Causes of chronic heart failure

Written by Liu Ying
Cardiology
Updated on September 04, 2024
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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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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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Can people with chronic heart failure smoke?

Patients with chronic heart failure should not smoke, as smoking can enhance the excitability of the sympathetic nervous system. Increased excitability of the sympathetic nervous system releases norepinephrine, elevating norepinephrine levels. This can cause peripheral vasoconstriction, increase the afterload on the heart, and accelerate heart rate. Both of these effects can increase myocardial oxygen consumption. Furthermore, norepinephrine has a direct toxic effect on myocardial cells, promoting myocardial cell apoptosis and participating in the pathological process of ventricular remodeling. Moreover, excitement of the sympathetic nervous system can also enhance myocardial stress, potentially promoting the occurrence of arrhythmias. Therefore, patients with chronic heart failure should not smoke.

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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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What medicine is used for chronic heart failure?

Chronic heart failure is also relatively common in clinical practice. The treatment of heart failure mainly includes preventing and delaying the onset of heart failure, alleviating the symptoms of clinical heart failure patients, improving the long-term prognosis of patients, and reducing mortality. These are the treatment principles for heart failure. After the occurrence of heart failure, its treatment mainly includes the treatment of the basic etiology, as well as the elimination of various precipitating factors, such as infections, etc. The pharmacological treatment mainly includes several aspects: first, the use of diuretics; second, the use of renin, angiotensin, and aldosterone system inhibitors; third, the use of receptor blockers; and fourth, the correct use of positive inotropic drugs, etc. Heart failure can alleviate the clinical symptoms of patients through pharmacological treatments.

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Written by Wang Li Bing
Intensive Care Medicine Department
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How is heart failure treated?

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.