How is heart failure treated?

Written by Wang Li Bing

Intensive Care Medicine Department

Updated on September 11, 2024

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Heart failure is very common in clinical settings. The main treatments include strengthening the heart, diuresis, and vasodilation for symptomatic treatment. A mask or high-flow oxygen can be used if the patient's heart failure symptoms are difficult to correct, or if cardiogenic shock occurs. Aortic balloon counterpulsation and tracheal intubation can be adopted, with ventilator support for ventilation, and blood dialysis and other symptomatic supportive treatments can be used. Another point is to actively control or eliminate the causes of heart failure, etc.

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Causes of acute heart failure

Acute heart failure refers to the acute onset of heart failure or an exacerbated clinical syndrome, which can present as either newly developed acute or acute decompensation of chronic heart failure. Clinically, it is commonly divided into two main categories. One category is acute left heart failure, often caused by acute decompensation of chronic heart failure, or by acute coronary syndrome, hypertensive emergencies, acute cardiac valvular dysfunction, severe myocarditis, serious arrhythmias, and peripartum cardiomyopathy. The other category is acute right heart failure, which can be caused by right ventricular infarction, acute large pulmonary embolism, and right-sided valvular heart disease.

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Is there a cure for chronic heart failure?

Chronic heart failure is often a later stage of many diseases, and patients in this category typically exhibit symptoms of recurrent exertional dyspnea. These symptoms are often related to physical activity, overeating, or excessive and rapid infusion of fluids. Many patients often ask their doctors if there is hope for their chronic heart failure, and the answer is definitely yes. Currently, the pharmacological and device treatments for heart failure are highly effective. Under the guidance of a doctor, standardized pharmacological treatment can often effectively improve the symptoms of chronic heart failure.

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Written by Wang Li Bing

Intensive Care Medicine Department

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Treatment methods for chronic heart failure

The treatment of heart failure mainly includes the following points. The first major category is etiological treatment, where we should actively manage all common diseases that may impair cardiac function, such as hypertension, coronary heart disease, diabetes, etc. The second category is to eliminate the factors that lead to heart failure, such as infections, especially respiratory infections. The third major category is for patients to pay attention to rest, control physical activity, avoid emotional excitement, and control sodium intake to reduce blood volume. The fourth category is drug therapy, which commonly includes the use of diuretics, ACE inhibitors, positive inotropic drugs, and β-blockers in clinical practice. (Medication should be administered under the guidance of a doctor.)

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Symptoms of chronic heart failure

Chronic heart failure can be divided into left heart failure, right heart failure, and total heart failure. The symptoms of left heart failure primarily manifest as congestion in the pulmonary circulation, that is, a reduction in cardiac output. Patients may experience varying degrees of breathing difficulties, starting with exertional dyspnea, then orthopnea, followed by paroxysmal nocturnal dyspnea, and eventually acute pulmonary edema. Additional symptoms may include coughing, expectoration, hemoptysis, fatigue, tiredness, dizziness, reduced exercise tolerance, and symptoms of insufficient blood supply to organs and tissues, including oliguria and kidney damage. The symptoms of right heart failure can present as gastrointestinal symptoms, such as abdominal distension, loss of appetite, nausea, vomiting, and also exertional dyspnea. When both left and right heart failures occur, it is referred to as total heart failure. In cases of total heart failure, symptoms of both left and right heart failures may be present.

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Late-stage symptoms of heart failure

The most common symptom of late-stage heart failure is dyspnea, which is often persistent. Even in a resting state, there can be shortness of breath. Mild activities, such as eating and urination, can exacerbate the breathing difficulties. Patients in the late stages of heart failure often experience persistent edema, and conventional diuretics are not effective. Patients may also exhibit restlessness, nausea, vomiting, loss of appetite, reduced urine output, and other symptoms. Additionally, low blood pressure can be observed on cardiac monitoring, among other findings.