Congestive Heart Failure
Definition
心脏不能泵出适量的血液 body. 这会导致血液在静脉中回流. 它会导致脂肪堆积过多 肺和脚等部位有液体.
随着时间的推移,心力衰竭会越来越严重. Vital organs can be damaged from low blood flow.
Blood Flow through the Heart |
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Causes
导致心力衰竭的主要原因有:
其他常见原因包括:
- 心脏瓣膜出现问题的原因:
- Rheumatic heart disease
- Bacterial endocarditis
- 先天缺陷出生时就有的缺陷
- Calcium deposits from atherosclerosis
- High blood pressure
- Diabetes
其他不太常见的原因包括:
- Cardiomyopathy—weakened, damaged heart muscle
- Some medicines
- Arrhythmias—abnormal heart beats
- Hyperthyroidism—overactive thyroid
- Amyloidosis
- Kidney or liver failure
- Thiamine ( vitamin B1) deficiency
Risk Factors
心力衰竭在老年人中更为常见. Other things that 增加心力衰竭风险的因素包括:
- Obesity
- 摄入过多的盐和脂肪
- Excess alcohol intake
- Smoking
- Pregnancy
- High fever
- Severe infection, such as pneumonia
- Chronic lung disease— emphysema
- Chemotherapy
- 心理健康问题,比如 depression or anxiety
Symptoms
Heart failure can cause:
- 呼吸短促——起初只在活动时发生,然后进展到 休息时呼吸短促的
- Unexplained weight gain
- 肿胀脚、脚踝或腿的肿胀
- Needing to sleep propped up
- Fatigue, weakness
- Wheezing
- Cough-可能是干的,也可能是湿的 听起来,可能有粉红色的,有泡沫的痰
- 尿频,尤指在夜间尿频
- Belly pain
Diagnosis
医生会询问症状和过去的健康状况. 会做一次身体检查. 医生可能会注意到由心力衰竭引起的变化,如腿部积液. 他们在听心音时也可能听到不正常的声音. 血液检查可以用来寻找心脏变化的某些标志.
测试可以帮助显示心脏的哪些部分受到了影响. They 也能显示出血流的变化吗. This can be done with:
- ECG
- Echocardiogram
- Nuclear scanning
- Coronary angiography
- Exercise stress test
医生将使用测试结果来确定心力衰竭的程度. This will help guide the treatment plan.
Treatment
治疗的目的是防止症状恶化. Treatment can ease 改善症状和生活质量. 有些人的心脏也会有所改善 strength. 心力衰竭需要终生护理.
治疗方法因人而异,因人而异. 每天追踪体重和症状会 help catch changes early. 快速治疗这些变化可能有助于防止心力衰竭 getting worse.
心力衰竭可能是由其他健康问题引起的. 治疗这个问题可能会改善心力衰竭或防止病情恶化. 对于任何形式的心力衰竭,治疗可能包括:
Medications
减轻心脏负荷的药物可以通过:
- Widening blood vessels
- Helping the heart pump
- 减慢心率,降低 blood pressure
- Removing excess fluid
- Reducing cholesterol levels
Lifestyle Changes
日常习惯会影响心脏健康. Changes that may help 缓解心脏压力的方法包括:
- Quitting smoking
- Eating a heart healthy diet that is low in fat, high in fiber她有很多蔬菜和水果
- Reducing salt intake
- Working out regularly
- Keeping a healthy weight
- 避免酒精或可能对心脏造成压力的娱乐性药物
- 管理和减轻压力
Heart Support and Surgery
心力衰竭可引起心律问题,或因心律问题而恶化. A defibrillator or pacemaker may be implanted. 如果心脏开始有危险,他们会电击 rhythms.
其他设备可以帮助支持心脏. 他们可能在短时间内需要帮助 从受伤或疾病中恢复. 它们也可能在最后阶段支持心脏 心脏衰竭的危险,直到可以进行移植手术. 这些设备增加了 血液被输送到身体,而没有使心脏更加努力地工作. Examples include:
- 主动脉内气囊泵(IABP)
- Ventricular assist device
严重的心力衰竭可能需要心脏移植,如果有其他治疗方法 not helped.
Prevention
预防心力衰竭的最好方法是降低风险 心脏病、高血压和糖尿病. General steps include:
- 每周运动150分钟
- Quitting smoking
- Limiting alcohol
- Maintaining a healthy weight
- Eating a healthy diet
References
- 充血性心力衰竭和先天性缺陷. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Congestive-Heart-Failure%5FUCM%5F307111%5FArticle.jsp#.Wbk5j7KGNQJ.
- Explore heart failure. 全国心脏、肺和血液协会 Institute website. Available at: http://www.nhlbi.nih.gov /健康/健康话题/主题/高频.
- 心力衰竭伴射血分数降低(HFrEF). EBSCO DynaMed website. Available at: http://www.dynamed.com/condition/heart-failure-with-reduced-ejection-fraction-hfref.
- 改变生活方式导致心力衰竭. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Lifestyle-Changes-for-Heart-Failure%5FUCM%5F306341%5FArticle.jsp#.Wbk6sbKGNQJ.
- Paterna, S., Parrinello, G., et al. Medium term effects of 不同剂量的利尿剂、钠和液体给药对神经激素和 近期代偿性心力衰竭患者的临床结局. American Journal of Cardiology, 2009; 103 (1): 93-102.
- Physical changes to report. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Physical-Changes-to-Report%5FUCM%5F306356%5FArticle.jsp#.Wbk69LKGNQI.
- Yancy, C.W., Jessup, M., et al. 2013 ACCF/AHA guideline for 心力衰竭的管理:美国心脏病学会的一份报告 基金会/美国心脏协会实践指南工作组. Journal of the American College of Cardiology, 2013; 62 (16): e147-e239.
- 4/2/2014动态系统文献监测 http://www.dynamed.http://www.qualityimprovement/choo-wisely/2015年7月23日更新.
- 2017.1/18动态系统文献监测 http://www.dynamed.Emdin, C.A., Odutayo, A., et al. 焦虑作为心血管疾病危险因素的荟萃分析. American Journal of Cardiology, 2016; 118 (4): 511-519.