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Heart failure
Which department should I go to for heart failure?
Heart failure primarily includes left heart failure, right heart failure, and total heart failure. Patients should visit the cardiology outpatient clinic. Left heart failure mainly manifests as pulmonary congestion, which can cause varying degrees of breathing difficulty, coughing, expectoration of pink frothy sputum, palpitations, and fatigue. Right heart failure primarily appears as liver congestion and other symptoms related to the digestive system, such as nausea, vomiting, and gastrointestinal discomfort. Total heart failure includes symptoms of both left heart failure and right heart failure, and medical attention should be sought promptly after the onset of heart failure.
Symptoms of chronic heart failure
Chronic heart failure can be divided into left heart failure, right heart failure, and total heart failure. The symptoms of left heart failure primarily manifest as congestion in the pulmonary circulation, that is, a reduction in cardiac output. Patients may experience varying degrees of breathing difficulties, starting with exertional dyspnea, then orthopnea, followed by paroxysmal nocturnal dyspnea, and eventually acute pulmonary edema. Additional symptoms may include coughing, expectoration, hemoptysis, fatigue, tiredness, dizziness, reduced exercise tolerance, and symptoms of insufficient blood supply to organs and tissues, including oliguria and kidney damage. The symptoms of right heart failure can present as gastrointestinal symptoms, such as abdominal distension, loss of appetite, nausea, vomiting, and also exertional dyspnea. When both left and right heart failures occur, it is referred to as total heart failure. In cases of total heart failure, symptoms of both left and right heart failures may be present.
The basic mechanisms of heart failure
Heart failure is not an independent disease; it can be caused by various factors, such as myocardial infarction, cardiomyopathy, and various myocarditis, which lead to changes in the heart structure and subsequent cardiac dysfunction. Heart failure is mainly due to a disturbance in the heart's contractile function or diastolic function, which prevents the heart from adequately ejecting the returning blood volume. This results in pulmonary congestion, systemic circulation congestion, and a series of syndromes caused by insufficient arterial perfusion.
Is the heart rate fast or slow in heart failure?
Heart failure is also relatively common in clinical practice, primarily due to dysfunction in the heart's contractile or relaxation capabilities. This leads to ineffective expulsion of venous blood returning to the heart, resulting in venous congestion and a series of symptoms. Patients typically experience varying degrees of breathing difficulty, coughing, expectoration, coughing up pink frothy sputum, as well as gastrointestinal symptoms. Following the onset of heart failure, a patient's heart rate generally increases as a compensatory response to promote increased cardiac output. If a patient enters the terminal stage of heart failure, a decrease in heart rate may occur, and can even lead to death.
Is acute heart failure dangerous?
Acute heart failure is very dangerous in clinical practice. It is mainly caused by a sudden decrease in cardiac output, leading to insufficient perfusion in tissues and organs and acute blood stasis syndrome. The main clinical symptoms include severe respiratory distress, often accompanied by restlessness, profuse sweating, frequent coughing with pink frothy sputum, and in severe cases, sudden cardiac and respiratory arrest can occur. After the occurrence of acute heart failure, effective measures should be taken to alleviate symptoms such as respiratory distress. The most effective methods in clinical practice include strengthening the heart, promoting diuresis, and dilating blood vessels.
Causes of acute heart failure
Acute heart failure refers to the acute onset of heart failure or an exacerbated clinical syndrome, which can present as either newly developed acute or acute decompensation of chronic heart failure. Clinically, it is commonly divided into two main categories. One category is acute left heart failure, often caused by acute decompensation of chronic heart failure, or by acute coronary syndrome, hypertensive emergencies, acute cardiac valvular dysfunction, severe myocarditis, serious arrhythmias, and peripartum cardiomyopathy. The other category is acute right heart failure, which can be caused by right ventricular infarction, acute large pulmonary embolism, and right-sided valvular heart disease.
Causes of Heart Failure
Heart failure can be divided into acute heart failure and chronic heart failure. There are many causes of acute heart failure, such as acute coronary syndrome, hypertensive emergency, acute massive pulmonary embolism, right ventricular infarction, severe pulmonary hypertension, and so on. Chronic heart failure can also have many causes, for example, coronary artery disease and hypertension have become the main causes of chronic heart failure, rheumatic heart disease, and valvular heart disease can also cause chronic heart failure. Chronic cor pulmonale and high-altitude heart disease also have a certain incidence rate in China, among others.
Chronic heart failure means
Chronic heart failure refers to a condition where the heart is unable to effectively pump blood throughout the body to meet the needs of vital organs, leading to a series of clinical symptoms caused by venous congestion and arterial ischemia. Symptoms include post-activity palpitations, orthopnea, swelling of the lower limbs, and enlarged liver. This condition causes great distress to patients and requires long-term use of effective medications to alleviate chronic heart failure. Patients with chronic heart failure need to ensure adequate rest, avoid overexertion, adhere to a low-salt diet, and limit the intake of spicy and greasy foods to prevent exacerbation of heart failure.
Late-stage symptoms of heart failure
The most common symptom of late-stage heart failure is dyspnea, which is often persistent. Even in a resting state, there can be shortness of breath. Mild activities, such as eating and urination, can exacerbate the breathing difficulties. Patients in the late stages of heart failure often experience persistent edema, and conventional diuretics are not effective. Patients may also exhibit restlessness, nausea, vomiting, loss of appetite, reduced urine output, and other symptoms. Additionally, low blood pressure can be observed on cardiac monitoring, among other findings.
How is acute heart failure treated?
Acute heart failure presents with significant respiratory distress and symptoms of hypoxia. Immediate intervention is necessary to alleviate breathing difficulties. Clinically, the following measures are generally adopted: First, position the patient to sit up with legs dangling to decrease venous return to the heart. Second, administer high-flow oxygen through a nasal cannula, and if necessary, proceed with endotracheal intubation and ventilator support. Third, administer morphine subcutaneously or intravenously to reduce agitation and myocardial oxygen demand. Fourth, use rapid diuretics, such as furosemide. Fifth, utilize vasodilators such as nitroglycerin or nitroprusside. Sixth, use positive inotropic agents such as dopamine or dobutamine as appropriate. Seventh, employ digitalis drugs, but avoid use in acute myocardial infarction within the first 24 hours. Eighth, consider using an intra-aortic balloon pump or other cardiopulmonary support systems, etc., and after stabilization of acute heart failure, further treat the underlying cause, etc. (Use medications under the guidance of a doctor.)