Compensatory mechanisms of acute heart failure

Written by Zhou Yan
Geriatrics
Updated on December 21, 2024
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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.

Other Voices

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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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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 Liu Ying
Cardiology
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Can heart failure be cured?

We say that some early-stage heart failure can be cured, such as peripartum cardiomyopathy and thyrotoxic cardiomyopathy. If discovered and treated early, there is hope for a cure. However, most heart failure cannot be cured. Although some psychological failures cannot be cured, if patients can receive early treatment and effective treatment, take their medication on time, and have regular check-ups as advised by their doctor, most heart failure can still be controlled or alleviated. However, if heart failure is detected and not actively treated, even mild heart failure may gradually worsen, or even become end-stage 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.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What medicine is used for acute heart failure?

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.