Congestive pneumonia - causes and signs of congestive pneumonia

Stages

The mechanism of the pathology is associated with slow overflow of the veins due to impaired blood outflow processes.

The first phase is characterized by venous hyperemia in the lung tissue, in which the capillaries lengthen and expand, and subsequently the alveoli are compressed. In the second phase, the liquid component of the blood begins to leak from the veins into the alveoli and interstitial tissue, which on X-ray coincides with the picture of parenchymatous pneumonia and bronchopneumonia. In the third, edema of the interstitial tissue is noted, fibrous tissue grows and pneumosclerosis develops.

Causes

The cause of the pathology is congestion in the pulmonary circulation. In this case, the drainage function of the bronchi and pulmonary ventilation are impaired. Viscous and thick sputum begins to accumulate in the bronchi, pathogenic and opportunistic microorganisms develop, which provoke the development of congestive pneumonia.

In most cases, the disease is observed in patients suffering from somatic diseases:

• atherosclerosis;
• cardiosclerosis;
• heart disease;
• hypertension;
• atrial fibrillation;
• bronchial asthma;
• ischemic heart disease;
• diabetes mellitus;
• chronic pyelonephritis.

The risk group includes patients over 60 years of age who are forced to remain in a passive state due to bone injuries, strokes, cancer, chest deformities, spinal curvatures, etc. At the microorganism level, the disease is provoked by streptococci, Haemophilus influenzae, and pneumococci.

Symptoms

The severity of clinical symptoms of congestive pneumonia is determined by ventilation and hemodynamic disorders, the influence of inflammatory processes, and the severity of the underlying disease.

Body temperature is usually subfebrile or normal. In rare cases, febrile temperature is observed. Other symptoms are also noticeable:

• cough, accompanied by mucopurulent sputum;
• hemoptysis;
• complication of physical activity;
• progressive dyspnea and weakness.

If the disease is early in its onset (2-3 days of bed rest), the symptoms overlap with the manifestations of the underlying disease. With a stroke, there are disturbances of consciousness and breathing (arrhythmic and noisy). With cardiovascular pathologies, symptoms of heart failure may progress. The late form of congestive pneumonia (2-6 weeks) manifests itself more vividly.

Often the disease leads to complications in the form of pericarditis or exudative pleurisy.

Diagnostics

The difficulty of diagnosing the disease is determined by the vague picture of symptoms, as well as the pronounced severity of the underlying pathology. It is important not only to make an appointment with a pulmonologist, but also to consult with a cardiologist and neurologist.

When listening to the chest, moist fine-bubble wheezing and harsh breathing are noted in the posterior lower parts of the lungs. Radiography can reveal decreased transparency in the pulmonary passages on one or both sides, focal shadows, linear shadows, exacerbation of the pulmonary pattern, hemosiderin nodes, and expanded shadows in the roots of the lung.

Ultrasound allows you to clarify the diagnosis and detect the presence of effusion in the pleural cavity. EchoCG and ECG can be used. Blood tests do not show any special changes, except for mild leukocytosis and an increase in ESR. Microscopic examination of sputum can detect heart defect cells in the patient that contain hemosiderin.

Treatment

Therapy involves curing the bacterial infection. It is important to control lung ventilation, their perfusion, and reduce swelling.

Complex drug treatment involves the following groups of drugs:

• antibiotics;
• antioxidants;
• expectorants;
• diuretics;
• immunomodulatory drugs;
• cardiac glycosides;
• substances that improve metabolism in the heart muscle.

Physiotherapeutic measures include:

• oxygen therapy;
• chest massage;
• back massage;
• inhalations;
• therapeutic gymnastics.

Sputum from the tracheobronchial tree is removed using bronchoalveolar lavage, as well as bronchoscopy. If pericardial or pleural effusion is observed, pericardial puncture and thoracocentesis are prescribed.

It is also important to continue treating the underlying pathology that became the impetus for the development of congestive pneumonia.

Prevention

Particular attention should be paid to patients who are on bed rest. A number of measures are used for this:

• regular change of the patient's position;
• conducting simple but active physical exercises;
• percussion massage on the chest;
• cupping massage;
• application of mustard plasters and compresses.

If the patient is in a weakened state, a balanced and vitamin-rich diet should be organized.