What medicine is used for acute heart failure?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 25, 2024
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The most common clinical manifestation of acute heart failure is severe dyspnea, hypoxia, and even changes in consciousness, which are very common in clinical practice. For treatment, morphine can be administered intravenously or subcutaneously to reduce patient agitation and relieve myocardial oxygen consumption. Secondly, plastic can be used for rapid intravenous push. Thirdly, vasodilators can be used, such as glyceryl trinitrate and sodium nitroprusside intravenous infusion. Fourthly, positive inotropic drugs can be used, such as dopamine and dobutamine. Additionally, cardiac glycosides, such as digoxin, can be used.

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Written by Zhang Yue Mei
Cardiology
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Heart Failure Drug Therapy

Due to some myocardial diseases that cause damage to the myocardium, or other reasons that increase the heart's load, heart failure may occur. Clinical treatment involves strengthening the heart and promoting diuresis, improving blood vessel function, increasing the heart’s contractility, reducing the heart’s resistance, and decreasing the volume of blood returning to the heart. Through these effective drug treatments, heart failure can be corrected. Patients with heart failure should avoid excessive fatigue and maintain a low-salt diet to prevent increasing the burden on the heart.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Acute heart failure typical symptoms

The typical symptoms of acute heart failure include sudden severe difficulty breathing, increased respiratory rate, and patients generally presenting a forced sitting position, with pale, grayish complexion and cyanotic lips. They often have profuse sweating, restlessness, frequent coughing, and coughing up pink frothy sputum. The condition can be critical, leading to consciousness disturbances due to lack of oxygen. Once acute heart failure occurs, active treatment is essential. The most common clinical approaches include strengthening the heart, diuresis, and vasodilation for symptomatic active management.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Clinical manifestations of heart failure

Heart failure is divided into left heart failure, right heart failure, and total heart failure. Left heart failure mainly manifests as exertional dyspnea or nocturnal paroxysmal dyspnea. It is often accompanied by palpitations, orthopnea, coughing, coughing up pink frothy sputum, accompanied by palpitations, fatigue, etc. Right heart failure primarily presents with symptoms of the digestive system, such as abdominal distension, nausea, vomiting, edema, oliguria, etc. Once heart failure occurs, active treatment must be administered. In clinical practice, treatments mainly include cardiotonics, diuretics, vasodilators, and other symptomatic treatments.

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Written by Wei Shi Liang
Intensive Care Unit
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Causes of Acute Heart Failure

The main causes of acute heart failure include coronary heart disease, valvular disease, hypertension, and cardiomyopathies, such as toxic cardiomyopathy or hypothyroidism-related cardiomyopathy, as well as idiopathic cardiomyopathy. Myocarditis and arrhythmia-related causes can also lead to heart failure, but there are often triggers present clinically. Common triggers include poor treatment compliance, arrhythmias, anemia, infections, myocardial ischemia, excessive fluid intake, poor dietary control, and increased cardiac output, such as during strenuous activity and pregnancy, which can lead to increased cardiac output and cause heart failure. Conditions such as excessive fluid volume, hypertension, hyperthyroidism, and pulmonary embolism can also trigger heart failure.

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Written by Zhou Yan
Geriatrics
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Compensatory mechanisms of acute heart failure

There are several compensatory methods for acute heart failure. The first is mechanical ventilation, including non-invasive mechanical ventilation and tracheal intubation. Mechanical ventilation is commonly referred to as assisted breathing with a ventilator. The second is continuous renal replacement therapy, commonly known as total ultrafiltration, which can be used to remove excess fluid and metabolic waste from the body. The third is intra-aortic balloon counterpulsation, which can effectively improve myocardial perfusion, reduce myocardial oxygen consumption, and increase cardiac output. The fourth is extracorporeal membrane oxygenation, commonly known as ECMO, which provides external cardiopulmonary support when the heart cannot maintain systemic perfusion or when the kidneys cannot adequately exchange gases. The fifth is the implantable left ventricular assist device, which can maintain peripheral perfusion during acute heart failure and reduce myocardial oxygen consumption, thus reducing cardiac injury. These five methods can provide compensatory treatment when drug therapy is ineffective for patients with acute heart failure.