Collapse is a medical term. Collapse heart disease

Almost all of us have encountered this painful condition like vascular collapse on own experience or from the experiences of loved ones. If collapse is accompanied by loss of consciousness, then this condition is called fainting. But quite often a collaptoid state develops against the background of preserved consciousness.

Collapse is, by definition, an acutely developing vascular insufficiency. The name "collapse" comes from the Latin word collapsus, meaning "weakened" or "fallen."

At the first signs of the development of cardiovascular collapse, it is necessary to provide first aid medical care. This condition often leads to the death of the patient. To prevent negative consequences you should know the reasons that cause collapse and be able to
it is right to prevent them.

How does acute vascular insufficiency develop?

Collapse is characterized by a decrease vascular tone, which is accompanied by a relative decrease in the volume of blood circulating in the body. In simple words, vessels dilate in a short period of time, and the available bloodstream blood becomes insufficient for vital blood supply important organs. The body does not have time to quickly react to changes in vascular tone and release blood from the blood depots. acute vascular insufficiency, collapse develops acutely and rapidly.

If the collapse is accompanied by a critical disruption of the blood supply to the brain, then fainting or loss of consciousness occurs. But this does not happen in all cases
collaptoid state.

As collapse develops, health deteriorates, dizziness and pallor appear. skin and mucous membranes, may protrude cold sweat. Breathing becomes frequent and shallow, heart rate increases, and blood pressure decreases.

Cardiovascular collapse: first aid

As a rule, collapse develops against a background of weakening of the body after serious illnesses, infections, intoxications, pneumonia, with physical and mental stress, with a decrease or increase in blood sugar levels. If the collapsed state or fainting lasts more than 1-2 minutes, then one should suspect some kind of serious illness and call an ambulance doctor.

First first aid in case of cardiovascular collapse and fainting should be as follows: eliminate potential hazards (electricity, fire, gas), make sure the patient has free breathing or provide it (unfasten the collar, belt, open the window), pat his cheeks and splash his face with cold water.

If such conditions occur repeatedly, their duration and frequency increase, then it is necessary to carry out a complete clinical examination to determine the cause of their occurrence.

Collapse is an acute vascular insufficiency characterized by sharp decline vascular tone and fall blood pressure.

Collapse is usually accompanied by impaired blood supply, hypoxia of all organs and tissues, decreased metabolism, depression of vital important functions body.

Causes

Collapse can develop as a result of many diseases. Most often, collapse occurs in cardiac pathology. vascular system(myocarditis, myocardial infarction, thromboembolism pulmonary arteries etc.), as a result of acute loss of blood or plasma (for example, with extensive burns), dysregulation of vascular tone during shock, severe intoxication, infectious diseases, diseases of the nervous system, endocrine systems, as well as in case of overdose of ganglion blockers, neuroleptics, sympatholytics.

Symptoms

The clinical picture of collapse depends on its cause, but the main manifestations are similar to collapse of different origins. There is a sudden progressive weakness, chilliness, dizziness, tinnitus, tachycardia (rapid pulse), blurred vision, and sometimes a feeling of fear. The skin is pale, the face becomes sallow in color, covered with sticky cold sweat; with cardiogenic collapse, cyanosis (bluish color of the skin) is often noted. Body temperature decreases, breathing becomes shallow and rapid. Blood pressure decreases: systolic - to 80-60, diastolic - to 40 mm Hg. Art. and below. As the collapse deepens, consciousness is impaired, and disorders often occur heart rate, reflexes disappear, pupils dilate.

Cardiogenic collapse, as a rule, is combined with cardiac arrhythmia, signs of pulmonary edema (breathing difficulties, cough with copious foamy, sometimes pink-tinged, sputum).

Orthostatic collapse occurs when there is a sudden change in body position from horizontal to vertical and quickly stops after transferring the patient to a lying position.

Infectious collapse, as a rule, develops as a result of a critical decrease in body temperature. Skin moisture and severe muscle weakness are noted.

Toxic collapse is often combined with vomiting, nausea, diarrhea, signs of acute renal failure(swelling, difficulty urinating).

Diagnostics

The diagnosis is made based on clinical picture. Studying hematocrit and blood pressure over time gives an idea of ​​the severity and nature of the collapse.

Types of disease

• Cardiogenic collapse - as a result of decreased cardiac output;
• Hypovolemic collapse - as a result of a decrease in circulating blood volume;
• Vasodilatory collapse - as a result of vasodilation.

Patient Actions

If a collapse occurs, you should immediately contact the ambulance service.

