Heart, as a “power pump” for the human body, transmits blood to the organs of the body day and night. However, when heart function is gradually impaired and chronic heart failure occurs, it causes great distress and threats to the lives of patients.
Chronic heart failure is a clinical syndrome caused by cardiac structure and functional abnormalities caused by various heart diseases that prevent the heart from effectively pumping the blood out to meet the needs of the body. In short, the heart’s “capacity to work” has declined and it is not able to perform its tasks properly.
Chronic heart failure can be divided into left heart failure, right heart failure and whole heart failure. The main signs of left heart failure are respiratory difficulties, cough, cough and inactivity, with pulmonary oedema in serious cases; the main manifestations of right heart failure are circulatory haematosis, which is as follows: amputation, abdominal swelling, liver swelling, etc.; and whole heart failure with symptoms of left heart failure and right heart failure.
I. Symptoms of chronic heart failure
1. Respiratory difficulties
This is one of the most common symptoms of chronic heart failure. Early periods may occur after physical activity, and as the condition increases, it can be difficult to breathe as it evolves to rest. In serious cases, the patient may appear to sit and breathe at the end, i.e. to sit and not to lie down.
2. Inadequate and exhausted
As a result of the decline in heart function, there is insufficient blood supply for the organs of the body, resulting in a feeling of weakness and fatigue. Even in a state of rest, there is a feeling of lack of strength and a marked decrease in activity endurance.
3 Euphoria
When the right heart collapses, the circulation of blood causes an oedema to the lower limb. Eedema usually spread upwards from ankles. In serious cases, there may be edema, even with abdominal, chest, etc.
4. Cough and cough
When left heart failure, circulatory blood causes cough and cough. Coughs tend to occur at night and in severe cases can cough pink foam, which is typical of acute pulmonary oedema.
Five. Desperate appetite and vomiting.
In the case of right heart failure, gastrointestinal silting affects digestive function, leading to symptoms such as appetite failure, nausea and vomiting.
Six. Heartbreak and panic.
When heart function is impaired, the heart rate may accelerate or suffer from heart disorder, and the patient may feel consternation and panic.
II. Causes of chronic heart failure
1. Coronary heart disease
Coronary heart disease is one of the most common causes of chronic heart failure. The sclerosis of coronary porridge results in a lack of blood supply to the heart, chronic myocardial insinuation of oxygen, gradual cardiac necrosis and fibrosis leading to a decrease in heart function.
High blood pressure
Long-term high blood pressure increases the heart burden, increases the size of the heart and eventually causes heart failure. According to statistics, the risk of heart failure for patients with hypertension is 2-3 times higher than for normal people.
3. Cardiac disease
Various types of cardiovascular diseases, such as amphibious cardiac disease and fat cardiac disease, affect the structure and functioning of the heart and cause chronic heart failure.
Heart valve disease
A narrow or incomplete heart valve can alter the blood flow mechanics of the heart, increase the burden of the heart and cause heart failure over time.
Diabetes
Chronic high blood sugar can damage heart vessels and myocardial cells and increase the risk of heart failure.
Lung diseases, such as chronic obstructive pulmonary diseases and pulmonary diseases such as pulmonary embolism, can lead to high pulmonary artery, thus affecting the right heart function and causing right heart failure.
III. Diagnosis of chronic heart failure
1 Symptoms and signs
The doctor makes a preliminary determination as to whether the patient is likely to suffer from chronic heart failure on the basis of symptoms such as respiratory difficulties, lack of strength, oedema etc., as well as signs such as expansion of the heart, acceleration of the heart rate, pulmonary lardering, cardiac arrhythmia etc.
Laboratory inspection
(1) Blood examination: including blood protocol, liver and kidney function, electrolyte, sodium brain (BNP) etc. BNP is an important indicator for the diagnosis of heart failure, with elevated levels suggesting that heart failure may exist.
(2) EKG: Helps the doctor to determine whether there is a heart disorder, myocardiosis, etc.
3. Visual inspection
(1) Ultrasound Cardiac Motion: This is an important means of diagnosing chronic heart failure, providing a visual representation of the structure and function of the heart, measuring the size of the heart, the thickness of the room wall, the condition of the valve and the parameters of the heart function.
(2) Chest X-line: can observe the size, morphology and lung of the heart and help to determine whether pulmonary oedema exists, etc.
(3) Magnetic resonance of the heart (MRI): MRI can provide more detailed information on the structure and function of the heart.
Treatment for chronic heart failure
General treatment
(1) Lifestyle adjustment: Patients should be careful to rest and avoid overwork and intense exercise. Reducing sodium salt intake and avoiding heavy drinking water. Stop smoking and keep a good mind.
(2) Treatment of causes of illness: active treatment of congenital diseases such as control of hypertension, diabetes, treatment of coronary heart disease, heart valve disease, etc.
2. Drug treatment
(1) Urine: can reduce heart burden and oedema symptoms.
Angiogen conversion enzyme inhibitor (ACEI) and angiogen II receptor (ARB): can inhibit renal-vascular stressor-dehydesterone systems, reduce post-heart load and improve heart function.
(2) Beta receptor retardant: can slow down the heart rate, reduce the oxygen consumption of myocardial muscles and improve heart function.
(3) Accumulative receptor: can inhibit the effect of formaldehyde and reduce the reorganisation of the heart.
(4) Positive muscular drugs: For people with severe heart failure, positive muscular drugs, such as yellow oceanic drugs, can be used to enhance myocardial contraction.
3. Non-pharmacological treatment
(1) Cardiac resynchronisation treatment (CRT): For certain chronic heart failure patients, CRT can improve heart function by adjusting the heart ‘ s electrical activity to make it more coherent.
(2) ICD: For chronic heart failure patients at risk of sudden death, ICDs can automatically discharge, restore and prevent sudden death when there is a severe heart disorder.
Prevention of chronic heart failure
Actively treating pre-existing diseases such as hypertension, coronary heart disease, diabetes, etc.
Maintaining a healthy lifestyle: reasonable diet, adequate exercise, cessation of alcohol, weight control and avoidance of excessive stress.
2. Periodic medical examinations: especially for high-risk groups such as the family history of heart disease, hypertension, diabetes, etc., there should be regular cardiac examinations to detect heart problems at an early stage and to treat them in a timely manner.
For chronic heart failure, we need to give high priority to the importance of understanding its symptoms, causes, periodic medical examinations, etc., in protecting the heart ‘ s health and preventing the occurrence of chronic heart failure.
References:
1 Inner Science, author: Ghumbo et al., Press: People ‘ s Health Press
“Diagnosis and progress of treatment for chronic heart failure”, Chinese Journal of Cardiovascular Diseases
