Clinical manifestations of heart failure

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 27, 2024
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Heart failure is divided into left heart failure, right heart failure, and total heart failure. Left heart failure mainly manifests as exertional dyspnea or nocturnal paroxysmal dyspnea. It is often accompanied by palpitations, orthopnea, coughing, coughing up pink frothy sputum, accompanied by palpitations, fatigue, etc. Right heart failure primarily presents with symptoms of the digestive system, such as abdominal distension, nausea, vomiting, edema, oliguria, etc. Once heart failure occurs, active treatment must be administered. In clinical practice, treatments mainly include cardiotonics, diuretics, vasodilators, and other symptomatic treatments.

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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.

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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.

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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.

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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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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.)