What are the primary symptoms of congestive heart failure. How is CHF diagnosed and treated. What lifestyle changes can help manage congestive heart failure. What medications are commonly prescribed for CHF. When should you seek immediate medical attention for CHF symptoms.

Understanding Congestive Heart Failure (CHF)

Congestive heart failure (CHF), often simply referred to as heart failure, is a serious cardiovascular condition where the heart struggles to pump blood effectively throughout the body. This inefficient pumping leads to a backup of blood in various parts of the circulatory system, resulting in congestion and fluid buildup in tissues and organs.

CHF can affect either the left side, right side, or both sides of the heart. When one side fails, it puts additional strain on the other side, potentially leading to overall heart failure.

Types of Heart Failure

• Left-sided heart failure: Blood backs up into the lungs, causing respiratory issues
• Right-sided heart failure: Blood backs up into the body, causing swelling in extremities and organs
• Biventricular heart failure: Both sides of the heart are affected

Common Causes of Congestive Heart Failure

CHF typically develops as a result of underlying health conditions that weaken or damage the heart muscle over time. Some of the most common causes include:

• Coronary artery disease and heart attacks
• High blood pressure (hypertension)
• Valvular heart disease
• Cardiomyopathy (diseases of the heart muscle)
• Arrhythmias (abnormal heart rhythms)
• Chronic lung diseases
• Thyroid disorders
• Severe anemia
• Congenital heart defects

Is heart failure always caused by a single condition? Not necessarily. In many cases, CHF results from a combination of factors that gradually weaken the heart’s ability to pump efficiently.

Recognizing the Symptoms of Congestive Heart Failure

The symptoms of CHF can vary depending on which side of the heart is affected and the severity of the condition. However, some common signs and symptoms include:

Left-sided Heart Failure Symptoms

• Shortness of breath, especially during physical activity or when lying down
• Persistent coughing or wheezing
• Fatigue and weakness
• Rapid or irregular heartbeat

Right-sided Heart Failure Symptoms

• Swelling in the legs, ankles, and feet (edema)
• Abdominal swelling or pain
• Unexplained weight gain
• Nausea and loss of appetite

Can CHF symptoms come on suddenly? While CHF typically develops gradually, acute heart failure can occur, causing a rapid onset of severe symptoms that require immediate medical attention.

Diagnosing Congestive Heart Failure

Diagnosing CHF involves a combination of physical examination, medical history review, and various diagnostic tests. Healthcare providers may use the following methods to confirm a diagnosis:

1. Physical examination: Checking for signs of fluid retention, listening to heart and lung sounds
2. Blood tests: To check for biomarkers associated with heart failure
3. Chest X-ray: To look for an enlarged heart or fluid in the lungs
4. Electrocardiogram (ECG): To detect abnormal heart rhythms
5. Echocardiogram: Using sound waves to assess heart structure and function
6. Stress tests: To evaluate heart function during physical activity
7. Cardiac catheterization: In some cases, to directly measure heart pressures and blood flow

Why is early diagnosis crucial in CHF? Early detection allows for prompt treatment, potentially slowing the progression of the disease and improving quality of life.

Treatment Options for Congestive Heart Failure

While there is no cure for CHF, various treatment options can help manage symptoms, improve quality of life, and potentially slow the progression of the disease. Treatment typically involves a combination of lifestyle changes, medications, and in some cases, surgical interventions.

Lifestyle Modifications

• Reducing sodium intake
• Limiting fluid consumption
• Maintaining a healthy weight
• Regular, moderate exercise as recommended by a healthcare provider
• Quitting smoking
• Managing stress

Medications

Several types of medications may be prescribed to manage CHF symptoms and improve heart function:

• ACE inhibitors or ARBs: To relax blood vessels and reduce strain on the heart
• Beta-blockers: To slow heart rate and reduce workload
• Diuretics: To remove excess fluid from the body
• Aldosterone antagonists: To help the body eliminate excess fluid and sodium
• Digoxin: To strengthen heart contractions and slow heart rate

Surgical and Device-Based Treatments

In more severe cases or when medication and lifestyle changes are insufficient, additional interventions may be necessary:

• Coronary bypass surgery: To improve blood flow to the heart
• Heart valve repair or replacement
• Implantable cardioverter-defibrillator (ICD): To monitor and correct dangerous heart rhythms
• Cardiac resynchronization therapy (CRT): To coordinate the pumping action of the heart’s chambers
• Left ventricular assist device (LVAD): To help the heart pump blood more effectively
• Heart transplant: As a last resort for end-stage heart failure

How effective are these treatments in managing CHF? While treatments can significantly improve symptoms and quality of life, their effectiveness varies depending on the individual and the severity of their condition. Regular follow-ups with healthcare providers are essential to monitor progress and adjust treatment as needed.

