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Acute cardiovascular insufficiency


May be as a result of prolonged oxygen deprivation (hypoxia) due to blood loss or respiratory distress, traumatic shock, heart defects, hypertension, myocardial infarction, toxic substances.
The heart muscle loses its contractile ability, therefore it cannot pump blood flowing to the heart, cardiac output sharply decreases. As a result, there is stagnation of blood. If the failure of the left ventricle of the heart prevails, the blood stagnates mainly in the lungs. This is manifested by shortness of breath, tachycardia, cyanosis, dysfunction of other important organs, and particularly the kidneys.
If right ventricular insufficiency prevails, the blood stagnates in the large circulation, edema appears, the liver increases, the blood flow rate decreases and oxygen supply to various tissues and organs decreases.
First aid should be primarily aimed at strengthening the contractility of the heart. To do this, use drugs such as strophanthin, Korglikon, digoxin. Strofantina (0.05% solution) 0.5 ml diluted in 20 ml of 40% or 5% glucose and slowly injected into a vein. In case of acute insufficiency associated with angina, the patient should be given a nitroglycerin tablet under the tongue. In order to reduce blood stagnation in the pulmonary vessels, administration of aminophylline is very effective. This drug can be used both intravenously in the form of a 2.4% solution, and intramuscularly in the form of a 24% solution. The patient should also enter any of the urinary agents - furosemide or Novurite. To reduce hypoxia give breathe moistened oxygen.
It is necessary to transport the patient with great care. If the blood pressure is reduced slightly, the patient should be given an exalted position, and to reduce blood flow to the heart, put the harness on the limbs, clamping only the venous vessels. It must be remembered that the most effective treatment can only be carried out in a hospital setting (see Chap. Internal Diseases, Cardiovascular Disease section. Heart Failure).