(Disclaimer: This article is only for popular science purposes, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: This case is a rare old man who came to our hospital because of “chest tightness and shortness of breath in the last 3 days, inability to lie down at night, accompanied by edema of the lower limbs, loss of appetite, poor quality of sleep, panic attacks, and weakness, accompanied by edema of the lower limbs”. Combined with the medical history and chest CT examination, the patient was considered to have chronic heart failure, which is a type of congestive heart failure. After systematic and standardized drug treatment, the patient’s chest tightness was significantly relieved and his health was gradually restored. Basic information] Male, 68 years old [Type of disease] Chronic heart failure [Hospital] The First Affiliated Hospital of Anhui Medical University [Date of consultation] January 2022 [Treatment plan] Drug therapy (digoxin tablets, metoprolol succinate extended-release tablets, furosemide tablets, spironolactone tablets, sakubatrizol valsartan sodium tablets, rivaroxaban tablets, nitroglycerin) [Treatment cycle] 12 days of hospitalization, outpatient follow up 3 months 【Treatment effect】Significant relief of chest tightness and shortness of breath, increased tolerance of physical activity I. Initial interview The patient was seen in January 2022, panting when he came in, and a little bit stable when he sat down. Self-reported: chest tightness and shortness of breath began to appear more than 10 years ago, due to the fact that they appeared mostly during heavy physical activities and general physical labor had no effect, so they did not pay attention to them. 3 years ago, the symptoms worsened, and chest tightness and shortness of breath with lower limb fatigue could be seen during general physical activities such as walking fast and climbing slopes. He had two visits to the local hospital, considering chronic heart failure, and was given diuretic, cardiotonic, vasodilator drugs and other symptoms improved, but failed to adhere to long-term medication after discharge. In the last 3 days, she had chest tightness and shortness of breath again, and could not lie down at night, accompanied by lower limb edema, loss of appetite and poor sleep quality. Combined with the past medical history, chronic heart failure was initially considered. Due to the obvious chest tightness and shortness of breath, the patient was immediately admitted to the hospital. Examination: P: 104 beats/min, R: 24 beats/min, BP: 140/82 mmHg; jugular venous distension, hepatic and jugular regurgitation sign (+), normal thorax; both lungs have coarse respiratory tones, and wet rales can be detected in the two lower lungs; the heart boundary is enlarged to the left, heart rate is 135 beats/min, rhythm is irregular, the first heart sound is not equal in intensity, and no obvious pathologic murmur can be detected in the valvular regions; both lower extremities have moderate sunken edema. Relevant examinations showed: BNP: 1883.88pg/ml; ECG: fast-rate atrial fibrillation; cardiac color ultrasound: left atrium, left ventricle, right atrium enlarged, left ventricle overall myocardial activity is suppressed, LVEF 42%; chest CT: a small amount of pleural effusion on both sides. Chest CT showed a small amount of pleural effusion on both sides. Combined with medical history, laboratory tests and imaging, the diagnosis of chronic heart failure was clear. After immediately communicating with the patient and his family about his condition, the patient began to be a little worried, but after analyzing the pros and cons of the treatment, the patient expressed his willingness to be actively treated. The patient was immediately treated with furosemide tablets for diuresis; spironolactone tablets for potassium diuresis and inhibition of ventricular remodeling; nitroglycerin to reduce the anterior and posterior loads on the heart; digoxin tablets to strengthen the heart and slow down the ventricular rate; sakubutravir sodium tablets to inhibit the RAAS system (the renin-angiotensin-aldosterone system) and to reverse ventricular remodeling; metoprolol succinate delayed-release tablets to help control ventricular rate and reduce oxygen consumption; and rivaroxaban tablets for anticoagulation therapy. On the day of admission, the patient was treated with furosemide tablets, spironolactone tablets, nitroglycerin and digoxin tablets. 2 days later, the patient’s symptoms of chest tightness and shortness of breath were relieved, but the activity level was poor; after further completing the cardiac ultrasound, chest CT, electrocardiogram and other related examinations, rivaroxaban tablets, sakubatrizole valdecoxib sodium tablets and metoprolol succinate extended-release tablets were added, and the patient’s symptoms of chest tightness and shortness of breath were relieved significantly. On the 12th day of admission, the patient no longer had obvious chest tightness and shortness of breath, could lie down at night, edema subsided, and general physical activities could be tolerated, and was allowed to be discharged from the hospital. Before discharge, the patient was instructed to come to the hospital for regular review, including: liver function, renal function, coagulation function, electrocardiogram, cardiac ultrasound, etc., and the loading of drugs was adjusted under the guidance of the doctor to achieve the optimal dosage for improving the prognosis. (Review cardiac ultrasound) IV. Precautions We are glad that the patient’s symptoms of chest tightness and shortness of breath have been relieved and his physical condition has gradually become better after drug treatment. However, after discharge from the hospital, the patient should not be taken lightly, and the consolidation treatment as well as daily care are equally important. Diet, control sodium intake, control the daily intake, avoid high salt, high sugar, high fat diet, recommended light, nutritious, easy to digest diet, recommended consumption of fresh fruits and vegetables, can effectively prevent electrolyte imbalance; life, observation of the daily urine volume, urine traits, color and so on. Secondly, due to long-term oral diuretics, it is necessary to pay attention to potassium supplementation, and regularly review electrolytes in outpatient clinics, in order to avoid electrolyte imbalance, which may lead to related complications. In addition, improve self-monitoring of blood pressure and heart rate, and maintain emotional stability. If symptoms such as chest tightness and shortness of breath recur, consult a doctor promptly to avoid delaying treatment. V. Personal perception Chronic heart failure is one of the types of congestive heart failure, which is the end stage of all kinds of heart disease. Improving the quality of life and prolonging the prognosis is the fundamental goal of treatment. The disease develops slowly, progresses slowly, and is most common in middle-aged and elderly people with underlying diseases such as high blood pressure and heart disease, with dyspnea and shortness of breath as the first symptoms, which aggravate progressively. In the acute stage of chronic heart failure, immediate medical attention is needed to correct the symptoms and remove the cause of the disease to avoid further deterioration, in order to prevent sudden cardiac death. Even if it has entered the chronic phase, as in this case, timely medical attention is needed to improve the prognosis, and adherence to long-term oral drug therapy and maintaining a healthy lifestyle are the keys to prolonging the prognosis.