Living with Congestive Heart Failure: Self-Care and Management

Successfully managing CHF requires active participation from patients in their own care. Here are some key self-care strategies:

1. Monitoring daily weight: Sudden weight gain can indicate fluid retention
2. Tracking symptoms: Keeping a log of symptoms and their severity
3. Taking medications as prescribed: Never skipping doses or stopping medications without consulting a doctor
4. Following a heart-healthy diet: Low in sodium, saturated fats, and added sugars
5. Staying physically active: Following an exercise plan approved by a healthcare provider
6. Managing stress: Through relaxation techniques, meditation, or counseling
7. Attending regular check-ups: For ongoing monitoring and adjustment of treatment plans

Why is self-care so important in CHF management? Consistent self-care can help prevent exacerbations, reduce hospitalizations, and improve overall quality of life for individuals with CHF.

Complications and Prognosis of Congestive Heart Failure

CHF is a progressive condition that can lead to various complications if not properly managed. Some potential complications include:

• Kidney damage or failure
• Liver damage
• Heart valve problems
• Heart rhythm disturbances
• Pulmonary hypertension
• Sudden cardiac arrest

The prognosis for individuals with CHF can vary widely depending on factors such as:

• The underlying cause of heart failure
• The severity of the condition
• How well the patient responds to treatment
• The presence of other health conditions
• The patient’s age and overall health

Can the progression of CHF be slowed or reversed? In some cases, especially when caught early and with proper treatment, the progression of CHF can be slowed. In certain situations, such as when heart failure is caused by a treatable condition like a heart valve problem, symptoms may even improve significantly with appropriate interventions.

When to Seek Immediate Medical Attention

While managing CHF is an ongoing process, there are certain symptoms that require immediate medical attention. Patients and their caregivers should be aware of these warning signs:

• Sudden, severe shortness of breath
• Chest pain or pressure that doesn’t go away with rest
• Fainting or severe weakness
• Rapid or irregular heartbeat accompanied by other symptoms
• Coughing up pink, foamy mucus
• Sudden, severe swelling in the legs or abdomen

Why is prompt action crucial in these situations? These symptoms may indicate a worsening of heart failure or the development of acute complications that require immediate treatment to prevent further damage to the heart and other organs.

Research and Future Directions in Congestive Heart Failure Treatment

The field of CHF research is continually evolving, with scientists and medical professionals working to develop new treatments and improve existing ones. Some areas of ongoing research include:

• Gene therapy: Targeting specific genes involved in heart function
• Stem cell therapy: Using stem cells to regenerate damaged heart tissue
• Novel drug therapies: Developing new medications to improve heart function and reduce symptoms
• Improved mechanical assist devices: Creating more effective and less invasive devices to support heart function
• Personalized medicine: Tailoring treatments based on an individual’s genetic profile and specific type of heart failure

How might these advancements impact CHF treatment in the future? As research progresses, we may see more targeted and effective treatments that could potentially slow or even reverse the progression of heart failure in some patients, leading to improved outcomes and quality of life.

In conclusion, congestive heart failure is a complex condition that requires a multifaceted approach to management. While it presents significant challenges, advances in treatment and careful self-management can help many individuals with CHF lead full and active lives. By understanding the condition, recognizing its symptoms, and working closely with healthcare providers, patients can play an active role in managing their heart health and improving their overall well-being.

Managing Your Congestive Heart Failure – Symptoms & Treatment

What Is Heart Failure (HF)?

Heart failure, also known as congestive heart failure (CHF), is a condition in which the heart cannot (fails to) pump enough blood to organs and tissues. One side of the heart (or both sides) cannot force enough blood out, so blood backs up. Congestion, or abnormal buildup of fluid, occurs in tissues or organs, and blood doesn’t move well through the vascular system.

If the left side of the heart fails, the system on the right side becomes congested. The congested side of the heart must work harder and may also fail. The same thing can happen on the right side.

