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Falha cardíaca

O que é? Qual é o tratamento?

A insuficiência cardíaca se desenvolve lentamente, a medida  que o músculo cardíaco vai se debilitando. Em um coração saudável, as câmaras se contraem e relaxam de modo coordenado ou em sincronia. No caso das pessoas com insuficiência cardíaca, seus corações não bombeiam da maneira sincronizada como deveriam e o sangue também não circula como deveria.

Quais são as causas?

As causas de uma insuficiência cardíaca variam de acordo com a idade e os antecedentes familiares, porém têm um fator comum: de algum modo danificam o músculo cardíaco, e ele não bombeia o sangue como deveria. Existem vários fatores de risco de insuficiência cardíaca, e é importante mencionar que um desses fatores ou a combinação de vários fatores pode resultar em uma fibrilação ventricular.

  • Doença arterial coronária e ataque cardíaco
    O músculo cardíaco tem seus próprios vasos sanguíneos, denominados artérias coronárias, que transportam o sangue rico em oxigênio para as paredes do coração. Quando um vaso é obstruído, fluxo sanguíneo para o coração é interrompido, provocando um dano permanente a uma parte do músculo e produzindo um ataque cardíaco. Sua gravidade dependerá do dano sofrido pelo músculo e do tempo em que o coração não recebeu oxigênio.
  • Problemas respiratórios
    Estão entre os sintomas mais habituais de insuficiência cardíaca. Alguns são produzidos quando se acumula líquido nos pulmões e tecidos circundantes, podendo provocar sufocamento depois de realizar exercício leve, respiração ofegante (parecida com aquelas que se apresentam nos casos de asma), ou tosse seca depois de ficar deitado durante algumas horas. As fases avançadas de insuficiência cardíaca podem provocar uma sensação de asfixia.
  • Se a quantidade de sangue que chegar aos tecidos do corpo for muito escassa, os tecidos podem reter líquido e começar a inchar. A inchação começa pelos pés, continua pelos tornozelos e pelas pernas, e depois pelo abdômen. Na medida em que os tecidos retiverem sal e água, pode haver um aumento de peso, embora se coma menos.

Outros sintomas de insuficiência cardíaca são: fadiga, palpitações, dificuldade para se concentrar, tonturas, desmaios e problemas para cair no sono.

Como é realizado o diagnóstico?

Além de um exame físico, o médico pode indicar um exame de sangue, radiografias, eletrocardiograma, ecocardiograma ou outras análises para diagnosticar a insuficiência cardíaca.
Um diagnóstico precoce é fundamental para um tratamento que pode retardar a aparição de alguns sintomas.
O médico pode utilizar diferentes métodos para saber quando se sofre de alguma insuficiência cardíaca, determinando a gravidade da doença e a melhor forma de tratá-la.Este começará perguntando sobre os antecedentes médicos e os sintomas. Depois avaliará o coração, levando em conta que caso esteja dilatado, irá apresentar um ritmo irregular. Também avaliará se há um som anormal nos pulmões, se há inflamação ou dor ao apalpar a área hepática, e se há retenção de líquidos. Para confirmar um diagnóstico de insuficiência cardíaca, o médico pode solicitar alguns exames, tais como exame de sangue, radiografias de tórax, eletrocardiograma, ecocardiograma, exame de esforço, cateterismo, estudo eletrofisiológico.

Em que consiste o tratamento?

A insuficiência cardíaca não pode ser curada, mas existem muitas opções de tratamento, que podem ajudar a evitar que a doença avance, podendo assim levar uma vida mais normal, reduzir os sintomas, a necessidade de hospitalização e reduzir o risco de morte.
Os diferentes tratamentos incluem mudanças no estilo de vida, remédios, dispositivos implantáveis e cirurgias. A possibilidade de uma terapia para a insuficiência cardíaca e seus efeitos pode variar de uma pessoa a outra. O médico indicará qual é o tratamento apropriado para cada caso.

A terapia de ressincronização cardíaca (TRC) é uma das opções. Realiza-se através de um dispositivo que, mediante o uso de pulsos elétricos sincronizados, ajudam a fazer com que o ritmo do coração com insuficiência cardíaca seja mais parecido a uma pulsação normal.

Antes de iniciar o tratamento, consultar sempre um médico.

Prevenção  

Aconselha-se a seguir uma dieta com baixa ingestão de gorduras e rica em fibras, reduzir o consumo de álcool, não fumar, e fazer exercícios físicos de forma regular.