Heart failure


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.)


Heart Failure Drug Therapy
Due to some myocardial diseases that cause damage to the myocardium, or other reasons that increase the heart's load, heart failure may occur. Clinical treatment involves strengthening the heart and promoting diuresis, improving blood vessel function, increasing the heart’s contractility, reducing the heart’s resistance, and decreasing the volume of blood returning to the heart. Through these effective drug treatments, heart failure can be corrected. Patients with heart failure should avoid excessive fatigue and maintain a low-salt diet to prevent increasing the burden on the heart.


Clinical manifestations of chronic heart failure
Chronic heart failure primarily includes left heart failure, right heart failure, and total heart failure. Left heart failure can present with varying degrees of respiratory difficulty, such as exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea, etc. Secondly, symptoms can include coughing and expectorating, coughing up pink frothy sputum, and patients may experience fatigue, dizziness, and palpitations, among others. Right heart failure mainly manifests as gastrointestinal symptoms, such as abdominal distension, poor appetite, nausea, vomiting, etc. Total heart failure encompasses the clinical manifestations of both right and left heart failure.


The basic etiology of chronic heart failure
Chronic heart failure is one of the most common complications of various organic heart diseases, and there are many causes of chronic heart failure. The main reason is due to primary diseases that have not been effectively treated. Long-term myocardial ischemia, hypoxia, excessive fatigue, emotional excitement, overeating, too full, constipation, and other reasons increase the cardiac burden, leading to chronic heart failure. People with organic heart disease must treat the primary disease under the guidance of a doctor. At the same time, pay attention to rest, avoid emotional excitement, eat easily digestible food, maintain a low-salt, low-fat diet, and ensure smooth bowel movements to prevent increasing the cardiac burden and causing heart failure.


Causes of acute heart failure include
Most patients with acute heart failure have a history of heart disease, and the common causes mainly include: 1. Acute myocardial necrosis or damage, such as acute coronary syndrome, peripartum cardiomyopathy, and myocardial damage caused by drugs or toxins, including sepsis-induced myocardial damage. 2. Acute exacerbation of chronic heart failure due to infection or other stressful factors. 3. Acute hemodynamic changes, mainly including conditions like cardiac tamponade, hypertensive crisis, aortic dissection, and acute valvular regurgitation, all of which can lead to acute heart failure.


Causes of Acute Heart Failure
The main causes of acute heart failure include coronary heart disease, valvular disease, hypertension, and cardiomyopathies, such as toxic cardiomyopathy or hypothyroidism-related cardiomyopathy, as well as idiopathic cardiomyopathy. Myocarditis and arrhythmia-related causes can also lead to heart failure, but there are often triggers present clinically. Common triggers include poor treatment compliance, arrhythmias, anemia, infections, myocardial ischemia, excessive fluid intake, poor dietary control, and increased cardiac output, such as during strenuous activity and pregnancy, which can lead to increased cardiac output and cause heart failure. Conditions such as excessive fluid volume, hypertension, hyperthyroidism, and pulmonary embolism can also trigger heart failure.


Can people with chronic heart failure smoke?
Patients with chronic heart failure should not smoke, as smoking can enhance the excitability of the sympathetic nervous system. Increased excitability of the sympathetic nervous system releases norepinephrine, elevating norepinephrine levels. This can cause peripheral vasoconstriction, increase the afterload on the heart, and accelerate heart rate. Both of these effects can increase myocardial oxygen consumption. Furthermore, norepinephrine has a direct toxic effect on myocardial cells, promoting myocardial cell apoptosis and participating in the pathological process of ventricular remodeling. Moreover, excitement of the sympathetic nervous system can also enhance myocardial stress, potentially promoting the occurrence of arrhythmias. Therefore, patients with chronic heart failure should not smoke.


How is heart failure treated?
Heart failure is very common in clinical settings. The main treatments include strengthening the heart, diuresis, and vasodilation for symptomatic treatment. A mask or high-flow oxygen can be used if the patient's heart failure symptoms are difficult to correct, or if cardiogenic shock occurs. Aortic balloon counterpulsation and tracheal intubation can be adopted, with ventilator support for ventilation, and blood dialysis and other symptomatic supportive treatments can be used. Another point is to actively control or eliminate the causes of heart failure, etc.