Água no Pulmão É um Perigo REAL
Dr. Helder Gomes
[{'start': '0.000', 'end': '4.960', 'text': 'acute pulmonary edema waterlogged lung'}, {'start': '2.919', 'end': '8.000', 'text': 'These are different names for'}, {'start': '4.960', 'end': '10.280', 'text': 'exactly the same thing. This'}, {'start': '8.000', 'end': '12.440', 'text': 'means that water has accumulated in'}, {'start': '10.280', 'end': '15.240', 'text': 'the lungs mainly for two'}, {'start': '12.440', 'end': '17.760', 'text': 'reasons: a kidney problem or'}, {'start': '15.240', 'end': '20.039', 'text': 'a heart problem. Especially if you'}, {'start': '17.760', 'end': '22.800', 'text': 'have a heart problem,'}, {'start': '20.039', 'end': '25.920', 'text': 'heart failure, you should be aware'}, {'start': '22.800', 'end': '27.800', 'text': 'of these four main causes that'}, {'start': '25.920', 'end': '30.439', 'text': 'make people with'}, {'start': '27.800', 'end': '32.200', 'text': 'heart failure have some kind of pulmonary edema.'}, {'start': '30.439', 'end': '34.040', 'text': 'My name is Elder Gomes. I am a'}, {'start': '32.200', 'end': '36.680', 'text': 'cardiologist. Before we get to'}, {'start': '34.040', 'end': '38.239', 'text': 'know these four main causes, we'}, {'start': '36.680', 'end': '42.000', 'text': 'need to take a step'}, {'start': '38.239', 'end': '44.360', 'text': 'back and learn more about what'}, {'start': '42.000', 'end': '46.440', 'text': 'acute pulmonary edema is. The heart has several'}, {'start': '44.360', 'end': '49.079', 'text': 'parts, but the one that will interest'}, {'start': '46.440', 'end': '51.320', 'text': 'us in this video today is the'}, {'start': '49.079', 'end': '53.280', 'text': 'left ventricle. For several reasons,'}, {'start': '51.320', 'end': '55.920', 'text': 'the left ventricle may have'}, {'start': '53.280', 'end': '58.440', 'text': 'difficulty relaxing and receiving'}, {'start': '55.920', 'end': '61.519', 'text': 'the blood that comes from the lungs, or'}, {'start': '58.440', 'end': '63.559', 'text': 'it may have some difficulty contracting. And'}, {'start': '61.519', 'end': '66.200', 'text': 'then ejecting the blood to the various'}, {'start': '63.559', 'end': '68.720', 'text': 'parts of the body. In both cases, if there is'}, {'start': '66.200', 'end': '71.000', 'text': 'any overload on this ventricle,'}, {'start': '68.720', 'end': '72.840', 'text': 'which is not working so well, it'}, {'start': '71.000', 'end': '75.479', 'text': 'will not be able to receive the blood coming'}, {'start': '72.840', 'end': '78.200', 'text': 'from the lungs. Then, the blood that should'}, {'start': '75.479', 'end': '81.079', 'text': 'go to the left ventricle can'}, {'start': '78.200', 'end': '83.520', 'text': 'accumulate, generating  Acute'}, {'start': '81.079', 'end': '86.079', 'text': 'pulmonary edema is the leading cause of'}, {'start': '83.520', 'end': '88.119', 'text': 'pulmonary edema, which is why it is so important to'}, {'start': '86.079', 'end': '90.479', 'text': 'treat it. It has a complicated name, but it'}, {'start': '88.119', 'end': '92.560', 'text': 'means something very simple. It'}, {'start': '90.479', 'end': '94.520', 'text': 'means that the patient has not been taking the'}, {'start': '92.560', 'end': '97.159', 'text': 'medications as prescribed. During'}, {'start': '94.520', 'end': '99.600', 'text': 'the consultation, I generally explain the function'}, {'start': '97.159', 'end': '102.079', 'text': 'of each medicine used in'}, {'start': '99.600', 'end': '105.719', 'text': 'heart failure. This makes the