內容目錄

Heart failure (referred to as “heart failure”) is the last battlefield of cardiovascular disease. It is also a serious challenge for cardiovascular science in the 21st century. In order to better raise the awareness and attention of the whole people on heart failure, November 26 every year is designated as “National Heart Failure Day”. Let’s learn about heart failure with the editor!

What is heart failure?

Heart failure is also called cardiac insufficiency, which is due to changes in the structure or function of the heart caused by various reasons, which makes the systolic or diastolic function of the heart dysfunction, and cannot fully discharge the venous return blood from the heart, resulting in blood stasis in the venous system and blood in the arterial system. Insufficient perfusion, which causes cardiac circulatory syndrome.

Heart failure is a serious stage in the development of cardiovascular disease. At this time, the pumping function of the heart declines, just like a “ball” with reduced elasticity, the blood output cannot meet the body’s metabolic needs, and the blood in the organs and tissues cannot smoothly flow back to the heart. Patients may experience dyspnea, fatigue, and edema (especially in the lower extremities).

What are the dangers of heart failure?

1. Heart failure is a progressive disease. With the development of the disease, the clinical symptoms will continue to increase, and even affect life.

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2. Heart failure will directly affect your social interaction, restrict daily activities, and bring about negative emotions such as depression and anxiety.

3. Heart failure will bring serious economic burden to oneself, family and society.

4. Patients with heart failure may need to be hospitalized frequently, and the mortality rate of heart failure is high.

What are the causes of heart failure?

1. All kinds of heart damage or pathological changes will lead to heart failure to a certain extent;

2. Coronary heart disease, heart disease Heart failure, hypertension, arrhythmia, etc. are common causes of heart failure;

3. Diabetes, obesity, metabolic syndrome, chronic bronchitis with emphysema, pulmonary embolism, etc. Disease can also lead to cardiac dysfunction.

4. Long-term alcohol abuse, drug abuse, and the application of certain drugs can also cause serious damage to the heart.

7 warning signs of heart failure

1. I don’t even have the strength to walk the dog

Shortness of breath and poor energy are two common symptoms of heart failure. Many patients become out of breath after just a few minutes of activity due to reduced heart function, which reduces blood flow to muscles and tissues. For many heart failure patients, gentle physical activity is beneficial and strengthens the heart. The stronger the heart, the more powerful the delivery.

2. Depression

The prevalence of depression in patients with heart failure is 2-3 times that of normal people. This is mainly because they are worried about their own health, worrying about dragging down their family and friends, and suffering from heart failure symptoms such as fatigue all day long. It is recommended that you communicate with your doctor more. Studies have shown that regular gentle physical exercise is not only good for the heart, but also makes the patient’s mentality more positive.

3. The shoes don’t fit well

Swollen feet and ankles are also common symptoms of heart failure. This is caused by fluid buildup from heart failure and decreased kidney function. It is usually relieved by lying down and resting for a while. For persistent swelling, or inexplicable weight gain, such as an increase of 1-2kg within 24 hours, it is necessary to seek medical treatment in time to find out the cause.

4. Add another pillow to sleep

People with heart failure may have difficulty breathing when lying down because of fluid buildup in the lungs. To alleviate this situation, it is recommended to add an extra pillow to support the body to a relatively vertical position, which helps breathing and makes the patient feel comfortable.

5. Difficulty falling asleep

Up to half of people with heart failure experience central sleep apnea, a sleep disorder caused by the brain’s inability to send Caused by the command of the muscle. The disease interrupts normal breathing and blocks oxygen to the brain, allowing the brain to quickly wake the sufferer from deep sleep.

6. I also want to wear gloves in the house

Patients with heart failure will feel cold all over and have cold hands and feet. This is because most of the available blood in their body goes to the brain and other vital organs, leading to poor peripheral blood circulation. Wearing warmer clothing, short walks and regular massages can improve blood circulation.

7. Unstoppable cough

Heart failure is often accompanied by persistent coughing and wheezing, another result of fluid buildup in the lungs. The exacerbation of cough and wheezing is usually a manifestation of heart failure, and it is also a warning that patients need to seek medical treatment in time.