What Causes HF?

Diseases that stress heart muscle can cause HF. These conditions include high blood pressure, heart attack, heart muscle and valve diseases, infections, arrhythmias (abnormal heart rhythms), anemia, thyroid disease, pulmonary disease, and too much fluid in the body.

What Are the Symptoms of HF?

When the left side of the heart fails, fluid leaks into the lungs. Fatigue (tiredness), difficulty breathing (especially at night when lying down), coughing, or shortness of breath can result.

In right-sided heart failure, the liver swells, which may cause pain in the abdomen (belly). Legs and feet may swell also.

How Is HF Diagnosed?

A physical examination will show changes, such as swelling in the legs or crackling breath sounds, indicating excess fluid in the lungs.

A chest x-ray can show an enlarged heart and signs of fluid accumulation into the lungs. An echocardiogram (a test using sound waves to show the moving heart) can also reveal heart size and disease of the heart muscle or valve problems.

How Is HF Treated?

Initial symptoms should be managed so the failing heart doesn’t have to work as hard.

The cause of HF also needs treatment. For example, if a heart valve problem is the cause, surgery may be needed to repair or replace the valve. Lifestyle changes will be needed. Smoking lowers the blood oxygen level and makes the heart work harder, so avoid tobacco. Less fluid and salt in the diet reduces fluid in the body. Also, if overweight, losing weight will help. Dietitians and nutritionists can help plan a diet.

Oxygen may be given to reduce the workload on the lungs.

Medicines may be prescribed to reduce fluid in the body or help the ventricle contract better. Diuretics remove fluid. Nitrates open blood vessels so blood flows more easily. Angiotensin-converting enzyme (ACE) inhibitors help the ventricle contract. Beta-blockers help by slowing the heart rate. Other drugs reduce blood pressure. All may have side effects, including dehydration, cough, dizziness, fainting, and fatigue.

Pacemakers and implantable defibrillators may be used in some cases.

Heart transplantation is an option in some patients when other treatments fail.

DOs and DON’Ts in Managing HF:

• DO take your medicines properly.
• DO maintain your ideal body weight.
• DO reduce salt and extra fluid in your diet.
• DO get your family involved in your care, especially the needed lifestyle changes.
• DO call your health care provider if you have side effects from your drugs or new or worsening symptoms, such as increasing shortness of breath, chest pain, or fainting.

• DON’T forget to take all your medicines as directed.
• DON’T smoke.
• DON’T stop taking any medicines without telling your health care provider.

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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor

Heart Failure, Tachycardia, and More

Written by WebMD Editorial Contributors

• Heart Problems That Affect Your Breathing
• Check With Your Doctor

You breathe in and out thousands of times a day and rarely give it a thought — until it starts to feel hard. Breathing problems can happen for many reasons, like being out of shape, congestion, fever, or asthma. But in some cases, they’re a sign that something is wrong with your heart.

Whatever the reason, always take breathing issues seriously. Tell your doctor so they can help you figure out the cause. And if your problem is sudden and severe, you should get medical help right away.

Heart failure (sometimes called congestive heart failure). Even though “failure” is in the name, it doesn’t mean that your heart stops beating. It means that it’s not serving the needs of your body. Shortness of breath and feeling tired can be signs of the condition. Often people also have swelling in their ankles, feet, legs, and mid-section because the heart is not strong enough to pump blood properly.

In the early stages of heart failure, you may have trouble breathing after exercise, getting dressed, or walking across a room. But as the heart gets weaker, you may feel breathless even when you lie down. See your doctor if that’s happening to you. They can recommend medicines and treatments that can help.

Tachycardia is a fast heart rate — usually more than 100 beats per minute in an adult. There are several kinds, but one that may cause shortness of breath is SVT, or atrial tachycardia. In SVT, the heart rate speeds up because the heart’s electrical signals don’t fire properly. People who have SVT and are short of breath should get medical help right away. Your doctor may recommend other things that can help, too, like quitting smoking and drinking less coffee and alcohol.

Pulmonary edema. This condition means there’s extra fluid in your lungs, which makes it hard to breathe. It’s usually caused by heart problems. If the heart is ill or damaged, it cannot pump out enough of the blood it gets from the lungs. When that happens, pressure in the heart builds up and pushes fluid into the lungs’ air sacs, where it doesn’t belong. Breathing problems may happen over time, or they may come all of a sudden.

