Treatment of Chronic Heart Failure

Written by Zhang Yue Mei
Cardiology
Updated on August 31, 2024
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Chronic heart failure is a common and frequent disease in clinical practice, often caused by severe myocardial damage, which leads to insufficient myocardial contraction and results in inadequate peripheral blood supply. The primary principles of treatment are to reduce the heart's burden, enhance its contractile strength, decrease the heart's workload, and reduce the returning blood volume to alleviate the heart's burden. Treatment involves using vasodilators to decrease cardiac resistance, positive inotropic drugs to strengthen cardiac contraction, and diuretics and a low-salt diet to reduce cardiac volume and returning blood volume. By employing these methods, the symptoms of chronic heart failure can be improved.

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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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Written by Zhang Yue Mei
Cardiology
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How is chronic heart failure treated?

Patients with chronic heart failure should avoid overexertion and ensure ample rest to prevent exacerbating the cardiac burden. Emotional upsets should be avoided as they can intensify heart failure. In terms of diet, avoid high-protein, easily digestible foods and consume more vegetables and fruits instead. Avoid overly salty foods as they contain a higher amount of sodium chloride which can increase blood volume and worsen heart failure. While treating the primary disease, efforts should be made to minimize the burden on the heart, utilizing effective diuretics to reduce blood volume and correct chronic heart failure.

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Written by Liu Ying
Cardiology
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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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Written by Wang Li Bing
Intensive Care Medicine Department
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Clinical manifestations of chronic heart failure

Chronic heart failure primarily includes left heart failure, right heart failure, and total heart failure. Left heart failure can present with varying degrees of respiratory difficulty, such as exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea, etc. Secondly, symptoms can include coughing and expectorating, coughing up pink frothy sputum, and patients may experience fatigue, dizziness, and palpitations, among others. Right heart failure mainly manifests as gastrointestinal symptoms, such as abdominal distension, poor appetite, nausea, vomiting, etc. Total heart failure encompasses the clinical manifestations of both right and left heart failure.

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Written by Liu Ying
Cardiology
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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.