Treatment of collapse

Treatment measures are carried out intensively and urgently. In all cases, a patient with collapse is placed in horizontal position with legs raised, covered with a blanket. A 10% solution of caffeine sodium benzoate is administered subcutaneously. Needs to be eliminated possible reason collapse: removal toxic substances from the body and the introduction of an antidote for poisoning, stopping bleeding, thrombolytic therapy. With thromboembolism of the pulmonary arteries, acute heart attack myocardium, paroxysm is stopped with medication atrial fibrillation and other heart rhythm disturbances.

Also held pathogenetic therapy which includes intravenous administration saline solutions and blood substitutes for blood loss or blood thickening in patients with hypovolemic collapse, introduction hypertonic solution sodium chloride during collapse against the background of uncontrollable vomiting and diarrhea. If it is necessary to urgently increase blood pressure, norepinephrine, angiotensin, and mesaton are administered. In all cases, oxygen therapy is indicated.

Complications of collapse

The main complication of collapse is loss of consciousness varying degrees. Mild fainting is accompanied by nausea, weakness, and pale skin. Deep fainting may be accompanied by convulsions, increased sweating, involuntary urination. Fainting can also result in injury from a fall. Sometimes collapse leads to the development of a stroke (a disorder cerebral circulation). Possible various damages brain.

Repeated episodes of collapse lead to severe brain hypoxia, aggravating the accompanying neurological pathology, development of dementia.

Prevention

Prevention consists of treating the underlying pathology, constant monitoring for the sick in in serious condition. It is important to take into account the pharmacodynamics of medications (neuroleptics, ganglion blockers, barbiturates, antihypertensives, diuretics), individual sensitivity to drugs and nutritional factors.

Collapse– one of the forms of acute vascular insufficiency, which is characterized by a drop in vascular tone and a decrease in the volume (mass) of circulating blood (CBV), accompanied by a sharp drop in blood pressure and leading to the decline of all life processes.

This “simple”, according to many doctors, formulation of the concept of “collapse” can easily be found on the pages of websites medical profile. Great, really! Of course, everyone understands everything! Since it is clear to us (medical practitioners) that you do not understand anything, we suggest breaking this “case,” as they say, into pieces.

If we translate this phrase into a generally understandable human language, it will immediately become clear that collapse is a condition in which the vessels of the human body cannot provide an influx required quantity blood to all organs. The most important thing you need to understand is that the brain and heart do not receive oxygenated blood. And, as we know from school, the brain is “the head of everything” for many people, and the heart is also a very, very necessary organ.

A natural question arises: “why does collapse occur?”

Causes of collapse:

sudden massive blood loss. As usual, this is associated with rupture of internal organs or serious external damage to the body.

sudden disturbance of heart rhythm or disturbance of its contractility.

Both reasons lead to the fact that the heart does not push the required amount of blood into the vessels. Examples of such diseases include: myocardial infarction, blockage large vessels lungs with a blood clot or air lock (pulmonary embolism), all sorts of sudden cardiac arrhythmias.

sharp expansion of peripheral vessels. This condition may occur against the background high temperature and humidity environment , during illness with various acute infectious diseases (pneumonia, sepsis, typhoid fever etc.), the strongest allergic reaction

, drug overdose. in adolescents puberty Collapse may occur due to strong emotional experiences, such as of a negative nature

, and positive.

Regardless of the reason that caused the collapse, the manifestations of signs of this condition in people of any age are almost always similar.

Clinical manifestations of collapse:

deterioration of health occurs suddenly.

there are complaints about headache, tinnitus, weakness, discomfort in the heart area, darkening in the eyes.

consciousness is preserved, but some retardation is possible, and in the absence of help, loss of consciousness is possible.

Blood pressure drops sharply and by significant amounts.

the skin becomes damp, cold, pale.

Facial features become sharper, eyes become dull.

breathing becomes shallow and frequent.

The pulse is difficult to palpate.

Emergency first aid for collapse:

Whatever the reason that triggered the development of the collaptoid state, a doctor’s examination is needed in any case. The patient himself may object to the examination, but you must remember that collapse is a consequence of a serious problem in the body. A momentary improvement in the patient’s well-being is not a guarantee of future well-being. Calling a doctor is a prerequisite for complete assistance. In the meantime, you are waiting for the ambulance team to do the following:

Place the patient on a hard surface. A flat and hard surface is the best platform for carrying out resuscitation measures if the need arises.

elevate your feet (put a chair under them or place things under them). This is done to increase blood flow to the brain and heart.

provide an influx fresh air. Simply open a window or balcony door.

loosen tight clothing. To improve overall blood flow, you need to unfasten the belt, collar and cuffs of your clothing.

give the cotton wool with ammonia a whiff. Absence ammonia can be replaced with stimulation (light massage) nerve endings

earlobes, temples, dimples and lips.

if collapse is caused by blood loss from an external wound, try to stop the bleeding.

