I. Etiology of heart failure.
Various cardiovascular diseases, including coronary heart disease, hypertension, wind heart disease, cardiomyopathy, myocarditis, etc., eventually lead to a larger heart, changes in morphology, weakened myocardial contractility and heart failure (heart failure). Acute heart failure often causes death quickly, and chronic heart failure is a long-term process that takes a toll on life.
Other systemic diseases, such as diabetes mellitus, thyroid disease, and rheumatic diseases, can also lead to heart enlargement and heart failure.
Neuroendocrine hyperactivation plays a crucial role in the pathogenesis of chronic heart failure.
Heart failure is divided into left heart failure and right heart failure, and the following is mainly about left heart failure.
Second, the triggers for the occurrence of heart failure.
1, Infection Respiratory tract infection is the most common.
2. Arrhythmias Atrial fibrillation is the most common. Various rapid and slow arrhythmias can trigger or aggravate heart failure.
3, increased blood volume high salt diet, too much fluid infusion too fast.
4.Overexertion, emotional excitement.
5, improper treatment Improper discontinuation of diuretic drugs and vasodilator drugs.
6.Exacerbation of existing heart disease or combination of other diseases.
Third, the clinical manifestations of heart failure.
1. Heart failure is mainly manifested by varying degrees of shortness of breath, including exertional dyspnea; inability to rest in a flat position due to shortness of breath, requiring high pillow position or seat rest; having fallen asleep and suddenly awakened from suffocation, forced to sit up with dyspnea, which can be relieved after sitting up and resting; the most serious case is acute pulmonary edema.
2.Coughing, coughing sputum, hemoptysis.
3, weakness, tiredness, dizziness, palpitations.
4. Oliguria and renal impairment.
IV. Diagnosis of heart failure.
The diagnosis of left heart failure is mainly based on the history of underlying heart disease, clinical symptoms and physician examination, and cardiac color Doppler ultrasound suggesting left ventricular enlargement and reduced ejection fraction (EF) can be diagnosed.
V. Treatment of heart failure.
The treatment of heart failure includes not only short-term improvement of symptoms, but also prevention and delay of heart failure, improvement of long-term prognosis and reduction of mortality. It is a long-term comprehensive treatment. It cannot be stopped because of the recent absence of symptoms, which may recur in the short term and is detrimental to the long-term prognosis.
1, etiological treatment: actively control the primary disease, such as coronary heart disease, hypertensive disease, diabetes, etc.
2, remove the causative factors: avoid colds, too much and too fast infusion, overexertion, emotional excitement, discontinuation of medication, etc.
3.Rest and proper control of sodium intake.
4.Medication: including diuretics, angiotensin-converting enzyme inhibitors (ACEI ××pril) or receptor antagonists (ARB ××sartan), beta-blockers (betaxolol, bisoprolol, etc.), and positive inotropic drugs (digoxin, etc.).
It is important to remind that.
(i) Medication needs to be administered under the guidance of clinicians; if improperly administered, it can aggravate the symptoms of heart failure and cause adverse consequences.
(ii) Angiotensin-converting enzyme inhibitors (ACEI ××pril) or receptor antagonists (ARB ××sartan), β-blockers (betaxolol, bisoprolol, etc.) are crucial in the treatment of heart failure and cannot be easily discontinued. In some diseases (such as cardiomyopathy), the heart can return to normal size and cardiac function after long-term adherence to ACEI/ARB and β-blockers, while Once the medication is stopped, the heart will continue to expand and then heart failure will occur, so the medication must be adhered to for a long time.