Causes of vomiting in heart failure

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 24, 2024
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Heart failure in clinical practice can be divided into left heart failure, right heart failure, and total heart failure. The symptoms of left heart failure primarily manifest as pulmonary congestion, including varying degrees of dyspnea, cough, coughing up pink frothy sputum, palpitations, fatigue, etc. As for right heart failure, it mainly shows as gastrointestinal congestion, with symptoms such as nausea, vomiting, loss of appetite, etc. Once heart failure symptoms appear, the patient must seek medical attention promptly, actively treat the primary disease, correct the symptoms and signs of heart failure, and then avoid excessive physical activity, infections, and other triggers that could exacerbate heart failure.

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Written by Zhou Yan
Geriatrics
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Triggers of acute heart failure

The triggers of acute heart failure include the following aspects: Respiratory infections are the most common and important trigger, and infective endocarditis is also not uncommon. However, due to its concealed onset, it is easily underdiagnosed. The second is arrhythmia, among which atrial fibrillation is one of the most common arrhythmias in organic heart disease and is also an important factor leading to heart failure. Additionally, rapid arrhythmias can also cause acute heart failure. The third is an increase in blood volume, such as excessive salt intake or excessive or rapid intravenous fluid administration. The fourth is excessive physical exertion or emotional excitement, such as during late pregnancy or childbirth. The fifth aspect is improper treatment, inappropriate use of diuretics or antihypertensive drugs, which can also trigger an episode of acute heart failure. Furthermore, whether it is an exacerbation of existing heart disease or complications with other diseases, such as coronary heart disease with myocardial infarction, rheumatic disease becoming active, or complications with hyperthyroidism or anemia, can all cause acute heart failure.

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Written by Wang Li Bing
Intensive Care Medicine Department
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The basic mechanisms of heart failure

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 Zhang Yue Mei
Cardiology
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What causes acute heart failure?

Acute heart failure can occur in diseases of the heart itself, as well as in other serious diseases that lead to heart failure. Common cardiac diseases include severe arrhythmias, cardiomyopathy, and myocardial infarction. If these diseases are not well treated, they can cause acute heart failure. Other diseases can be seen in cases such as drug poisoning, severe anemia, severe infection, and during the treatment of other diseases when excessive use of fluids increases the burden on the heart, leading to acute 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.

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Written by Zhang Lu
Obstetrics
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Can childbirth lead to heart failure?

Childbirth refers to the delivery of a fetus through vaginal delivery or cesarean section, and it represents a significant strain on a woman’s heart. Regardless of the type of delivery, there is a possibility of leading to heart failure to some extent. Especially during the second stage of labor, pregnant women often exert greater effort, significantly increasing the load on the heart. If there is poor heart function or pre-existing cardiac disease, it could lead to heart failure. In some cases, if the heart disease is severe and cannot withstand delivery, a cesarean section must be chosen. However, cesarean delivery can also lead to heart failure, mainly due to a large amount of blood flowing back to the peripheral circulation from the uterus after the fetus is delivered, causing a significant increase in the preload on the heart and easily leading to the onset of heart failure.