Why does heart failure cause edema?

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 09, 2024
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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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Is acute heart failure dangerous?

Acute heart failure is very dangerous in clinical practice. It is mainly caused by a sudden decrease in cardiac output, leading to insufficient perfusion in tissues and organs and acute blood stasis syndrome. The main clinical symptoms include severe respiratory distress, often accompanied by restlessness, profuse sweating, frequent coughing with pink frothy sputum, and in severe cases, sudden cardiac and respiratory arrest can occur. After the occurrence of acute heart failure, effective measures should be taken to alleviate symptoms such as respiratory distress. The most effective methods in clinical practice include strengthening the heart, promoting diuresis, and dilating blood vessels.

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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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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 Wei Shi Liang
Intensive Care Unit
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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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Geriatrics
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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.