What medicine is used for acute heart failure?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 25, 2024
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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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Geriatrics
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Compensatory mechanisms of acute heart failure

There are several compensatory methods for acute heart failure. The first is mechanical ventilation, including non-invasive mechanical ventilation and tracheal intubation. Mechanical ventilation is commonly referred to as assisted breathing with a ventilator. The second is continuous renal replacement therapy, commonly known as total ultrafiltration, which can be used to remove excess fluid and metabolic waste from the body. The third is intra-aortic balloon counterpulsation, which can effectively improve myocardial perfusion, reduce myocardial oxygen consumption, and increase cardiac output. The fourth is extracorporeal membrane oxygenation, commonly known as ECMO, which provides external cardiopulmonary support when the heart cannot maintain systemic perfusion or when the kidneys cannot adequately exchange gases. The fifth is the implantable left ventricular assist device, which can maintain peripheral perfusion during acute heart failure and reduce myocardial oxygen consumption, thus reducing cardiac injury. These five methods can provide compensatory treatment when drug therapy is ineffective for patients with acute heart failure.

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Written by Wang Li Bing
Intensive Care Medicine Department
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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.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Why does heart failure cause ascites?

Heart failure is relatively common in clinical settings, primarily divided into left heart failure, right heart failure, and global heart failure. The clinical manifestations of left heart failure are mainly reflected in symptoms of pulmonary congestion. It can present as varying degrees of dyspnea, cough, expectoration, palpitations, and fatigue. Right heart failure is mainly due to obstruction of the inferior vena cava flow, leading to increased venous pressure and capillary pressure. This causes plasma components to extravasate and ultimately leads to the formation of ascites. Global heart failure includes the symptoms of both left and right heart failure. Therefore, it is essential to seek medical attention promptly after heart failure occurs.

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Can heart failure cause suffocation?

Heart failure is caused by various reasons leading to the heart's blood supply being relatively or absolutely insufficient, causing a series of pathological and physiological disorders in patients. Patients often manifest symptoms like difficulty breathing, tightness in breath, and even a feeling of suffocation. However, generally, the symptoms caused by heart failure are not these. This is because suffocation occurs due to airway narrowing or the narrow space around the patient, leading to insufficient oxygen intake, causing a series of syndromes. Therefore, although people with heart failure feel suffocated, they are not actually suffocating; it is just a manifestation of inadequate circulatory supply.

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Triggers of acute heart failure

The triggers of acute heart failure include the following aspects: Respiratory infections are the most common and important trigger, and infective endocarditis is also not uncommon. However, due to its concealed onset, it is easily underdiagnosed. The second is arrhythmia, among which atrial fibrillation is one of the most common arrhythmias in organic heart disease and is also an important factor leading to heart failure. Additionally, rapid arrhythmias can also cause acute heart failure. The third is an increase in blood volume, such as excessive salt intake or excessive or rapid intravenous fluid administration. The fourth is excessive physical exertion or emotional excitement, such as during late pregnancy or childbirth. The fifth aspect is improper treatment, inappropriate use of diuretics or antihypertensive drugs, which can also trigger an episode of acute heart failure. Furthermore, whether it is an exacerbation of existing heart disease or complications with other diseases, such as coronary heart disease with myocardial infarction, rheumatic disease becoming active, or complications with hyperthyroidism or anemia, can all cause acute heart failure.