"Strength" is not in line with "heart" - heart failure

Heart failure, as the last battlefield of heart disease, is becoming the most important cardiovascular disease. On the one hand, it is at the end of the cardiovascular event chain and is the serious and terminal stage of cardiovascular disease; on the other hand, the "last battlefield" also means that there are still many unresolved issues in the field of heart failure.

1. What is heart failure?

The heart is a "pump" that collects and discharges blood, like an engine that pushes blood to the whole body. When the heart load increases or the heart muscle is damaged, the heart is like a ball with reduced elasticity, the blood pumping function decreases, the output blood volume cannot meet the needs of organs and tissues, and the blood in the organs and tissues cannot flow back to the heart smoothly. We call this state heart failure, or "heart failure" for short.

2. What are the risk factors for heart failure?

(1) Infection: Respiratory tract infection is the most common and can aggravate pulmonary circulation congestion.

(2) Arrhythmia: Atrial fibrillation is the most common, and other types of arrhythmias can induce cardiac arrhythmia.

(3) Increased blood volume: such as excessive intake of sodium salt, excessive and rapid intravenous fluid infusion, etc.

(4) Excessive physical labor: fatigue or emotional excitement.

(5) Improper treatment: such as inappropriate discontinuation of diuretics or antihypertensive drugs.

(6) Exacerbation of existing heart disease or complications of other diseases: such as myocardial infarction due to coronary atherosclerotic heart disease, rheumatic activity due to rheumatic valvular heart disease, combined with hyperthyroidism or anemia, etc.

3. How to self-judge the extent of heart failure?

New York Heart Association (NYHA) heart function classification: The impaired heart function is divided into four levels according to the degree of activity that induces heart failure symptoms.

6-minute walk test: It is a good indicator for assessing the exercise endurance of patients with chronic heart failure. Patients are asked to walk as fast as possible in a straight corridor and the walking distance in 6 minutes is measured. If the walking distance is less than 150 meters, it indicates severe heart failure; 150-450 meters indicates moderate heart failure; more than 450 meters indicates mild heart failure.

4. What is the basis for activities for patients with heart failure?

(1) If you experience chest tightness and palpitations during strenuous activities, it indicates that your heart function is in stage I, and you should avoid participating in strenuous activities.

(2) During normal physical activities, if chest tightness or palpitations occur, it indicates that the heart function is in stage II. In this case, you should limit physical labor and increase rest time. You can adopt exercise methods such as walking, jogging, practicing Qigong, and Tai Chi.

(3) If chest tightness and palpitations occur during normal physical labor, it indicates that the heart function is at level III, and the time for bed rest should be increased.

(4) If you experience chest tightness and palpitations while lying in bed, it indicates that your heart function is at level IV. In this case, you must stay in bed and rest. However, this does not mean you should just lie in bed and not move. You can do leg muscle relaxation and contraction exercises frequently.

5. What should patients with heart failure pay attention to when they are active?

(1) Good mood: Depressed mood and excessive mental stress can increase the burden on the heart and affect heart health.

(2) Combine rest and activity: arrange your work and rest time reasonably, and take a lunch break of about one hour every day; do appropriate activities, and when exercising, you should control the degree so that you do not feel tired.

(3) Keep the indoor temperature constant: It is best to keep it around 20°C in winter. When using an electric fan in summer, avoid direct airflow. When using air conditioning, be careful not to make the temperature difference between indoor and outdoor too large.

(4) Indoor ventilation: In winter, the room should be ventilated at least twice a day, each time for half an hour, but you should pay attention to keeping yourself warm to avoid colds caused by air convection.

6. “In and out” in moderation - How do patients with heart failure control water intake and excretion?

Heart failure patients can prepare a graduated water cup and a measuring cup to accurately measure the amount of fluid they take in and excrete (mainly urine) every day. Heart failure patients should generally drink less than 1500mL (about the amount of 3 mineral water bottles) of water every day. When drinking water, they should swallow it slowly, one mouthful at a time. If they don't feel thirsty, they don't drink. It is very important for heart failure patients to monitor urine volume in the early stages of treatment. Use a measuring cup to measure the amount of urine each time, write down the value, and calculate the total for 24 hours, which is the daily fluid excretion.

7. Can patients with heart failure stop taking medication after being discharged from the hospital?

Heart failure cannot be cured fundamentally. Therefore, patients with heart failure need long-term oral medication. Depending on the improvement of the condition, some drugs can be reduced or even stopped, but this needs to be done according to the doctor's advice. Remember not to stop taking the drug on your own.

8. What should patients with heart failure pay attention to in their daily lives?

(1) Dietary adjustment: limit fluid intake; follow a low-salt diet, as excessive salt intake can cause sodium and water retention and worsen heart failure; follow a low-fat diet, control fat intake and avoid excessive calories; quit smoking and drinking; eat small meals frequently, especially don’t eat too much at dinner, so as not to increase the burden on the heart.

(2) Pay attention to self-monitoring: Patients with heart failure should pay attention to changes in their heart rate, blood pressure, urine volume, and weight. It is best to weigh yourself at the same time every day, observe whether your lower limbs are swollen, and whether you wake up from sleep at night. If you feel unwell, you should seek medical attention immediately.

(3) Regular follow-up: The treatment of heart failure is a long-term process. Regular follow-up should be performed according to the doctor's instructions and medication should be adjusted according to the situation.