Remember!

Under no circumstances should you give the patient nitroglycerin, validol, no-shpu, valocordin, or corvalol. These drugs dilate blood vessels, which in this case are already not in good shape.

Do not give medications or drinks to the victim by mouth if he is unconscious!

You cannot revive a patient by hitting him on the cheeks!

Indications for hospitalization:

This issue is considered by doctors in each specific case.

There are differences between the concepts of “collapse” and “shock”. We will briefly consider this issue separately, because people often confuse these concepts. This may not be of practical importance for the provision of first aid, but this information will not harm the general development.

Shock is, like collapse, a general reaction of the body to a powerful damaging factor. This factor can be all kinds of injuries, poisoning, death of a large section of the heart muscle, loss of most of the blood, severe pain. The state of shock begins to develop from the phase of excitation of the patient, and then abruptly gives way to a pronounced depression of consciousness and motor activity of the person. Blood pressure during shock decreases to such an extent that the excretory function of the kidneys ceases. On your own without drug treatment blood pressure does not rise.

Collapse is a manifestation of acute insufficiency of the vascular system, caused by a drop in vascular tone or a decrease in the volume of circulating fluid (CVF). This symptom complex is often commonplace and familiar to many representatives adolescence, as well as people suffering vegetative-vascular dystonia. However, the pathology of this condition can lead to more serious consequences.

Mechanisms of collapse

Collapse in itself is not a disease, it is the body’s reaction to internal pathogenic factors.

There are 2 main mechanisms for the development of collapse:

1. A decrease in the tone of arterioles and venules due to the direct action of a pathogenic agent on the vascular wall or vasomotor center, which leads to an increase in the capacity of the vascular bed and a decrease in venous inflow to the heart, a drop in blood pressure (since venous inflow largely determines subsequent systole).

2. A rapid decrease in circulating blood volume during massive blood loss. When losing less blood volume, the body copes by increasing the heart rate and spasms small vessels caused by the release of catecholamines into the blood. When the collapse develops, the data defensive reactions They are simply ineffective because the blood loss is too great.

Catecholamines (contraction hormones) - adrenaline, norepinephrine. One of the functions they perform is to mobilize the internal forces of the body and prepare it for physical work. Their dual influence on human vascular tone makes these substances an important link in the development of collapse and shock.

These mechanisms are often combined. As a result of a drop in blood pressure, blood supply to tissues is disrupted, and hypoxia (oxygen starvation) develops. Since the function of the blood flow is not only to deliver oxygen to tissues, but also to remove accumulated carbon dioxide (CO2), metabolic acidosis of the circulatory type develops, i.e., the accumulation of waste products by cells, which leads to increased permeability of the endothelium. Violations rheological properties blood (viscosity) create the prerequisites for the development DIC syndrome(disseminated intravascular coagulation) - the formation of microclots in the blood and even greater suppression of the body’s nutrition.

If you don't provide help on time - death inevitable.

Kinds

In medicine, there are many collapses; it would be more practical to identify the common causes that cause them:

• lack of fluid;
• heart pathologies;
• vasodilation.

Hypovolemic collapse occurs due to excessive loss of body fluid - dehydration, blood loss (external traumatic and internal cavitary and parenchymal), as a result of which the volume of blood circulating through the vessels drops sharply.

Cardiogenic collapse develops against the background of heart valve insufficiency, acute disorder cardiac activity or a sharp decrease in cardiac output.

Vasodilation becomes the cause of vascular dysfunction in situations of severe and infectious conditions(When we're talking about about sepsis - the entry of microorganisms into the bloodstream, fibrinolytic enzymes such as streptokinase, streptodecase, which prevent normal thrombus formation, play an important role in disrupting the functionality of blood vessels), oxygen starvation, overheating, pathologies endocrine glands. Adenosine, histamine, excess kinins, improper use of medications entail an increase in resistance in the peripheral bloodstream - DIC syndrome.
Deserves special attention orthostatic collapse or orthostatic hypotension. Occurs during a sudden change in body position (usually when standing up) - the heart does not have time to respond to the increased load by increasing its own work, and due to a drop in pressure it does not reach the brain. sufficient quantity blood. The result is dizziness, darkening of the eyes. In a couple of seconds healthy person everything returns to normal, but in adolescents (whose immature the cardiovascular system at this time is naturally weak) and people with weakened vascular tone may develop a fainting state.