Get medical help right away if you have trouble breathing that’s worse when you lie down, if you have to gasp for breath, feel like you are drowning, have blue or gray skin color, cough up spit that may have blood in it, or feel your heartbeat is fast or irregular.

Cardiomyopathy is a serious problem with the heart muscle that makes it hard for it to pump and send blood to the body. There are different types of cardiomyopathy and many reasons it happens, such as a heart attack, diabetes, or cancer treatment. Or the reason could be linked to excess weight, too much alcohol, or high blood pressure. In some cases, doctors don’t know why it happens.

You may not notice any symptoms of cardiomyopathy at first. But as it gets worse you may feel breathless when you’re active or even at rest. You may get swollen legs, ankles, and feet. You could feel tired or dizzy, have a cough while lying down, a fast, fluttering heartbeat, or chest pain. If you have trouble breathing, or chest pain that lasts more than a few minutes, get emergency help.

If you have a breathing problem, you need to see a doctor. They will examine you and may want to check your blood or do other tests to find out what’s going on.

You might want to make notes about how you feel and bring them to your appointment. That way, you won’t forget the important details. You may also want to write down some questions you’d like to ask the doctor. The more your doctor knows, the better.

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Obstructive bronchitis

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27 April 2021 Views: 373 progressive impairment of pulmonary ventilation. Obstructive bronchitis is manifested by cough with sputum, expiratory dyspnea, wheezing, respiratory failure. Diagnosis of obstructive bronchitis is based on auscultatory, x-ray data, the results of a study of the function of external respiration. Therapy for obstructive bronchitis includes the appointment of antispasmodics, bronchodilators, mucolytics, antibiotics, inhaled corticosteroid drugs, breathing exercises, and massage.

General information

Bronchitis (simple acute, recurrent, chronic, obstructive) is a large group of inflammatory diseases of the bronchi, different in etiology, mechanisms of occurrence and clinical course. Obstructive bronchitis in pulmonology includes cases of acute and chronic inflammation of the bronchi, occurring with a syndrome of bronchial obstruction that occurs against the background of mucosal edema, mucus hypersecretion and bronchospasm. Acute obstructive bronchitis often develop in young children, chronic obstructive bronchitis – in adults.

Chronic obstructive bronchitis, along with other diseases that occur with progressive airway obstruction (pulmonary emphysema, bronchial asthma), is commonly referred to as chronic obstructive pulmonary disease (COPD). In the UK and the US, COPD also includes cystic fibrosis, bronchiolitis obliterans, and bronchiectasis.

Causes

Acute obstructive bronchitis is etiologically associated with respiratory syncytial viruses, influenza viruses, parainfluenza virus type 3, adenoviruses and rhinoviruses, viral-bacterial associations. In the study of bronchial flushing in patients with recurrent obstructive bronchitis, DNA of persistent infectious agents – herpesvirus, mycoplasma, chlamydia – is often isolated. Acute obstructive bronchitis occurs predominantly in young children. The most susceptible to the development of acute obstructive bronchitis are children who often suffer from acute respiratory viral infections, who have a weakened immune system and an increased allergic background, and a genetic predisposition.

The main factors contributing to the development of chronic obstructive bronchitis are smoking (passive and active), occupational risks (contact with silicon, cadmium), air pollution (mainly sulfur dioxide), deficiency of antiproteases (alpha1-antitrypsin), etc. The risk group for the development of chronic obstructive bronchitis includes miners, construction workers, metallurgical and agricultural industries, railway workers, office workers associated with printing on laser printers, etc. Chronic obstructive bronchitis is more common in men.

Pathogenesis

The summation of genetic predisposition and environmental factors leads to the development of an inflammatory process, which involves small and medium-sized bronchi and peribronchial tissue. This causes a violation of the movement of the cilia of the ciliated epithelium, and then its metaplasia, the loss of ciliated cells and an increase in the number of goblet cells. Following the morphological transformation of the mucosa, a change in the composition of the bronchial secretion occurs with the development of mucostasis and blockade of the small bronchi, which leads to a violation of the ventilation-perfusion balance.

