First Aid and Medical Treatment for Acute Heart Failure

Source: Life Times

Speaker: Wang Yulong, Associate Chief Physician of the Department of Cardiovascular Diseases, Bozhou Hospital of Traditional Chinese Medicine, Anhui Province

The heart acts as the "power pump" of the human body. When this "pump" suddenly fails to work properly and blood cannot circulate smoothly, acute heart failure (hereinafter referred to as "acute heart failure") will occur. Acute heart failure has a sudden onset and progresses rapidly. If the family does not respond properly or delays medical treatment, it will easily endanger life. People with a history of heart disease, hypertension, diabetes and other underlying diseases, as well as their family members, mastering correct first aid and medical treatment knowledge can play an important role in saving lives and optimizing the prognosis.

1.Identify the Signals: Grasp the Early Manifestations of Critical Conditions‌

First, it is necessary to accurately identify the typical signals of acute heart failure, which is the premise of correct response. When an acute heart failure attack occurs, the core manifestation is "shortness of breath", especially when sleeping at night, the patient may suddenly wake up due to suffocation, and need to sit up to barely breathe. At the same time, it may be accompanied by symptoms such as chest tightness, chest pain, palpitation, dizziness, and fatigue. Some patients may also have a cough, and the sputum coughed up is mostly white and foamy. In severe cases, pink foamy sputum may appear, which is a sign of critical condition. In addition, lower limb edema, sudden decrease in urine output and other conditions may also be early warning signals of acute heart failure attack. Once found, vigilance should be raised immediately.

2.Home Management: Correct Rescue to Win Time‌

After finding suspected symptoms of acute heart failure, correct handling methods can effectively relieve the condition and win time for medical treatment. First of all, keep the patient's respiratory tract unobstructed, immediately untie the restraints such as the patient's collar and belt, let the patient take a semi-recumbent position or sitting position with legs hanging down naturally, which can reduce the amount of blood returning to the heart, reduce the burden on the heart, and relieve dyspnea. Remember not to let the patient lie flat, in case the amount of blood returning to the heart increases, which will aggravate the burden on the heart and lead to deterioration of the condition. Secondly, keep the room quiet and well-ventilated to avoid noisy environments stimulating the patient.

If the patient carries first-aid drugs such as nitroglycerin, they can use it correctly under the guidance of a doctor, but attention should be paid to the applicable population and contraindications of the drug, and nitroglycerin is forbidden for patients with hypotension. If the patient suffers respiratory and cardiac arrest, the family members should immediately perform cardiopulmonary resuscitation and call the emergency number at the same time. While waiting for the ambulance, the family members should closely observe the patient's consciousness, breathing, pulse and other conditions, and do not move the patient at will, unless it is necessary to evacuate from a dangerous environment. When moving, pay attention to keeping the patient's body stable and avoid violent shaking.

3.Timely Medical Treatment: Convey First Aid Requests Standardly‌

While taking family response measures, it is necessary to call the emergency number immediately. Delayed medical treatment is one of the important reasons for the high mortality rate of acute heart failure. When calling the emergency number, clearly state the patient's symptoms, location, underlying medical history and other information, so that the first-aid personnel can quickly prepare first-aid equipment and drugs. While waiting for the ambulance, sort out the patient's medical records, examination reports, commonly used drugs, etc. in advance, so that they can be handed over to the doctor in time after arriving at the hospital, helping the doctor quickly understand the patient's condition.

It should be specially noted that when acute heart failure attacks, do not drive the patient to the hospital by yourself. On the one hand, the patient's condition may suddenly deteriorate on the way, and the car lacks professional first-aid equipment and personnel, so timely rescue cannot be carried out; on the other hand, family members may make driving mistakes due to emotional tension in emergency situations, causing traffic accidents and delaying treatment. Therefore, you should call the emergency number and wait for professional first-aid personnel to send the patient to the hospital.

4.Traditional Chinese Medicine Assistance: Relieve Symptoms and Alleviate the Condition‌

From the perspective of traditional Chinese medicine (TCM), acute heart failure falls into the categories of "heart failure disease", "dyspnea syndrome", "edema", etc. Its onset is mostly caused by deficiency of healthy qi, phlegm and blood stasis blocking collaterals, internal retention of water dampness. Under the inducements such as emotional stimulation, overwork, and contraction of external pathogenic factors, it will lead to sudden collapse of heart yang and disorder of qi movement. In the first aid of acute heart failure, TCM emphasizes "treating the symptoms in case of acute conditions", taking restoring yang to rescue from collapse, benefiting qi to relieve asthma, and promoting diuresis to reduce edema as the core principles. It can be used as an auxiliary means of Western medicine first aid, but it must be carried out under the guidance of professional TCM physicians.

While waiting for the ambulance, if conditions permit, family members can use simple TCM auxiliary conditioning methods under the guidance of professional physicians to relieve symptoms. For example, for patients with chest tightness and dyspnea, Neiguan acupoint (located 2 cun above the transverse wrist crease, between the two tendons) can be pressed with moderate force for 3 to 5 minutes each time, which can calm the mind and soothe the chest. In addition, it is very important to keep the patient's mood stable. TCM believes that "anger injures the liver" and "overthinking injures the spleen", and bad emotions will aggravate the disorder of qi movement. Family members should comfort the patient in time to avoid emotional excitement, and maintaining a peaceful state of mind helps to relieve the condition.

It needs to be emphasized that TCM auxiliary conditioning can only relieve some symptoms and cannot replace Western medicine first-aid measures. Acute heart failure is a critical illness, and the final treatment must be carried out in the hospital. Doctors will take treatment measures such as oxygen inhalation, diuresis, vasodilation, and application of positive inotropic drugs according to the patient's condition. If necessary, advanced life support such as mechanical ventilation and blood purification will be carried out. For patients with underlying heart diseases, they can receive syndrome differentiation conditioning under the guidance of TCM physicians in daily life, such as taking TCM herbs that can tonify qi, activate blood circulation and promote diuresis, cooperating with acupuncture, moxibustion and other appropriate TCM techniques to enhance physical fitness, stabilize the condition and reduce the number of acute heart failure attacks.

Disclaimer: The information in this article is for popular science reference only and does not constitute medical diagnosis advice.