Late-stage symptoms of heart failure

Written by Liu Ying
Cardiology
Updated on September 17, 2024
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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.

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Written by Liu Ying
Cardiology
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Causes of chronic heart failure

Chronic heart failure is the terminal manifestation and leading cause of death in cardiovascular diseases. Although there has been significant progress in the treatment of heart failure in China, the number of deaths from heart failure continues to rise. Coronary artery disease and hypertension have become the main causes of chronic heart failure. Rheumatic heart disease and valvular heart disease are also causes of chronic heart failure. Valvular heart diseases, such as mitral stenosis, mitral regurgitation, aortic stenosis, aortic regurgitation, pulmonary valve diseases, and tricuspid valve diseases, can all lead to heart failure. Additionally, chronic pulmonary heart disease and high-altitude heart disease also have certain regional prevalences in China.

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Written by Zhang Yue Mei
Cardiology
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Treatment of Chronic Heart Failure

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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Clinical manifestations of chronic heart failure

Chronic heart failure primarily includes left heart failure, right heart failure, and total heart failure. Clinically, left heart failure is the most common. The clinical manifestations of left heart failure primarily involve pulmonary congestion and reduced cardiac output, which can present as varying degrees of dyspnea, such as exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Patients may experience coughing, expectoration, pink frothy sputum, fatigue, tiredness, dizziness, palpitations, and more. Right heart failure primarily manifests as gastrointestinal and liver congestion, causing abdominal distension, poor appetite, nausea, vomiting, and more. Total heart failure naturally includes the clinical manifestations of both left and right heart failure.

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Written by Liu Ying
Cardiology
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Causes of Heart Failure

Heart failure can be divided into acute heart failure and chronic heart failure. There are many causes of acute heart failure, such as acute coronary syndrome, hypertensive emergency, acute massive pulmonary embolism, right ventricular infarction, severe pulmonary hypertension, and so on. Chronic heart failure can also have many causes, for example, coronary artery disease and hypertension have become the main causes of chronic heart failure, rheumatic heart disease, and valvular heart disease can also cause chronic heart failure. Chronic cor pulmonale and high-altitude heart disease also have a certain incidence rate in China, among others.

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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.