Acute vascular insufficiency

(OSN)
Vascular insufficiency is a violation of local or general circulation, which
is based on the insufficiency of the function of blood vessels, caused in
turn by a violation of their patency, a decrease in tone, the volume of
blood passing through them. There are acute and chronic vascular
insufficiency.
• When your veins have trouble sending blood from your limbs back to
the heart, it's known as venous insufficiency. In this condition, blood
doesn't flow back properly to the heart, causing blood to pool in the
veins in your legs.
• Acute arterial insufficiency is a medical condition in which the tissues
do not receive enough oxygen and nutrients (ischemia) due to poor
arterial blood supply.
• Most cases of acute arterial insufficiency are caused by
atherosclerosis, a condition in which the arteries become clogged by
cholesterol plaques. This results in poor blood flow to the affected
blood vessels and may also lead to the increased formation of blood
clots (thrombus) due to the turbulence caused by these plaques.
Negative factors
• Advanced age.
• Diabetes.
• High blood cholesterol levels.
• High blood pressure.
• High-fat diet.
• Obesity.
• Personal or family history of heart disease.
• Smoking.
• The most common causes of heart failure:
• suffered myocardial infarction;
• coronary heart disease;high blood pressure;
• diseases of the heart valves;
• inflammatory and non-inflammatory myocardial diseases;
• congenital heart defects;
• lung diseases;
• alcohol abuse, drug use.
• The heart with "heart failure" does not provide the body with oxygen
and nutrients.
• With heart failure, the work of the heart as a "pump" becomes
difficult. The pump is getting worse. It needs to be either repaired or
changed, but in this case it is very difficult and expensive, because we
have to support our main body: this is the treatment of this disease
Symptoms
• The symptoms of the disease are generally common for heart
ailments. These are:
• shortness of breath
• rapid heartbeat
• Fatigue
• swelling mainly of the lower extremities
• general weakness.
• In addition, it is often frequent urination and dry cough.More often,
the disease develops on the basis of arterial hypertension, coronary
heart disease, malformations and inflammatory heart diseases. Its
causes are about the same as those of other heart diseases.
 • Acute vascular insufficiency (OSN) is a condition
characterized by a violation of the ratio between the
capacity of the vascular bed and the volume of
circulating blood. There are the following clinical
forms of acute vascular insufficiency - fainting,
collapse, shock.
Fainting, collapse, shock
• Fainting is a short-term loss of consciousness caused by an acute violation of
cerebral circulation, resulting from a mental or reflex effect on the regulation of
blood circulation, accompanied by vegetative-vascular disorders, a decrease in
muscle tone and a drop in pressure.
• Collapse is an acutely developing vascular insufficiency with a violation of
vascular tone and a decrease in the mass of circulating blood, manifested by a
sharp decrease in arterial and venous pressure, signs of brain hypoxia and
suppression of vital body functions.
• Shock is an acutely developing pathological process that develops due to the
impact of extreme external or internal factors, characterized by a sharp
decrease in tissue perfusion, severe disorders of the central nervous system,
blood circulation, respiration and metabolism.
What is the difference between collapse and
shock?
• Shock, in contrast to collapse, is the reaction of the body to super-
strong, especially painful, irritation, accompanied by more severe
disorders of vital functions of the nervous and endocrine systems,
blood circulation, respiration, metabolic processes and often
excretory kidney function.
Collapse
• There are several forms of collapse: infectious, toxic, hypoxic,
orthostatic, and also, depending on the clinical features,
sympathicotonic, vagotonic and paralytic collapse are distinguished.
• Sympathicotonic collapse is observed with blood loss, neurotoxicosis,
dehydration, pneumonia. The maximum blood pressure is elevated,
tachycardia is pronounced.
• Vagotonic collapse is observed in fainting states, fright, anaphylactic
shock, hypoglycemic coma and insufficiency of the adrenal cortex. A
sharp drop in blood pressure as a result of the active expansion of
arterioles leads to cerebral ischemia. The difference between the
maximum and minimum blood pressure increases significantly with a
decrease in the minimum. Bradycardia is noted.
• Paralytic collapse is a consequence of depletion of the mechanisms
regulating blood circulation, occurs in a number of pathological
conditions (severe dehydration, neurotoxicosis, diabetic coma, etc.).
• The severity of the collapse can be light, medium-heavy and heavy.
The severity criterion is the degree of violation of blood pressure and
heart rate:
• Mild collapse: heart rate increases by 20-30%, blood pressure is
normal, pulse pressure decreases.
• Moderate clinical form: heart rate increases by 40-60%, blood
pressure is reduced within the range of SAD 60-80 mmHg, DB below
60 mmHg, phenotype of "continuous tone".
• Severe collapse: consciousness is clouded to somnolence, sopor.
Heart rate increases by 60-100%, SAD is below 60 mmHg, may not be
determined
Treatment of heart failure
• Treatment involves the use of the following main groups of drugs:
• Diuretics (diuretics) - achieving and maintaining euvolemia with the
lowest effective doses.
• ACE inhibitors (Angiotensin converting enzyme)- relax blood vessels
• Beta blockers - slow down the heart rate, lower blood pressure and
thus protect your heart from the prolonged effects of adrenaline and
norepinephrine.
• Cardiac glycosides - cardiotonic and antiarrhythmic effects (in which the
weakening of the contractile capacity of the myocardium leads to
decompensation of cardiac activity.)
• Nitrates- to reduce preload on the heart, to improve hemodynamics
• Euvolemia is a condition accompanied by the consumption of an
optimal volume of fluid that allows the body to meet metabolic needs
without accumulating excessive fluid volume.
• Treatment usually takes place at home.
• For patients at the first stage, an examination by a cardiologist is
necessary once every half a year, at the second - once every 3
months, at the third stage – once a month. In any case, a doctor's
consultation is necessary, he prescribes the visiting regime.

• Non-medical treatments in the form of moderate exercise, such as

walking, is also important to help reduce the progression of the
disease. Surgical treatment is reserved for severe cases of occlusion.
First aid
• First of all, you need to call an ambulance. Before the arrival of
doctors, lay the sufferer on his back, on a hard, flat horizontal surface.
The legs need to be slightly raised relative to the body for blood flow
to the brain. If the collapse is caused by a large blood loss, try to stop
the bleeding.