The basic mechanisms of heart failure

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 20, 2024
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Heart failure is not an independent disease; it can be caused by various factors, such as myocardial infarction, cardiomyopathy, and various myocarditis, which lead to changes in the heart structure and subsequent cardiac dysfunction. Heart failure is mainly due to a disturbance in the heart's contractile function or diastolic function, which prevents the heart from adequately ejecting the returning blood volume. This results in pulmonary congestion, systemic circulation congestion, and a series of syndromes caused by insufficient arterial perfusion.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Common causes of heart failure

Heart failure is a syndrome that occurs when various structural or functional cardiac diseases impair ventricular filling or ejection function. Once heart failure occurs, medical treatment should be sought promptly. Common causes of heart failure mainly include the following points. The first category is primary myocardial damage, which mainly includes coronary heart disease, myocardial infarction, myocarditis, cardiomyopathy, and diabetic cardiomyopathy, among others. The second major category is cardiac load, such as excessive pressure load, commonly seen in hypertension, aortic valve stenosis, pulmonary hypertension, etc.; and excessive volume load, mainly found in cardiac valve insufficiency and congenital heart disease, among others.

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Written by Zhou Yan
Geriatrics
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Can acute heart failure be cured?

Acute heart failure refers to the acute onset or exacerbation of a clinical syndrome of heart failure, manifested as either acute onset of new heart failure or acute worsening of chronic heart failure. The goal of treatment is to improve symptoms, stabilize hemodynamic status, protect vital organ functions, improve prognosis, and prevent recurrence. Because the ischemia and hypoxia during an acute heart failure episode, along with severe respiratory distress, are life-threatening, urgent intervention is required. However, whether it can be cured depends on the underlying disease. Since the underlying disease is already present, it cannot be completely cured, but clinical symptoms and prognosis can be improved.

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Written by Zhang Yue Mei
Cardiology
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What is a good diet for heart failure?

Heart failure is one of the most common complications of various organic heart diseases. After the onset of heart failure, it is necessary to use effective medications to treat the primary disease causing the heart failure. At the same time, methods such as cardiotonics, diuretics, and vasodilators should be used to reduce the burden on the heart as much as possible and correct heart failure in a timely manner. Patients with heart failure should rest, keep calm, and avoid overexertion in daily life. Their diet should primarily consist of low-fat and low-salt foods, and they should abstain from smoking and drinking alcohol. They should avoid spicy foods, pickled foods, and overly salty foods. Eating overly salty foods can increase blood volume, increase the burden on the heart, and worsen heart failure. (The use of medications should be conducted under the guidance of a professional doctor.)

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Written by Wei Shi Liang
Intensive Care Unit
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Why does heart failure cause edema?

Edema caused by heart failure is mainly due to heart dysfunction, resulting in systemic circulation, venous congestion, and excessive fluid accumulation in the body's tissue spaces. The primary cause is right heart failure or total heart failure, and some special cases of pericarditis. The edema caused by this type of heart failure is often symmetrical, indenting, and sagging, and usually worsens with activity and lessens with rest. The common locations for fluid accumulation are in the sacral and perineal areas, while bedridden patients often show it in the ankle area. In severe cases, patients may experience generalized edema, and even develop ascites and pleural effusion. This condition is known as heart failure, and the type of edema it causes is called cardiogenic edema.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Which department should I go to for heart failure?

Heart failure primarily includes left heart failure, right heart failure, and total heart failure. Patients should visit the cardiology outpatient clinic. Left heart failure mainly manifests as pulmonary congestion, which can cause varying degrees of breathing difficulty, coughing, expectoration of pink frothy sputum, palpitations, and fatigue. Right heart failure primarily appears as liver congestion and other symptoms related to the digestive system, such as nausea, vomiting, and gastrointestinal discomfort. Total heart failure includes symptoms of both left heart failure and right heart failure, and medical attention should be sought promptly after the onset of heart failure.