Clinical manifestations of chronic heart failure

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 16, 2024
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Chronic heart failure primarily includes left heart failure, right heart failure, and total heart failure. Left heart failure can present with varying degrees of respiratory difficulty, such as exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea, etc. Secondly, symptoms can include coughing and expectorating, coughing up pink frothy sputum, and patients may experience fatigue, dizziness, and palpitations, among others. Right heart failure mainly manifests as gastrointestinal symptoms, such as abdominal distension, poor appetite, nausea, vomiting, etc. Total heart failure encompasses the clinical manifestations of both right and left heart failure.

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Causes of acute heart failure

Acute heart failure refers to the acute onset of heart failure or an exacerbated clinical syndrome, which can present as either newly developed acute or acute decompensation of chronic heart failure. Clinically, it is commonly divided into two main categories. One category is acute left heart failure, often caused by acute decompensation of chronic heart failure, or by acute coronary syndrome, hypertensive emergencies, acute cardiac valvular dysfunction, severe myocarditis, serious arrhythmias, and peripartum cardiomyopathy. The other category is acute right heart failure, which can be caused by right ventricular infarction, acute large pulmonary embolism, and right-sided valvular heart disease.

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What medicine is used for chronic heart failure?

Chronic heart failure is also relatively common in clinical practice. The treatment of heart failure mainly includes preventing and delaying the onset of heart failure, alleviating the symptoms of clinical heart failure patients, improving the long-term prognosis of patients, and reducing mortality. These are the treatment principles for heart failure. After the occurrence of heart failure, its treatment mainly includes the treatment of the basic etiology, as well as the elimination of various precipitating factors, such as infections, etc. The pharmacological treatment mainly includes several aspects: first, the use of diuretics; second, the use of renin, angiotensin, and aldosterone system inhibitors; third, the use of receptor blockers; and fourth, the correct use of positive inotropic drugs, etc. Heart failure can alleviate the clinical symptoms of patients through pharmacological treatments.

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The basic etiology of chronic heart failure

Chronic heart failure is one of the most common complications of various organic heart diseases, and there are many causes of chronic heart failure. The main reason is due to primary diseases that have not been effectively treated. Long-term myocardial ischemia, hypoxia, excessive fatigue, emotional excitement, overeating, too full, constipation, and other reasons increase the cardiac burden, leading to chronic heart failure. People with organic heart disease must treat the primary disease under the guidance of a doctor. At the same time, pay attention to rest, avoid emotional excitement, eat easily digestible food, maintain a low-salt, low-fat diet, and ensure smooth bowel movements to prevent increasing the cardiac burden and causing heart failure.

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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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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.