What Is Cardiac Insufficiency?

Cardiac insufficiency is due to a variety of reasons leading to a decrease in the contractile function of the myocardium, reducing the forward bleeding of the heart, and causing symptoms of blood stasis in the systemic circulation or pulmonary circulation. With the deepening of basic and clinical research on cardiac insufficiency, cardiac insufficiency is no longer considered as a simple hemodynamic disorder, and more importantly, the participation of multiple neurohumoral factors has promoted the continuous development of cardiac insufficiency. Clinical syndrome. The new concept believes that cardiac dysfunction can be divided into asymptomatic and symptomatic stages. The former has objective evidence of ventricular dysfunction (such as decreased left ventricular ejection fraction), but has no symptoms of typical congestive heart failure, and cardiac function is still in New York. The Grade I of the Cardiac Society (NY-HA) is a pre-stage of symptomatic heart failure. Sooner or later, symptomatic heart dysfunction will develop without effective treatment.

Basic Information

English name

cardiac insufficiency

Visiting department

Cardiology

Common causes

Reduced primary myocardial contractility and overloaded heart

Common symptoms

Palpitations, shortness of breath, dyspnea, venous irritation, hepatomegaly, oliguria, etc.

Causes of cardiac insufficiency

1. Reduced primary myocardial contractility

Such as various myocarditis, cardiomyopathy and ischemic heart disease.

2. Heart overload

Including the front load (capacity load) and after load (resistance load) are too heavy. Long-term overload can cause secondary weakening of myocardial contractility.

Classification of cardiac insufficiency

There are various classification criteria for cardiac insufficiency. According to the development process, it can be divided into acute cardiac insufficiency and chronic cardiac insufficiency. According to the location of the attack, it can be divided into left ventricular insufficiency, right ventricular insufficiency, and total ventricular insufficiency. The basic principles can be divided into systolic insufficiency and diastolic dysfunction and cardiac insufficiency.

Clinical manifestations of cardiac insufficiency

Cardiac insufficiency is often accompanied by palpitations, shortness of breath, dyspnea, venous bulging, liver enlargement, and oliguria.

The clinical manifestations of left ventricular dysfunction include pulmonary congestion, inability to lie flat, and dyspnea. As a result of decreased forward bleeding, limb weakness, dizziness, palpitation after exercise, and shortness of breath occur.

The clinical manifestations of right ventricular dysfunction include swelling of the lower limbs, abdominal distension, hepatosplenic congestion, and even pleural effusion and ascites.

Diagnosis of cardiac insufficiency

Can be diagnosed based on clinical manifestations and related examinations. The diagnosis of left heart failure is based on the signs of preexisting heart disease and the manifestation of pulmonary congestion. The diagnosis of right heart failure is based on the signs of the original heart disease and the signs of systemic congestion, and most patients have a history of left heart failure.

Cardiac Insufficiency Treatment

General treatment

(L) Remove or alleviate the underlying cause. All patients with heart failure should be evaluated for the underlying cause of heart failure. All patients with primary valvular disease with heart failure NYHAII and above, aortic disease with syncope, and heart pain should be repaired or valve replacement. Patients with ischemic cardiomyopathy and heart failure are associated with angina pectoris and patients with low left ventricular function but confirmed to have viable myocardium. Coronary vascular reconstruction is expected to improve cardiac function. Others include the effective control of hypertension, hyperthyroidism treatment, and surgical correction of wall tumors.

(2) Improve lifestyles and reduce the risk of new heart damage, such as quitting smoking and alcohol. Obese patients should lose weight. Control of hypertension and diabetes. Low-salt, low-fat diets, severe heart failure patients should limit the amount of human water and weigh daily to detect fluid retention early.

(3) Closely observe the evolution of the condition and follow up regularly

(4) Avoid the use of certain drugs Non-carrier anti-inflammatory drugs such as indomethacin, class I antiarrhythmic drugs and most calcium antagonists should be avoided.

(5) Other incentives to eliminate heart failure, such as controlling infection, treating arrhythmia, especially atrial fibrillation with rapid ventricular rate; correcting anemia, electrolyte disturbance, and attention to whether pulmonary infarction is complicated.

2. Drug treatment

(1) Cardiotonics such as digitalis, lanolin C, and lanolin K. Prevent drug poisoning.

(2) Diuretics Diuretics can cause electrolyte disturbances. Monitor changes in serum potassium when used. If patients have hypokalemia, they should be given foods with elevated levels such as bananas, citrus, dark vegetables, etc., and potassium salts should be added if necessary.

(3) Vasodilators such as nitroglycerin.

(4) Rest For patients with chronic cardiac insufficiency, proper rest is a method to reduce the load on the heart. Reducing the amount of activity can reduce the load on the heart and restore the heart. Depending on the condition, patients can be assisted to take a walk near the bed or indoors to strengthen their functional exercise, and avoid venous thrombosis, pulmonary embolism, epidemic pneumonia, indigestion, muscle atrophy, etc. that may be caused by prolonged bed rest.