Why does heart failure cause ascites?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 04, 2024
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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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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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Clinical manifestations of heart failure

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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Written by Wang Li Bing
Intensive Care Medicine Department
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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 Lu
Obstetrics
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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
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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.