patient'}, {'start': '102.079', 'end': '107.799', 'text': 'understand the function of each medicine and'}, {'start': '105.719', 'end': '109.840', 'text': 'why he should take it. If he understands the'}, {'start': '107.799', 'end': '112.119', 'text': 'importance of each one, it is quite'}, {'start': '109.840', 'end': '114.520', 'text': 'clear that if he does not take that'}, {'start': '112.119', 'end': '117.680', 'text': 'medicine, he will miss it. Therefore, during the consultation,'}, {'start': '114.520', 'end': '120.240', 'text': 'when you go to the cardiologist, understand.'}, {'start': '117.680', 'end': '123.079', 'text': 'Ask what each medication is for.'}, {'start': '120.240', 'end': '125.000', 'text': 'This will make it easier for you to understand the'}, {'start': '123.079', 'end': '126.920', 'text': 'usefulness of each medicine and the'}, {'start': '125.000', 'end': '129.200', 'text': 'importance of not abandoning each'}, {'start': '126.920', 'end': '131.480', 'text': 'medicine used. It has a function. To give'}, {'start': '129.200', 'end': '134.959', 'text': 'an example, one of the most used medicines'}, {'start': '131.480', 'end': '138.080', 'text': 'in heart failure are the ACE inhibitors,'}, {'start': '134.959', 'end': '139.959', 'text': 'Captoprio, Zinoprio, and Ramipril. There is'}, {'start': '138.080', 'end': '141.760', 'text': 'a huge family of this type of'}, {'start': '139.959', 'end': '144.360', 'text': 'medication and they are used in'}, {'start': '141.760', 'end': '146.800', 'text': 'heart failure to relieve the'}, {'start': '144.360', 'end': '149.239', 'text': 'overload on the left ventricle.'}, {'start': '146.800', 'end': '151.720', 'text': 'By lowering the pressure, we reduce'}, {'start': '149.239', 'end': '154.080', 'text': 'the effort that the left ventricle has to'}, {'start': '151.720', 'end': '156.480', 'text': 'make to eject the blood. In'}, {'start': '154.080', 'end': '159.480', 'text': 'addition, we interfere with a system'}, {'start': '156.480', 'end': '162.000', 'text': 'called the renin-angiotensin-'}, {'start': '159.480', 'end': '164.280', 'text': 'aldosterone system.  When the system is'}, {'start': '162.000', 'end': '167.159', 'text': 'overloaded, it causes the heart to'}, {'start': '164.280', 'end': '169.840', 'text': 'remodel, that is, it takes on a'}, {'start': '167.159', 'end': '172.280', 'text': 'different shape than normal. The walls of the'}, {'start': '169.840', 'end': '175.080', 'text': 'heart tend to become thicker and the'}, {'start': '172.280', 'end': '177.640', 'text': 'heart tends to grow. So when you take'}, {'start': '175.080', 'end': '180.040', 'text': 'these medications, you have the benefit of'}, {'start': '177.640', 'end': '182.319', 'text': 'protecting your left ventricle'}, {'start': '180.040', 'end': '185.440', 'text': 'because you reduce the overload since the'}, {'start': '182.319', 'end': '187.480', 'text': 'pressure is lower, but you also protect it'}, {'start': '185.440', 'end': '190.040', 'text': 'from the remodeling of those hormones that'}, {'start': '187.480', 'end': '192.159', 'text': 'cause the heart to change its'}, {'start': '190.040', 'end': '194.599', 'text': 'structure. The second major cause of'}, {'start': '192.159', 'end': '197.280', 'text': 'decompensation of heart failure'}, {'start': '194.599', 'end': '199.920', 'text': 'and therefore acute pulmonary edema are'}, {'start': '197.280', 'end': '201.840', 'text': 'infections. Therefore, there are some'}, {'start': '199.920', 'end': '204.440', 'text': 'efforts that we have to make so'}, {'start': '201.840', 