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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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 Zhang Yue Mei
Cardiology
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Can people with heart failure eat fish?

Patients with heart failure can eat fish, as fish contains a large amount of high-quality protein, vitamin B, trace elements, and minerals. Consuming fish can increase the high-quality protein the body needs, enhance the body's immunity and disease resistance. Especially for patients with heart failure, who suffer from chronic myocardial ischemia, need nutritional support. When preparing fish, it should not be made too salty, as patients with heart failure should follow a low-salt diet. If the fish is too salty, consuming it in excess could exacerbate heart failure. Preparing fish in a lighter way, such as making fish soup, can not only supplement the body's high-quality protein but also be easier to digest.

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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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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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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.