The content of nonspecific factors of local immunity, providing antiviral and antimicrobial protection, decreases in bronchial secretion: lactoferin, interferon and lysozyme. Thick and viscous bronchial secretion with reduced bactericidal properties is a good breeding ground for various pathogens (viruses, bacteria, fungi). In the pathogenesis of bronchial obstruction, an essential role belongs to the activation of cholinergic factors of the autonomic nervous system, which cause the development of bronchospastic reactions.

The complex of these mechanisms leads to swelling of the bronchial mucosa, hypersecretion of mucus and spasm of smooth muscles, i.e. the development of obstructive bronchitis. If the component of bronchial obstruction is irreversible, one should think about COPD – the addition of emphysema and peribronchial fibrosis.

Symptoms of acute obstructive bronchitis

As a rule, acute obstructive bronchitis develops in children of the first 3 years of life. The disease has an acute onset and proceeds with symptoms of infectious toxicosis and bronchial obstruction.

Infectious-toxic manifestations are characterized by subfebrile body temperature, headache, dyspeptic disorders, and weakness. Leading in the clinic of obstructive bronchitis are respiratory disorders. Children are worried about a dry or wet obsessive cough that does not bring relief and worsens at night, shortness of breath. Pays attention to the inflation of the wings of the nose on inspiration, participation in the act of breathing of the auxiliary muscles (muscles of the neck, shoulder girdle, abdominals), retraction of the compliant parts of the chest during breathing (intercostal spaces, jugular fossa, supra- and subclavian region). For obstructive bronchitis, an elongated whistling exhalation and dry (“musical”) rales, audible at a distance, are typical.

The duration of acute obstructive bronchitis is from 7-10 days to 2-3 weeks. In case of recurrence of episodes of acute obstructive bronchitis three or more times a year, they speak of recurrent obstructive bronchitis; if symptoms persist for two years, a diagnosis of chronic obstructive bronchitis is established.

Symptoms of chronic obstructive bronchitis

Cough and shortness of breath form the basis of the clinical picture of chronic obstructive bronchitis. When coughing, a small amount of mucous sputum is usually separated; during periods of exacerbation, the amount of sputum increases, and its character becomes mucopurulent or purulent. The cough is persistent and accompanied by wheezing. Against the background of arterial hypertension, episodes of hemoptysis may occur.

Expiratory dyspnea in chronic obstructive bronchitis usually joins later, however, in some cases, the disease may debut immediately with dyspnea. The severity of shortness of breath varies widely: from feelings of lack of air during exercise to severe respiratory failure. The degree of shortness of breath depends on the severity of obstructive bronchitis, the presence of an exacerbation, and comorbidities.

Exacerbation of chronic obstructive bronchitis can be provoked by respiratory infection, exogenous damaging factors, physical activity, spontaneous pneumothorax, arrhythmia, the use of certain medications, decompensation of diabetes mellitus, and other factors. At the same time, signs of respiratory failure increase, subfebrile condition, sweating, fatigue, myalgia appear.

Objective status in chronic obstructive bronchitis is characterized by prolonged expiration, participation of additional muscles in breathing, distant wheezing, swelling of the neck veins, changes in the shape of the nails (“watch glasses”). With an increase in hypoxia, cyanosis appears.

The severity of the course of chronic obstructive bronchitis, according to the guidelines of the Russian Society of Pulmonologists, is assessed by FEV1 (forced expiratory volume in 1 second).

• Stage I chronic obstructive bronchitis is characterized by an FEV1 value exceeding 50% of the standard value. At this stage, the disease has little effect on the quality of life. Patients do not need constant dispensary control by a pulmonologist.
• Stage II chronic obstructive bronchitis is diagnosed with a decrease in FEV1 to 35-49% of the standard value. In this case, the disease significantly affects the quality of life; Patients require regular follow-up with a pulmonologist.
• Stage III chronic obstructive bronchitis corresponds to an FEV1 of less than 34% of the expected value. At the same time, there is a sharp decrease in tolerance to stress, inpatient and outpatient treatment is required in the conditions of pulmonology departments and offices.

Complications of chronic obstructive bronchitis are pulmonary emphysema, cor pulmonale, amyloidosis, respiratory failure. To make a diagnosis of chronic obstructive bronchitis, other causes of shortness of breath and cough must be excluded, primarily tuberculosis and lung cancer.

