Causes of acute heart failure include

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 15, 2024
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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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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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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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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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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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What causes acute heart failure?

Acute heart failure can occur in diseases of the heart itself, as well as in other serious diseases that lead to heart failure. Common cardiac diseases include severe arrhythmias, cardiomyopathy, and myocardial infarction. If these diseases are not well treated, they can cause acute heart failure. Other diseases can be seen in cases such as drug poisoning, severe anemia, severe infection, and during the treatment of other diseases when excessive use of fluids increases the burden on the heart, leading to acute heart failure.