Causes of Acute Heart Failure

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 14, 2024
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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.

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Written by Wang Li Bing
Intensive Care Medicine Department
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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.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Acute heart failure typical symptoms

The typical symptoms of acute heart failure include sudden severe difficulty breathing, increased respiratory rate, and patients generally presenting a forced sitting position, with pale, grayish complexion and cyanotic lips. They often have profuse sweating, restlessness, frequent coughing, and coughing up pink frothy sputum. The condition can be critical, leading to consciousness disturbances due to lack of oxygen. Once acute heart failure occurs, active treatment is essential. The most common clinical approaches include strengthening the heart, diuresis, and vasodilation for symptomatic active management.

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Written by Wang Li Bing
Intensive Care Medicine Department
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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.

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Written by Wei Shi Liang
Intensive Care Unit
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Why does heart failure cause edema?

Edema caused by heart failure is mainly due to heart dysfunction, resulting in systemic circulation, venous congestion, and excessive fluid accumulation in the body's tissue spaces. The primary cause is right heart failure or total heart failure, and some special cases of pericarditis. The edema caused by this type of heart failure is often symmetrical, indenting, and sagging, and usually worsens with activity and lessens with rest. The common locations for fluid accumulation are in the sacral and perineal areas, while bedridden patients often show it in the ankle area. In severe cases, patients may experience generalized edema, and even develop ascites and pleural effusion. This condition is known as heart failure, and the type of edema it causes is called cardiogenic edema.

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Written by Wang Li Bing
Intensive Care Medicine Department
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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.