heart failure
Introduction
Introduction Heart failure is also called congestive heart failure or cardiac insufficiency. The heart is weakened by disease, overwork, and blood discharge, and the amount of blood discharged cannot meet the needs of organ and tissue metabolism. The main symptoms are difficulty breathing, wheezing, edema, etc. As the myocardial contractility weakens, the cardiac output decreases so that the amount of tissue and organ perfusion is insufficient and the pulmonary circulation or systemic blood stasis appears. Heart failure is not an independent disease, it is a serious stage of heart disease caused by various causes. The incidence is high and the five-year survival rate is similar to that of malignant tumors. Heart failure is due to initial myocardial damage and stress: including systolic or diastolic ventricular overload, changes in the number and quality of myocardial cells (staged such as myocardial infarction, diffuse such as myocarditis), causing the ventricle and/or atrium Hypertrophy and enlargement, ventricular remodeling, followed by ventricular relaxation and contraction function, gradually developed. Heart valve disease, coronary arteriosclerosis, hypertension, endocrine disorders, bacterial toxins, acute pulmonary infarction, emphysema or other chronic lung disorders can cause heart failure and produce heart failure. Pregnancy, fatigue, rapid intravenous rehydration, etc. can all increase the burden of the diseased heart and induce heart failure.
Cause
Cause
1. Heart failure refers to heart failure caused by contraction dysfunction of primary cardiac myofibrils. At this time, the dysfunction of the pump is primary. Heart failure occurs when the myocardium contracts due to various reasons and cannot deliver enough blood to the peripheral blood vessels to be required for systemic tissue metabolism.
2. Heart failure caused by other causes. In the case of valvular heart disease, cardiac hypertrophy and cardiac enlargement occur due to excessive myocardial overload, followed by myocardial contractility due to relatively insufficient myocardial contractility. At this time, the dysfunction of the pump is secondary and is easily reversed when the valve is removed.
3. Heart failure caused by causes other than myocardium, often accompanied by myocardial damage in the late stage.
4. In addition to diseases of the heart itself, such as congenital heart disease, myocarditis, cardiomyopathy, severe arrhythmia, endocarditis, etc., diseases other than the heart, such as acute nephritis, toxic pneumonia, severe anemia, hemolysis, massive veins Rehydration and complications after surgery can also cause heart failure.
Examine
an examination
Related inspection
Cardiopulmonary exercise test (CPET) urinary specific gravity urinary myoglobin (UMb) urinary myoglobin blood oxygen content
1. Pay attention to the cause of heart failure and the presence or absence of symptoms and signs of lung or (and) systemic blood stasis, and check according to the general routine of cardiovascular disease.
2. Complete venous pressure, erythrocyte sedimentation rate, liver and kidney function tests within 2 days after admission. Long-term low-salt diet or diuretics should be checked regularly for potassium, sodium, chlorine, and magnesium.
3. It is proposed to distinguish left heart, right heart or whole heart failure according to clinical manifestations and examinations, and determine the level of heart failure.
Diagnosis
Differential diagnosis
It should be differentiated from the following symptoms:
Neonatal heart failure
Neonatal heart failure (heart failure) is one of the most common critical illnesses in neonates. The disease develops rapidly, the clinical manifestations are atypical, and the performance of the older children is also very different. It is easy to be confused with other diseases, and it is difficult to diagnose in time. Delaying the disease, it is necessary to raise awareness and vigilance against heart failure, early diagnosis and active treatment.
2. Renal artery stenosis
The severity of renal artery stenosis varies from obvious renal artery stenosis to clinically small stenosis of renal artery lesions.
3. Sitting and breathing
It refers to the state in which the patient is forced to take a sitting position or a semi-recumbent position in order to reduce breathing difficulties. This is a more serious manifestation of heart failure, and there is obvious pulmonary congestion in the presence of sitting breathing.
