostic methods are laboratory and instrumental studies. The first group includes general and biochemical blood analysis, measurement of its gas composition. Instrumental examination includes an electrocardiogram, ultrasound or rheovasography of the veins of the lower extremity to find possible blood clots, X-ray, computed tomography.
The main X-ray signs of the disease are expansion, deformation and increased vascularization of the lung root, an area of increased density in the form of a wedge, which apex is directed to the lung root, and the base to the periphery. The presence of effusion in the pleural cavity is possible with a prolonged course of the disease.
Macrodrug of the affected lung, that is, its appearance, is characterized by plethora, the presence of a wedge-shaped zone of necrosis, punctate hemorrhages closer to the surface of the lung, hemodynamic disturbances in clogged vessels - stasis, dilatation. The micropreparation - a sample of the lung under a microscope - has a description characteristic of a heart attack: in the center there are necrotic masses, around them an inflammatory leukocyte shaft, erythrocyte infiltration.
Treatment tactics
Treatment is carried out in several stages, efforts are aimed at eliminating the cause of the disease and at alleviating its symptoms.
Fibrinolytics and vasodilators are prescribed to dissolve blood clots in the vessels and increase the lumen of the vessels. For this, heparin or its analogs are used.
To relieve pain, narcotic analgesics are used, since conventional pain relievers are not effective enough in this case.
Massive infusion therapy is performed to maintain the blood composition, normalize the internal environment, and control pressure - for this, saline solutions, pressor drugs are used.
Sometimes there is a need for surgical treatment, which consists in removing a blood clot or other cause of pulmonary edema, installing cava filters in the renal vein area.
Consequences of lung infarction and prognosis
What will happen to the patient after a heart attack? The disease is rarely fatal, but the timeliness of the medical care provided and secondary pathologies, i.e. complications, play an important role in the prognosis.
A typical consequence of a heart attack with adequate treatment is the replacement of the necrotic area of the lung with connective tissue. Because of this, the area of gas perfusion decreases, the functionality of the lung decreases.
A timely visit to a doctor increases the patient's chances of recovery
The connective tissue scar can become malignant, turning into cancer over time.
Other dangerous complications are:
- pneumonia caused by inflammation of the lung tissue around the focus of necrosis and blood congestion in the lungs. It is fraught with the addition of a bacterial pathogen, the development of adhesions and respiratory failure;
- lung abscess - can complicate pneumonia or occur in the focus of necrosis;
- collapse - occurs with a sharp drop in blood pressure, which often accompanies this pathology;
- chronic pulmonary insufficiency.
The prognosis depends on the time that elapsed before the elimination of ischemia with anticoagulants. In most cases, patients return to normal life. The development of complications worsens the prognosis.
Video
We offer for viewing a video on the topic of the article.
Nikita Gaidukov About the author
Education: 4th year student of the Faculty of Medicine No. 1, specializing in General Medicine, Vinnitsa National Medical University. N. I. Pirogov.
Work experience: Nurse of the cardiology department of the Tyachiv Regional Hospital No. 1, geneticist / molecular biologist in the Polymerase Chain Reaction Laboratory at VNMU named after N. I. Pirogov.
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