'end': '207.120', 'text': 'that these infections do not occur, such as a'}, {'start': '204.440', 'end': '209.120', 'text': 'urinary tract infection or pneumonia. All of'}, {'start': '207.120', 'end': '211.280', 'text': 'these infections can cause the'}, {'start': '209.120', 'end': '213.560', 'text': 'patient who has heart failure to'}, {'start': '211.280', 'end': '215.599', 'text': 'decompensate and reach the extreme of having'}, {'start': '213.560', 'end': '217.560', 'text': 'acute pulmonary edema. Of all'}, {'start': '215.599', 'end': '220.159', 'text': 'infections, there are some that we have to'}, {'start': '217.560', 'end': '222.360', 'text': 'be especially careful about,'}, {'start': '220.159', 'end': '224.840', 'text': 'mainly because they can be prevented. This'}, {'start': '222.360', 'end': '227.879', 'text': 'is the case with influenza and'}, {'start': '224.840', 'end': '230.239', 'text': 'pneumonia. In both cases, there are vaccines'}, {'start': '227.879', 'end': '232.879', 'text': 'so that the patient does not have any'}, {'start': '230.239', 'end': '235.760', 'text': 'serious form of these diseases. Of course, the'}, {'start': '232.879', 'end': '238.120', 'text': 'effectiveness of vaccines is not 100%, but'}, {'start': '235.760', 'end': '240.680', 'text': 'in vaccinated patients, we can'}, {'start': '238.120', 'end': '243.120', 'text': 'reduce the severity of these two diseases'}, {'start': '240.680', 'end': '245.239', 'text': 'and therefore the chance of them having any'}, {'start': '243.120', 'end': '246.840', 'text': 'decompensation of heart failure'}, {'start': '245.239', 'end': '249.120', 'text': "don't forget to like the video"}, {'start': '246.840', 'end': '251.000', 'text': 'and subscribe to the channel this is very'}, {'start': '249.120', 'end': '252.640', 'text': 'important so that I can'}, {'start': '251.000', 'end': '255.280', 'text': 'bring more and more content related to'}, {'start': '252.640', 'end': '257.560', 'text': 'cardiology the third cause which is also very'}, {'start': '255.280', 'end': '260.040', 'text': 'common is increased'}, {'start': '257.560', 'end': '262.720', 'text': 'water intake People with heart failure'}, {'start': '260.040', 'end': '265.040', 'text': 'sometimes need to reduce the volume of water they'}, {'start': '262.720', 'end': '267.400', 'text': 'drink every day and this is'}, {'start': '265.040', 'end': '270.199', 'text': 'information that although it has been known for a'}, {'start': '267.400', 'end': '272.120', 'text': 'long time many patients do not'}, {'start': '270.199', 'end': '274.560', 'text': 'know I have even made a video'}, {'start': '272.120', 'end': '277.120', 'text': 'about this about how much water you can'}, {'start': '274.560', 'end': '279.600', 'text': 'drink in a day Many times'}, {'start': '277.120', 'end': '282.400', 'text': 'you need to reduce a little or in'}, {'start': '279.600', 'end': '285.120', 'text': 'some cases reduce a lot the volume'}, {'start': '282.400', 'end': '287.000', 'text': 'of water you drink every day I will'}, {'start': '285.120', 'end': '289.240', 'text': 'leave the link in case you are interested'}, {'start': '287.000', 'end': '291.919', 'text': 'in watching it to later find out how'}, {'start': '289.240', 'end': '295.080', 'text': 'much water you can or cannot drink'}, {'start': '291.919', 'end': '297.080', 'text': 'so when you drink more water than'}, {'start': '295.080', 'end': '299.479', 'text': 'your heart is prepared to'}, {'start': '297.080', 'end': '301.720', 'text': 'pump this also causes water to'}, {'start': '299.479', 