Diagnosis

The program of examination of persons with obstructive bronchitis includes physical, laboratory, radiological, functional, endoscopic examinations. The nature of physical data depends on the form and stage of obstructive bronchitis. As the disease progresses, voice trembling weakens, a boxed percussion sound appears over the lungs, and the mobility of the lung edges decreases; auscultatory revealed hard breathing, wheezing with forced exhalation, with exacerbation – wet rales. The tone or number of wheezing changes after coughing.

X-ray of the lungs allows to exclude local and disseminated lung lesions, to detect concomitant diseases. Usually, after 2-3 years of obstructive bronchitis, an increase in the bronchial pattern, deformation of the roots of the lungs, and emphysema are detected. Therapeutic and diagnostic bronchoscopy for obstructive bronchitis allows you to examine the bronchial mucosa, collect sputum and bronchoalveolar lavage. Bronchography may be required to rule out bronchiectasis.

A necessary criterion for the diagnosis of obstructive bronchitis is the study of the function of external respiration. The data of spirometry (including those with inhalation tests), peak flowmetry, and pneumotachometry are of the greatest importance. Based on the data obtained, the presence, degree and reversibility of bronchial obstruction, pulmonary ventilation disorders, and the stage of chronic obstructive bronchitis are determined.

In the laboratory diagnostics complex, general blood and urine tests, blood biochemical parameters (total protein and protein fractions, fibrinogen, sialic acids, bilirubin, aminotransferases, glucose, creatinine, etc.) are examined. In immunological tests, the subpopulation functional ability of T-lymphocytes, immunoglobulins, CEC is determined. Determination of CBS and blood gases allows you to objectively assess the degree of respiratory failure in obstructive bronchitis.

Microscopic and bacteriological examination of sputum and lavage fluid is carried out, and in order to exclude pulmonary tuberculosis – sputum analysis by PCR and AFB. Exacerbation of chronic obstructive bronchitis should be differentiated from bronchiectasis, bronchial asthma, pneumonia, tuberculosis and lung cancer, pulmonary embolism.

Treatment of obstructive bronchitis

Acute obstructive bronchitis is treated with rest, plenty of fluids, humidification of the air, alkaline and medicinal inhalations. Etiotropic antiviral therapy is prescribed (interferon, ribavirin, etc.). With severe broncho-obstruction, spasmolytic (papaverine, drotaverine) and mucolytic (acetylcysteine, ambroxol) agents, bronchodilator inhalers (salbutamol, orciprenaline, fenoterol hydrobromide) are used. To facilitate the discharge of sputum, percussion massage of the chest, vibration massage, massage of the back muscles, and breathing exercises are performed. Antibacterial therapy is prescribed only when a secondary microbial infection is attached.

The goal of treating chronic obstructive bronchitis is to slow down the progression of the disease, reduce the frequency and duration of exacerbations, and improve the quality of life. The basis of pharmacotherapy of chronic obstructive bronchitis is basic and symptomatic therapy. Smoking cessation is a must.

Basic therapy includes the use of bronchodilators: anticholinergics (ipratropium bromide), b2-agonists (fenoterol, salbutamol), xanthines (theophylline). In the absence of the effect of the treatment of chronic obstructive bronchitis, corticosteroid drugs are used. Mucolytic drugs (ambroxol, acetylcysteine, bromhexine) are used to improve bronchial patency. The drugs can be administered orally, in the form of aerosol inhalations, nebulizer therapy or parenterally.

In case of layering of the bacterial component during periods of exacerbation of chronic obstructive bronchitis, macrolides, fluoroquinolones, tetracyclines, b-lactams, cephalosporins are prescribed in a course of 7-14 days. In case of hypercapnia and hypoxemia, oxygen therapy is an obligatory component of the treatment of obstructive bronchitis.

Prognosis and prevention of obstructive bronchitis

Acute obstructive bronchitis responds well to treatment. In children with an allergic predisposition, obstructive bronchitis may recur, leading to the development of asthmatic bronchitis or bronchial asthma. The transition of obstructive bronchitis to a chronic form is prognostically less favorable.

Adequate therapy helps to delay the progression of obstructive syndrome and respiratory failure. Unfavorable factors that aggravate the prognosis are the elderly age of patients, comorbidities, frequent exacerbations, continued smoking, poor response to therapy, and cor pulmonale.

