Causes of acute heart failure

The article was professionally consulted by Specialist Doctor II Nguyen Quoc Viet - Interventional Cardiologist - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.

Acute heart failure is the sudden onset of signs and symptoms of heart failure that requires urgent intervention. Besides the causes of acute heart failure, other predisposing factors may play a role in making the condition worse.

Acute heart failure is a complex clinical syndrome with symptoms of pulmonary congestion (acute pulmonary edema) and decreased cardiac output (cardiogenic shock). Symptoms on admission include either first-onset (in 20%) or recurrent (80% in acute decompensated heart failure against a background of chronic heart failure), or even no comorbidities. acute heart failure.
This disease can occur with reduced left ventricular function, also known as reduced EF or systolic heart failure. In addition, acute heart failure also occurs in patients with preserved left ventricular ejection fraction (diastolic heart failure). Approximately more than 50% of patients hospitalized for acute heart failure have a preserved ejection fraction.
According to epidemiological statistics on acute heart failure, each year there are more than 1 million hospitalizations due to acute heart failure, common among people over 65 - 70 years old with a history of cardiovascular disease, with a mortality rate within 1 year. year is 20%. In addition, patients are also more likely to be re-hospitalized after 30 days due to worsening of heart failure.

Acute heart failure is caused by myocardial cell dysfunction or destruction by myocardial inflammation or infiltration, or as a result of congenital diseases. Toxins and certain drugs can also cause myocardial damage. The scar tissue formed to replace the dead cells seriously affects the function of the heart muscle, manifesting in movement disorders or even inactivity of the heart walls.
The specific causes of acute heart failure are:
Acute coronary syndrome: Myocardial ischemia, injury or myocardial infarction; Mechanical complications of acute myocardial infarction: Interventricular septal perforation, acute mitral regurgitation and left ventricular rupture; Cardiac arrhythmias: Tachycardia (atrial fibrillation), bradycardia (third degree AV block); Cardiac tamponade; Acute pulmonary embolism; Heart valve damage: Valve tear, ulnar muscle rupture, aortic dissection, or prosthetic valve dysfunction. Acute or chronic renal failure in patients with pre-existing heart disease.

3.1. Rapidly worsening heart failure Events that result in rapid worsening of heart failure include:
Severe arrhythmias (fast/slow); Conduction disturbances; Acute coronary syndromes and complications, such as: Rupture of the interventricular septum or rupture of the mitral valve ligament; Acute pulmonary embolism; Acute hypertensive crisis; Cardiac tamponade; Aortic dissection; Surgery and some perioperative problems; Perinatal cardiomyopathy (Pregnancy and labor). 3.2. Worsening Heart Failure There are also a number of other events that are likely to slowly worsen heart failure, such as:
Cardiovascular: Infective endocarditis; Tachycardia / bradycardia, conduction disturbance but not sudden decrease in heart rate; Uncontrolled hypertension. Non-cardiovascular: Exacerbation of chronic obstructive pulmonary disease or bronchial asthma; Anemia; Kidney failure... By patient or doctor: Failure to adhere to diet or medication; a non-steroidal anti-inflammatory drug or corticosteroid; Adverse drug interactions; Addiction to alcohol and drugs. The causes of acute heart failure and the predisposing factors associated with acute heart failure may also include infection and febrile states, hyperthyroidism or hypothyroidism, physical or psychological stress, salt intake and increased imports, or due to surgery, ...

To determine the status of heart failure, the degree of heart failure, the cause of the heart failure, and comorbidities, patients can choose the Heart Failure Examination Package at Vinmec International General Hospital. Subjects who should be screened for cardiovascular disease annually include:
Group 1: Customers who have no symptoms of heart failure but have other cardiovascular diseases (hypertension, angina, diabetes, dysrhythmias). heartbeat, ... ). Or people in middle age (men ≥ 45 years old, women ≥ 50 years old), especially those with tobacco addiction, alcohol abuse or obesity. Group 2: People with common symptoms of heart failure such as shortness of breath, shortness of breath, persistent dry cough, feeling like body weakness, heaviness in the chest, dizziness, dizziness, fainting spells, pulse heart failure, edema, little urine, liver irritation, swollen neck veins,... When choosing to use the Heart Failure package at Vinmec International General Hospital, customers will be examined by Cardiology specialist, general practitioner. blood and urine cell analysis, quantification and measurement of substance activity in the blood, electrocardiogram, routine and stress echocardiography, chest x-ray along with a number of other services.