Why do we need to supplement potassium for heart failure?

Written by Fan Yan Fu
Cardiology
Updated on April 15, 2025
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Potassium ions are very important in the cardiac muscle cells, playing a critical role in maintaining the stability of the electrical activity of these cells. Thus, in conditions like heart failure or other cardiovascular diseases, it is essential to keep potassium levels within a certain range in order to reduce serious cardiac events. When potassium levels fall, cardiac electrical activity can become disordered, potentially leading to a sudden cardiac arrest. This is particularly the case in heart failure where the cardiac muscle cells are in a diseased state, making them more sensitive to low potassium levels. Thus, they are more prone to sudden cardiac arrest or sudden cardiac death. Therefore, for cardiovascular diseases, particularly heart failure, there is a high priority on supplementing potassium, generally increasing it to above 4.0 and even around 4.5 to be safe. Additionally, patients with heart failure often have poor diets, leading to lower potassium intake and consumption of potassium-rich foods, necessitating pharmacological potassium supplementation. Heart failure patients frequently use diuretics, which can lead to higher potassium loss, thus requiring additional potassium supplementation. For these reasons, potassium supplementation is particularly emphasized in patients with heart failure.

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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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Causes of acute heart failure include

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The basic mechanisms of heart failure

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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.