Measures for the primary prevention of obstructive bronchitis include maintaining a healthy lifestyle, increasing overall resistance to infections, improving working conditions and the environment. The principles of secondary prevention of obstructive bronchitis involve the prevention and adequate treatment of exacerbations to slow down the progression of the disease.
Source: https://www.krasotaimedicina.ru/diseases/zabolevanija_pulmonology/obstructive-bronchitis

Postcovid syndrome

Post-COVID syndrome is included in the International Classification of Diseases (ICD-10) in the wording “Post COVID-19 condition”. These are the consequences of COVID-19, with up to 20% of people who have had the disease suffering from long-term symptoms. This can be severe asthenia (weakness), and heaviness in the chest, a feeling of incomplete inspiration, headaches, joint and muscle pain, sleep disturbances, depression, cognitive decline, thermoregulation disorder, and more. Symptoms can last up to six months or longer.

The syndrome is diagnosed clinically. At the same time, a person who has had a hard time with COVID-19 may be slightly affected by the post-COVID syndrome. And for someone who has been ill in a mild form, a rather severe post-covid state may occur.

It has been established that vaccinated patients tolerate not only the disease itself more easily, but are also less susceptible to the very risk of such a syndrome. In vaccinated people, post-covid syndrome also happens, but much less often, less pronounced and ends much faster. In general, vaccinated people require far fewer different approaches and fewer drugs to recover from an infection.

Fatigue. Observed in 15–87% of recovered patients. In some cases, it turns into chronic fatigue syndrome. For most patients, fatigue resolves within a week of recovery, but for some it can persist for three months or longer. This condition happens not only after COVID-19, but also after other viral diseases.

Here are some tips on how to bounce back.

Think over the daily routine. There should be time for a good sleep – this is 7-8 hours. Walking, movies, reading help you recover faster, but they also require energy. Therefore, it is important to plan them and specifically insert them into the schedule. It will be possible to return to the usual daily routine when strength is restored.

Don’t berate yourself for not being productive. You can’t work through force: it will only get worse. At first, it is better to reduce the number of tasks per day and the length of working hours. Whenever you feel tired, take a break.

Rest properly. If you are tired, lie down comfortably, relax and do nothing at all for 10-15 minutes, don’t even read.

Increase activity slowly. This applies to both intellectual and physical activity. It is important to move, but only light exercises like daily walking and stretching are useful for fatigue.

Shortness of breath. Observed in 10–87% of recovered patients. The symptom affects those who felt short of breath during the acute stage of the disease. It passes slowly, in the majority of those who have recovered – within two to three months, sometimes longer.

In most patients, shortness of breath resolves without treatment. But you don’t have to endure discomfort. The easiest way to manage shortness of breath is to take one of the positions that doctors recommend to help you breathe easier. You can also practice special breathing exercises.

Sitting breathing control. Relax your shoulders and neck, inhale slowly and deeply through your nose. Exhale slowly through your mouth as if blowing out a candle. Repeat several times. After some time, shortness of breath will decrease and pass.

Rectangular breathing. Sit down, find something rectangular in the room, such as a window or a picture, and move your eyes along the sides of the rectangle. Short – inhale, long – exhale. This makes it easier to control your breathing.

Walking breath control. One step – inhale, two steps – exhale.

Chest pain. Observed in 12–44% of recovered patients. It disappears gradually, at different rates for everyone, usually two to three months after recovery. It occurs mainly due to damage to the lungs.

If the chest pain is not very disturbing and gradually decreases, it is not necessary to consult a doctor. If it is accompanied by shortness of breath, dizziness, swelling and heart palpitations, you should consult a specialist.

Chronic cough. Observed in 17–26% of recovered patients. For many, the cough lasts two to three weeks after the first symptoms appear. In most patients, it disappears after three months from the onset of the disease.

Cough is a common symptom that accompanies recovery from viral infections. This is a protective reaction of the body, which seeks to clear the lungs of the remnants of dead cells and excess mucus. It can also occur due to irritation in the nasopharynx and throat, which is also a consequence of the disease.

In most cases, no treatment is required and the cough resolves on its own. At night, coughing will be less annoying if you sleep on your side.

Loss of smell. Observed in 13% of recovered patients. For most, the sense of smell gradually returns a month after recovery, but for some people, the symptoms last longer. Interestingly, in men, the sense of smell is restored faster than in women.

There are no medicines that restore the sense of smell after a coronavirus disease.