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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Treatment of Chronic Heart Failure

Chronic heart failure is a common and frequent disease in clinical practice, often caused by severe myocardial damage, which leads to insufficient myocardial contraction and results in inadequate peripheral blood supply. The primary principles of treatment are to reduce the heart's burden, enhance its contractile strength, decrease the heart's workload, and reduce the returning blood volume to alleviate the heart's burden. Treatment involves using vasodilators to decrease cardiac resistance, positive inotropic drugs to strengthen cardiac contraction, and diuretics and a low-salt diet to reduce cardiac volume and returning blood volume. By employing these methods, the symptoms of chronic heart failure can be improved.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What are the causes of chronic heart failure?

Chronic heart failure is also relatively common in clinical settings, mainly referring to patients with existing heart diseases. If a patient with a long history of hypertension experiences lung infection and fatigue, it can trigger an acute episode of chronic heart failure. At this time, the patient may experience symptoms such as difficulty breathing and fatigue. It is crucial to seek prompt medical attention, where common clinical treatments include cardiotonic, diuretic, and vasodilator therapies. For chronic heart failure, treatment should also actively address and remove the underlying causes and treat the primary disease to save the patient's life.

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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 Liu Ying
Cardiology
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Causes of Heart Failure

Heart failure can be divided into acute heart failure and chronic heart failure. There are many causes of acute heart failure, such as acute coronary syndrome, hypertensive emergency, acute massive pulmonary embolism, right ventricular infarction, severe pulmonary hypertension, and so on. Chronic heart failure can also have many causes, for example, coronary artery disease and hypertension have become the main causes of chronic heart failure, rheumatic heart disease, and valvular heart disease can also cause chronic heart failure. Chronic cor pulmonale and high-altitude heart disease also have a certain incidence rate in China, among others.

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Written by Zhang Shu Kun
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Where to massage for heart failure?

Patients with heart failure cannot be effectively treated by massage alone; it merely serves to alleviate symptoms. It is recommended to take medication for treatment purposes. However, massaging certain acupoints can be beneficial. Massaging the Neiguan point can significantly reduce symptoms of chest tightness and pain, and also alleviate fainting. Regularly massaging the Jiuwei point, also known as the Jianjing point, can effectively relieve angina caused by heart disease.