How do patients with heart failure adjust their lifestyle?

1. Water restriction

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Heart failure can lead to water and sodium retention, which in turn can promote the appearance of heart failure symptoms. Therefore, patients with heart failure should control their water intake:

①Patients with severe heart failure, fluid intake Limit the amount to 1.5-2.0L/day, which helps to relieve symptoms and congestion;

② For patients with severe hyponatremia (serum sodium <130mmol/L), fluid intake The intake should be <2L/d;

③Patients with mild to moderate symptoms have no benefit from routine restriction of fluid intake.

2. Limit salt

Patients with heart failure should properly control their daily salt intake, which should be less than ordinary table salt. Those who take diuretics should not Salt restriction is required.

①Patients with mild heart failure (asymptomatic after exercise), limit the daily sodium intake to 2g , which is equivalent to 5g of table salt;

②Patients with moderate heart failure (shortness of breath may occur after mild activity), the daily intake of sodium salt is limited to 1g, which is equivalent to 2.5 g salt;

③ For patients with severe heart failure (wheezing heavily, unable to get out of bed, etc.), the daily intake of sodium salt is limited to 0.4g, which is equivalent to 1g of table salt.

3. Ensure protein intake

Heart failure is a highly heterogeneous disease, and patients include dyscrasia with loss of appetite population, including obese people with metabolic syndrome.

①Patients with cachexia or malnutrition should ensure adequate protein intake, daily protein intake The intake should be at least 1.1g/Kg.

②Patients with normal nutritional status should routinely ensure a daily protein intake of at least 0.8g/kg.

③ Obese patients with heart failure should formulate individualized weight loss plans and limit calorie intake. The routine recommended daily energy is 500-750Kcal, and the absolute value of energy intake is maintained at 1500-1800Kca (for men) and 1200-1500Kcal (for women).

4. Appropriate amount of trace elements

Due to loss of appetite, or diet control, patients with heart failure may be deficient in certain trace elements, including multivitamins, Calcium, phosphorus, etc., especially the lack of vitamin B1 (thiamine), will cause myocardial metabolic disorders, and then induce or aggravate heart failure.

5. Increase fiber intake and optimize intestinal flora distribution

Heart failure patients will cause intestinal wall edema due to circulatory congestion , Intestinal mucosal barrier dysfunction, translocation of intestinal flora occurs. A cohort study found that compared with the normal population, the flora that decomposes and produces butyramine in patients with chronic heart failure decreased significantly, and the change of this flora may be related to many diseases such as atherosclerosis, hypertension, chronic kidney disease, and diabetes. risk factors for heart failure.

In addition, the intestinal flora is also involved in the synthesis of many important biologically active substances, including carnitine, Trimethylamine, bile acids, and short-chain fatty acids. Studies have shown that trimethylamine oxide (TMAO), which is metabolized by intestinal flora after red meat intake, can participate in atherosclerosis and adverse myocardial remodeling, and high levels of TMAO are also independent predictors of adverse outcomes in patients with heart failure .

After ingesting cellulose, it is decomposed by intestinal flora to produce short-chain fatty acids (SCFA). It can participate in the regulation of inflammation, immunity and blood pressure, and can bring certain benefits to the clinical outcome of patients with heart failure.

6. Moderate exercise

Appropriate exercise can reduce the risk of heart failure, especially in certain high-risk groups, such as the elderly, debilitated heart failure Patients with multiple comorbidities and limited mobility.

Exercise prescription for heart failure patients

References:

[1]【CHFA】National Heart Failure Day 11.26—Guiding patients Understanding heart failure, early diagnosis and early treatment! . Heart Failure and Cardiomyopathy Network.

[2] Vigilance: Seven possible early warning signs of heart failure. Jianyi Health

[3] Ji Wenyang. The 72-year-old grandpa had a “cold” and was admitted to the intensive care unit? What should we know about heart failure? . Heart Road Stardust.

[4]AggarwalM, Bozkurt B, Panjrath G, et al. Lifestyle Modifications for Preventing and Treating Heart Failure. J Am Coll Cardiol.2018; 72( 19): 2391-2405.