Orthostatic hypotension is diagnosed if the following conditions occur after several minutes of standing:

• blood pressure drop by 20 mm Hg. and more;
• drop in diastolic pressure (lower) by 10 mm Hg. and more;
• symptoms of brain tissue hypoxia (insufficient oxygen supply to brain tissue) - dizziness, darkening of the eyes, fainting.

Orthostatic hypotension is a violation of blood pressure during vertical loads or after a change in body position, and orthostatic collapse is a violation of brain perfusion and associated changes in consciousness.

Symptoms are typical for hypotonic and presyncope states:

• apathy;
• cold sweat;
• pale skin, especially in the lip area;
• weak, barely palpable pulse;
• frequent shallow breathing, arrhythmias are possible.

Collapse states of the body, unlike shock ones, are characterized by the absence of an erectile (excitatory) stage - as blood pressure progressively declines, consciousness turns off.

First aid

As soon as required urgent Care- call the doctors. Until the specialists arrive, it is necessary to bring the patient to his senses as quickly as possible.

Place the victim on a hard surface, slightly raise his legs (this will increase blood flow to the head), remove his outer clothing, remove everything that can hinder movement and breathing (suspenders, belt, backpack), provide oxygen to the room. Apply ammonia solution to the patient's nose. If the victim is bleeding, you should try to stop it.

Antispasmodics and blows to the face are ineffective.

Further treatment occurs in several directions:

1. 1. Causal - eliminating the factors that caused the collapse. Removal of poisons, elimination of hypoxia, activation sympathetic system, normalization of cardiac activity, stopping bleeding - all this will stop the deeper development of collapse.
2. 2. Pathogenetic - replenishment of structures destroyed by pathogenic factors, return of lost functions. This is restoration of the level of arterial and venous pressure, stimulation of respiration, activation of blood circulation, administration of blood substitutes and plasma, stimulation of the central nervous system.

Only timely medical intervention can help the patient regain lost functions and return to normal.

Collapse is a complex of disorders caused by acute vascular insufficiency, which develops as a result of the action of a wide variety of pathogenic factors. The pathophysiology of various collapses is similar. Patients require immediate first aid and sometimes surgery.

Cardiovascular collapse is a form of heart failure that occurs due to sharp drop tone blood vessels. At this time, there is a rapid decrease in the mass of circulating fluid, therefore, the blood flow to the heart decreases. Arterial-venous pressure drops, which in turn leads to inhibition of vital body functions.

Collapse translated from Latin means “fallen”, “weakened”. Its development is acute and rapid. Sometimes accompanied by loss of consciousness. This manifestation is quite dangerous, as it can lead to sudden death person. It happens that only a few minutes pass after an attack before irreversible ischemic changes, sometimes - hours. However modern methods Treatments for some forms of collapse help to increase the life expectancy of patients with this disorder.

Causes of collapse

Among the main reasons for an unexpected drop in vascular tone are:

• large blood loss;
• acute infections;
• intoxication;
• overdose of certain medications;
• consequence of anesthesia;
• damage to circulatory organs;
• severe dehydration;
• impaired regulation of vascular tone;
• injuries.

Symptoms

The clinical picture is clearly expressed. Taken together, the symptoms can immediately identify the pathology without confusing it with other diseases of the heart and blood vessels.

• sudden and rapid deterioration in health;
• severe and sharp headache;
• noise in ears;
• darkening of the eyes;
• general weakness due to low blood pressure;
• pallor;

• the skin quickly becomes cold, becomes damp, and acquires a bluish tint;
• respiratory dysfunction;
• weak palpation of the pulse;
• body temperature drops;
• sometimes there is loss of consciousness.

Note that a distinction is made between vascular and cardiac collapse. The first is less dangerous to the patient’s life, but it also requires an adequate response.

Therapeutic measures

At the slightest sign collapse, you should seek immediate attention qualified assistance. Mandatory hospitalization is required with further treatment of the underlying disease causing atony.

First therapeutic measures will be aimed at restoring vascular tone, blood volume, pressure, and circulation. Applicable conservative method– drug therapy.

And yet, in order to avoid relapse, it is imperative to undergo a course of treatment for the underlying disease causing the collapse.

Staying at home and hoping that everything will go away on its own will not work. Also, do not increase your blood pressure on your own by taking over-the-counter medications. medications. The appointment should be made by a cardiologist based on the results of high-quality diagnostics. A quick response and timely therapeutic assistance is the key to saving a human life!