The basic mechanisms of heart failure

Written by Wang Li Bing

Intensive Care Medicine Department

Updated on September 20, 2024

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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.

Other Voices

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Written by Zhang Lu

Obstetrics

53sec

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Can childbirth lead to heart failure?

Childbirth refers to the delivery of a fetus through vaginal delivery or cesarean section, and it represents a significant strain on a woman’s heart. Regardless of the type of delivery, there is a possibility of leading to heart failure to some extent. Especially during the second stage of labor, pregnant women often exert greater effort, significantly increasing the load on the heart. If there is poor heart function or pre-existing cardiac disease, it could lead to heart failure. In some cases, if the heart disease is severe and cannot withstand delivery, a cesarean section must be chosen. However, cesarean delivery can also lead to heart failure, mainly due to a large amount of blood flowing back to the peripheral circulation from the uterus after the fetus is delivered, causing a significant increase in the preload on the heart and easily leading to the onset of heart failure.

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Written by Wang Li Bing

Intensive Care Medicine Department

1min 21sec

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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.)

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Written by Wang Li Bing

Intensive Care Medicine Department

48sec

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Causes of vomiting in heart failure

Heart failure in clinical practice can be divided into left heart failure, right heart failure, and total heart failure. The symptoms of left heart failure primarily manifest as pulmonary congestion, including varying degrees of dyspnea, cough, coughing up pink frothy sputum, palpitations, fatigue, etc. As for right heart failure, it mainly shows as gastrointestinal congestion, with symptoms such as nausea, vomiting, loss of appetite, etc. Once heart failure symptoms appear, the patient must seek medical attention promptly, actively treat the primary disease, correct the symptoms and signs of heart failure, and then avoid excessive physical activity, infections, and other triggers that could exacerbate heart failure.

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Written by Wang Li Bing

Intensive Care Medicine Department

45sec

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What medicine is used for acute heart failure?

The most common clinical manifestation of acute heart failure is severe dyspnea, hypoxia, and even changes in consciousness, which are very common in clinical practice. For treatment, morphine can be administered intravenously or subcutaneously to reduce patient agitation and relieve myocardial oxygen consumption. Secondly, plastic can be used for rapid intravenous push. Thirdly, vasodilators can be used, such as glyceryl trinitrate and sodium nitroprusside intravenous infusion. Fourthly, positive inotropic drugs can be used, such as dopamine and dobutamine. Additionally, cardiac glycosides, such as digoxin, can be used.

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Written by Zhang Yue Mei

Cardiology

1min 2sec

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What is a good diet for heart failure?

Heart failure is one of the most common complications of various organic heart diseases. After the onset of heart failure, it is necessary to use effective medications to treat the primary disease causing the heart failure. At the same time, methods such as cardiotonics, diuretics, and vasodilators should be used to reduce the burden on the heart as much as possible and correct heart failure in a timely manner. Patients with heart failure should rest, keep calm, and avoid overexertion in daily life. Their diet should primarily consist of low-fat and low-salt foods, and they should abstain from smoking and drinking alcohol. They should avoid spicy foods, pickled foods, and overly salty foods. Eating overly salty foods can increase blood volume, increase the burden on the heart, and worsen heart failure. (The use of medications should be conducted under the guidance of a professional doctor.)