Ridley syndrome

　　The main causes of this syndrome include:

　　1. Myocardial lesions of the left ventricle, such as coronary heart disease, acute myocardial infarction, congestive cardiomyopathy, hypertrophic cardiomyopathy, myocarditis, and so on.

　　2. Overload of left ventricular pressure load, such as hypertension, aortic stenosis, obstructive cardiomyopathy, and so on.

　　3. Overload of left ventricular volume load, such as aortic valve insufficiency, mitral valve insufficiency, certain congenital cardiovascular diseases with left-to-right shunts (such as ventricular septal defect, patent ductus arteriosus, and so on).

　　4. Reduced diastolic compliance of the left ventricle, mainly seen in coronary heart disease, hypertension, obstructive cardiomyopathy, and diseases with left ventricular hypertrophy.

　　5. Severe arrhythmias, such as atrial fibrillation, atrial flutter, paroxysmal tachycardia, and high-degree atrioventricular block.

　　6. Cardiovascular diseases outside the heart, such as pulmonary embolism, cerebrovascular accidents, inhalation of irritant gases, excessive intravenous fluid administration, nephritis, renal failure, and so on.

　　Severe cases of Ridley syndrome can persist, with frequent coughing, worsening dyspnea, cyanosis, profuse sweating, cold extremities, and coughing up pink frothy sputum, which may develop into acute pulmonary edema and heart failure.

　　The most prominent clinical manifestations are paroxysmal nocturnal dyspnea and cardiogenic asthma. Typical attacks often occur 1 to 2 hours after deep sleep at night, where patients suddenly wake up due to suffocation and shortness of breath, forced to sit up immediately and open the windows, with the intention of alleviating the feeling of asphyxia, accompanied by paroxysmal cough, asthmatic respiratory sounds, or coughing up frothy sputum. In mild cases, the patient can sit for about ten minutes to one hour, and the difficulty in breathing can subside automatically, allowing the patient to fall asleep again. In severe cases, the attack can continue, with frequent coughing, worsening dyspnea, cyanosis, profuse sweating, cold extremities, and coughing up pink frothy sputum, which may develop into acute pulmonary edema. Physical signs include not only the signs of the primary disease, such as the enlargement of the left lower cardiac dullness, the lift of the apex beat, S4 and valve murmurs, but also the signs of left heart failure, such as an increased heart rate, early diastolic gallop rhythm, wet rales in both lungs (especially fine wet rales at the base of the left lung) and wheezing, pleural effusion (especially right pleural effusion), and blood pressure may temporarily increase due to compensatory sympathetic nervous system activity causing vasoconstriction of small arteries.

　　1. Prognosis

　　The prognosis of this condition is related to the nature of the underlying disease, such as mitral stenosis, which has a good prognosis after surgical treatment, while aortic valve disease, coronary heart disease, and those caused by it have poor prognosis, the condition often deteriorates rapidly, quickly involving the right ventricle and leading to heart failure.

　　2. Prevention

　　The original disease should be treated actively to improve cardiac function.

　　1. Laboratory examination

　　When complicated with infection, the total white blood cell count may increase. The proportion of neutrophils increases.

　　2. Other auxiliary examinations

　　X-ray examination shows increased shadowing at both lung apices, varying degrees of pulmonary congestion such as dilatation of the upper lobe pulmonary veins, interlobar edema, Kerley B line, or pulmonary edema (pulmonary fields appear as misty shadows). Enlargement of the left ventricle, increase in the size of the left atrium and pulmonary artery segment, etc. Electrocardiogram shows hypertrophy of the left ventricle, changes in ST-T. Echocardiography shows enlargement of the left ventricular diameter, decreased amplitude of ventricular wall motion, etc.

    In addition to conventional treatment, the following aspects should be paid attention to in the diet of Reilly syndrome patients:1. Eat foods that reduce blood viscosity; 2. Eat foods that relieve cough and asthma; 3. Eat nutrient-rich foods..

　　Efforts should be made to find the etiology of this condition and perform etiological treatment, such as paroxysmal dyspnea caused by mitral stenosis, which can completely disappear with mitral valvotomy. The treatment of paroxysmal nocturnal dyspnea is the same as that for other acute heart failure, such as sedation, oxygen therapy, assuming a sitting position, legs dangling down, and reducing venous return; using cardiotonics, diuretics, and vasodilators to improve cardiac function.