'end': '304.840', 'text': 'accumulate in the lungs generating'}, {'start': '301.720', 'end': '306.320', 'text': 'acute pulmonary edema not for nothing one of the'}, {'start': '304.840', 'end': '308.520', 'text': 'medications that we frequently use'}, {'start': '306.320', 'end': '310.199', 'text': 'in heart failure are'}, {'start': '308.520', 'end': '312.080', 'text': 'diuretics although they are not'}, {'start': '310.199', 'end': '315.440', 'text': 'medications that can make the'}, {'start': '312.080', 'end': '318.400', 'text': 'patient live longer certainly It is a'}, {'start': '315.440', 'end': '320.880', 'text': 'medication that greatly relieves the symptoms for'}, {'start': '318.400', 'end': '323.479', 'text': 'those who have shortness of breath on exertion  An'}, {'start': '320.880', 'end': '326.319', 'text': 'accumulation of water in the body due to an accumulation'}, {'start': '323.479', 'end': '328.840', 'text': 'of water in the lungs benefits greatly from the'}, {'start': '326.319', 'end': '331.560', 'text': 'use of diuretics and is the main'}, {'start': '328.840', 'end': '334.120', 'text': 'medication used as soon as the patient'}, {'start': '331.560', 'end': '336.479', 'text': 'arrives at the emergency room with acute'}, {'start': '334.120', 'end': '339.000', 'text': 'pulmonary edema. Therefore, if you have been'}, {'start': '336.479', 'end': '341.280', 'text': 'advised to reduce your water intake'}, {'start': '339.000', 'end': '343.919', 'text': 'every day, pay attention to this'}, {'start': '341.280', 'end': '345.960', 'text': 'guidance. If you do not follow it, it is quite'}, {'start': '343.919', 'end': '348.680', 'text': 'possible that you will pay the price of having'}, {'start': '345.960', 'end': '351.720', 'text': 'acute pulmonary edema or even shortness'}, {'start': '348.680', 'end': '354.400', 'text': 'of breath on exertion, which is very frequent.'}, {'start': '351.720', 'end': '357.039', 'text': 'Last but not least, I would say'}, {'start': '354.400', 'end': '359.840', 'text': 'that the vast majority of patients'}, {'start': '357.039', 'end': '362.160', 'text': 'simply ignore the fact that they'}, {'start': '359.840', 'end': '364.639', 'text': 'need to rehabilitate. When I say rehabilitate, I mean'}, {'start': '362.160', 'end': '367.039', 'text': 'physical exercise. The'}, {'start': '364.639', 'end': '369.120', 'text': 'patient is often mistaken in'}, {'start': '367.039', 'end': '371.800', 'text': 'thinking that because he has'}, {'start': '369.120', 'end': '374.440', 'text': 'heart failure, he has a weak heart. He'}, {'start': '371.800', 'end': '376.880', 'text': 'should not do physical exercise, when it is'}, {'start': '374.440', 'end': '379.240', 'text': 'exactly the opposite. Just as important as'}, {'start': '376.880', 'end': '381.639', 'text': 'medications, just as important'}, {'start': '379.240', 'end': '383.800', 'text': 'as fluid restriction when'}, {'start': '381.639', 'end': '386.639', 'text': 'indicated, and just as important as'}, {'start': '383.800', 'end': '388.599', 'text': 'vaccination are physical exercises. Of'}, {'start': '386.639', 'end': '390.919', 'text': 'course, you should talk to your'}, {'start': '388.599', 'end': '393.240', 'text': 'doctor to find out which'}, {'start': '390.919', 'end': '396.199', 'text': 'physical exercise is best for you so that this'}, {'start': '393.240', 'end': '399.960', 'text': 'exercise practice is safe.'