Clinical manifestations of chronic heart failure

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 26, 2024
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Chronic heart failure primarily includes left heart failure, right heart failure, and total heart failure. Clinically, left heart failure is the most common. The clinical manifestations of left heart failure primarily involve pulmonary congestion and reduced cardiac output, which can present as varying degrees of dyspnea, such as exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Patients may experience coughing, expectoration, pink frothy sputum, fatigue, tiredness, dizziness, palpitations, and more. Right heart failure primarily manifests as gastrointestinal and liver congestion, causing abdominal distension, poor appetite, nausea, vomiting, and more. Total heart failure naturally includes the clinical manifestations of both left and right heart failure.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Clinical manifestations of chronic heart failure

Chronic heart failure primarily includes left heart failure, right heart failure, and total heart failure. Clinically, left heart failure is the most common. The clinical manifestations of left heart failure primarily involve pulmonary congestion and reduced cardiac output, which can present as varying degrees of dyspnea, such as exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Patients may experience coughing, expectoration, pink frothy sputum, fatigue, tiredness, dizziness, palpitations, and more. Right heart failure primarily manifests as gastrointestinal and liver congestion, causing abdominal distension, poor appetite, nausea, vomiting, and more. Total heart failure naturally includes the clinical manifestations of both left and right heart failure.

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Written by Zhang Yue Mei
Cardiology
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How is chronic heart failure treated?

Patients with chronic heart failure should avoid overexertion and ensure ample rest to prevent exacerbating the cardiac burden. Emotional upsets should be avoided as they can intensify heart failure. In terms of diet, avoid high-protein, easily digestible foods and consume more vegetables and fruits instead. Avoid overly salty foods as they contain a higher amount of sodium chloride which can increase blood volume and worsen heart failure. While treating the primary disease, efforts should be made to minimize the burden on the heart, utilizing effective diuretics to reduce blood volume and correct chronic heart failure.

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Written by Liu Ying
Cardiology
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Symptoms of chronic heart failure

Chronic heart failure can be divided into left heart failure, right heart failure, and total heart failure. The symptoms of left heart failure primarily manifest as congestion in the pulmonary circulation, that is, a reduction in cardiac output. Patients may experience varying degrees of breathing difficulties, starting with exertional dyspnea, then orthopnea, followed by paroxysmal nocturnal dyspnea, and eventually acute pulmonary edema. Additional symptoms may include coughing, expectoration, hemoptysis, fatigue, tiredness, dizziness, reduced exercise tolerance, and symptoms of insufficient blood supply to organs and tissues, including oliguria and kidney damage. The symptoms of right heart failure can present as gastrointestinal symptoms, such as abdominal distension, loss of appetite, nausea, vomiting, and also exertional dyspnea. When both left and right heart failures occur, it is referred to as total heart failure. In cases of total heart failure, symptoms of both left and right heart failures may be present.

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Written by Liu Ying
Cardiology
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Can people with chronic heart failure smoke?

Patients with chronic heart failure should not smoke, as smoking can enhance the excitability of the sympathetic nervous system. Increased excitability of the sympathetic nervous system releases norepinephrine, elevating norepinephrine levels. This can cause peripheral vasoconstriction, increase the afterload on the heart, and accelerate heart rate. Both of these effects can increase myocardial oxygen consumption. Furthermore, norepinephrine has a direct toxic effect on myocardial cells, promoting myocardial cell apoptosis and participating in the pathological process of ventricular remodeling. Moreover, excitement of the sympathetic nervous system can also enhance myocardial stress, potentially promoting the occurrence of arrhythmias. Therefore, patients with chronic heart failure should not smoke.

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Written by Zhang Yue Mei
Cardiology
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Chronic heart failure means

Chronic heart failure refers to a condition where the heart is unable to effectively pump blood throughout the body to meet the needs of vital organs, leading to a series of clinical symptoms caused by venous congestion and arterial ischemia. Symptoms include post-activity palpitations, orthopnea, swelling of the lower limbs, and enlarged liver. This condition causes great distress to patients and requires long-term use of effective medications to alleviate chronic heart failure. Patients with chronic heart failure need to ensure adequate rest, avoid overexertion, adhere to a low-salt diet, and limit the intake of spicy and greasy foods to prevent exacerbation of heart failure.