}, {'start': '396.199', 'end': '403.240', 'text': 'However, exercising is essential. The heart tends'}, {'start': '399.960', 'end': '406.400', 'text': 'to adapt to exercise, so in the'}, {'start': '403.240', 'end': '409.840', 'text': 'long term, the patient tends to have an'}, {'start': '406.400', 'end': '413.479', 'text': 'increasingly greater tolerance to exercise.'}, {'start': '409.840', 'end': '416.120', 'text': 'Therefore, exercise  Physical exercises not only make'}, {'start': '413.479', 'end': '418.520', 'text': 'the patient improve their'}, {'start': '416.120', 'end': '421.360', 'text': 'functional class, that is, make them have'}, {'start': '418.520', 'end': '424.560', 'text': 'a greater tolerance to'}, {'start': '421.360', 'end': '427.599', 'text': 'exercise, but also make them'}, {'start': '424.560', 'end': '430.840', 'text': 'adapt so that they can adapt their'}, {'start': '427.599', 'end': '433.800', 'text': 'heart more and more to exercise and'}, {'start': '430.840', 'end': '436.240', 'text': 'improve efficiency and therefore'}, {'start': '433.800', 'end': '438.520', 'text': 'reduce the chance of having'}, {'start': '436.240', 'end': '440.560', 'text': 'acute pulmonary edema. So remember, these'}, {'start': '438.520', 'end': '443.759', 'text': 'four things make you improve'}, {'start': '440.560', 'end': '445.800', 'text': 'your symptoms and prevent you from'}, {'start': '443.759', 'end': '447.400', 'text': 'having acute pulmonary edema. So the'}, {'start': '445.800', 'end': '449.520', 'text': 'first thing is to remember to take your'}, {'start': '447.400', 'end': '451.840', 'text': 'medicine as prescribed. If you have'}, {'start': '449.520', 'end': '454.280', 'text': 'any questions, do not stop taking them. Go back to your'}, {'start': '451.840', 'end': '456.400', 'text': 'doctor and ask. After all, why am I taking'}, {'start': '454.280', 'end': '459.240', 'text': 'this medication? The second point is'}, {'start': '456.400', 'end': '460.800', 'text': 'vaccination. Infections are an important'}, {'start': '459.240', 'end': '463.440', 'text': 'factor in the decompensation of'}, {'start': '460.800', 'end': '465.120', 'text': 'heart failure, so do not leave it'}, {'start': '463.440', 'end': '467.440', 'text': 'aside. If it is indicated by your'}, {'start': '465.120', 'end': '470.000', 'text': 'doctor, take the necessary vaccines.'}, {'start': '467.440', 'end': '472.199', 'text': 'Remember that when indicated,'}, {'start': '470.000', 'end': '474.800', 'text': 'water restriction helps a lot to'}, {'start': '472.199', 'end': '477.639', 'text': 'control symptoms and helps a lot so that'}, {'start': '474.800', 'end': '479.479', 'text': 'we in the office use'}, {'start': '477.639', 'end': '482.280', 'text': 'smaller doses of medicines, for example,'}, {'start': '479.479', 'end': '484.919', 'text': 'diuretics. Also remember that although'}, {'start': '482.280', 'end': '488.240', 'text': 'exercise scares those who lack'}, {'start': '484.919', 'end': '490.520', 'text': 'strength, it is absolutely'}, {'start': '488.240', 'end': '493.000', 'text': 'necessary for you to improve more and'}, {'start': '490.520', 'end': '495.000', 'text': 'more and to prevent you from having'}, {'start': '493.000', 'end': '497.440', 'text': "pulmonary congestion.  I hope you don't"}, {'start': '495.000', 'end': '499.360', 'text': 'have water in your lungs. I hope you'}, {'start': '497.440', 'end': '501.400', 'text': "enjoyed the video. Don't forget"}, {'start': '499.360', 'end': '504.039', 'text': 'to subscribe to the channel and leave'}, {'start': '501.400', 'end': '507.400', 'text': 'any questions in the comments. Until'}, {'start': '504.039', 'end': '507.400', 'text': 'next video.'}]