Why do patients with heart failure need to limit drinking water? Why do patients with heart failure have water retention 1? What is heart failure?
2. What are the consequences of decreased cardiac ejection capacity?
To sum up, the water in patients with heart failure cannot be discharged, so it is natural to limit drinking water, otherwise it will be worse.
But it should be noted that all patients with heart failure, no matter the severity, should strictly limit drinking water? This is obviously unscientific. Heart failure is also light and heavy. Without principles, it is unscientific and cruel to patients to restrict drinking water with eyebrows and beards.
1, there is no need to restrict drinking water.
2. Limit the need for drinking water.
I often meet all kinds of heart patients when I make rounds, and sometimes I ask more questions about people with severe heart failure: How much water did you drink and how much did you pee today? Even if it is a serious situation, it is necessary to record in detail the amount of in and out, that is, how much you have eaten, how much you have drunk and how much you have peed.
Sometimes people without heart failure will ask: Doctor, why don't you ask me how much I ate, how much I drank and how much I peed? Don't value me?
That's not true.
Because not all heart diseases ask you how much you drink and how much you pee.
1. There are many kinds of heart diseases.
Heart disease is a big concept, not the name of a disease. All heart-related diseases can be called heart disease. The most common heart diseases are coronary heart disease, arrhythmia, valvular heart disease related to heart valve and cardiomyopathy related to heart and myocardium.
Specific coronary heart disease is divided into fatigue angina pectoris, unstable angina pectoris, myocardial infarction, asymptomatic coronary heart disease, heart failure and so on. Arrhythmia can be divided into tachyarrhythmia and chronic arrhythmia, in which tachyarrhythmia includes atrial fibrillation, atrial tachycardia, ventricular tachycardia, sinus tachycardia and ventricular fibrillation. Chronic arrhythmia includes sick sinus, atrioventricular block and sinus bradycardia. Cardiac valvular diseases include primary, secondary, senile and rheumatic diseases. Cardiomyopathy can be divided into alcoholic cardiomyopathy, ischemic cardiomyopathy, dilated cardiomyopathy and hypertrophic cardiomyopathy.
Third, what is heart failure?
Heart failure is not strictly the name of a heart disease, but a syndrome, which is the result of various heart disease syndromes.
Most heart diseases may develop into heart failure if they are not treated actively and formally.
For example, long-term uncontrolled hypertension leads to heart enlargement and heart failure;
For example, the treatment of coronary heart disease is not standardized, and long-term ischemia will lead to heart enlargement and heart failure;
For example, if the area of myocardial infarction is large, or the blood vessels are not opened in time at night, it will lead to heart enlargement and heart failure;
For example, various arrhythmias, if not controlled in time, will also lead to heart enlargement and long-term heart failure;
For example, progressive valvular heart disease, such as various cardiomyopathy, will develop into heart failure.
Heart failure is simply the function failure and heart failure after the heart expands.
The most typical symptoms of heart failure are chest tightness, dyspnea, edema of lower limbs and abdominal distension.
The five-year mortality rate of chronic heart failure is 50%, and the one-year mortality rate of severe heart failure is 50%.
One of the main reasons of heart failure is that there is more water in the body, and the total amount of water intake is greater than the water discharged, which will naturally leave more and more water in the body. All this water needs the heart to metabolize, so it will increase the burden on the heart. The heart itself has failed. At this time, increasing the workload of the heart will undoubtedly make matters worse. More and more water will naturally induce the aggravation of heart failure. Even induce acute heart failure, leading to death.
The most accurate way is to weigh yourself, that is, weigh yourself every day to see if you have gained weight. If it is heavier, it means that there is more water in the body. It is necessary to increase diuretics, excrete more, drink less alcohol and reduce intake.
However, this does not mean that people with heart failure should limit drinking water. At the very least, they should ensure that human body water is the most basic life guarantee, not afraid to drink it. If the water quality cannot be guaranteed to be normal, new problems will arise. As long as we don't drink more water on purpose.
Of course, everyone is not used to weighing. Simply put, it depends on the amount of urine. Less urine means too much water in your body. You need to supplement diuretics or reduce the amount of water you drink appropriately.
If you find that your feet are swollen, or your lower limbs are swollen, it means there is a lot of water in your body. Be sure to see a doctor and find a professional doctor to adjust the treatment.
In the sultry summer, a coma uncle came to the emergency department. According to the family's dictation, this uncle has been suffering from heart disease. After playing Taiji in the morning, he felt thirsty and drank a glass of water. Suddenly, he felt chest tightness and flustered, sat up and gasped, sweating and fainted. Fortunately, he was sent to the hospital for emergency treatment in time before he escaped. Water is the source of life in nature, but it is also the chief culprit that induces the coma of uncle heart disease. Next, the author will talk about the relationship between heart disease and drinking water restriction.
Definition of heart disease
Heart disease is a broad concept, which is the general name of heart-related diseases, including congenital heart disease, hypertensive heart disease, coronary heart disease, rheumatic heart disease, myocarditis and so on. The most common are arrhythmia, coronary heart disease related to cardiovascular diseases, cardiomyopathy related to myocardium and valvular heart disease related to heart valves.
Should all heart patients limit drinking water?
Only patients with heart failure need to limit drinking water. A normal heart is like a water pump, pumping blood out of the heart regularly. However, most patients with heart disease may eventually develop heart failure if they do not actively cooperate with the treatment. Once the heart fails, patients will have chest tightness, dyspnea, edema of lower limbs, inability to lie down and other related symptoms due to more water in the body. If you still drink plenty of water, it will increase the burden on your heart, leading to aggravated heart failure and even death. Therefore, patients with heart failure should pay attention to ensuring the balance between water output and water intake, so as to avoid suddenly increasing the burden on the heart and ensure the stability of the heart.
What should I pay attention to after restricting drinking water?
If you notice abnormal conditions such as large weight fluctuation, low urine output and edema of lower limbs, it means that there is more water in the body, so it is recommended to seek medical advice in time and adjust the treatment plan.
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To sum up, not all patients with heart disease must limit their drinking water, but patients with heart failure must limit their drinking water, and pay attention to the way of drinking water, not too strong. It should be a small number of times, with an interval of two to three hours each time. Don't drink hot water, cold water or even ice water, otherwise it will really be "sad"!
refer to
[1] process. Patients with heart failure drink too much water, so be careful of the heart "strike", family doctor, 2017-16.
What is heart failure?
The blood pumped by the heart can not meet the needs of various tissues and organs of the body, which is characterized by dyspnea, limited activity and fluid retention (edema, pleural effusion, etc. ), which is heart failure.
What are the causes of heart failure?
At present, the main causes of heart failure are hypertension, coronary heart disease, diabetes, cardiomyopathy, myocarditis, valvular disease, atrial fibrillation, tachycardia, hyperthyroidism, uremia and heavy drinking. Therefore, people with the above conditions must receive regular treatment and regular review to reduce or avoid the risk of heart failure in the future.
Why should patients with heart failure limit drinking water?
Limiting drinking water is very important in the treatment of heart failure. Because the heart function declines during heart failure, too much fluid intake will increase the burden on the heart, which is tantamount to adding insult to injury to the already tired heart, which will lead to further deterioration of heart function.
To limit the intake of liquid, it is also necessary to increase the amount of liquid discharged (mainly by increasing the amount of urine), and the amount of liquid discharged is greater than the intake, so that the blood volume in the body is reduced, the burden on the heart is reduced, the heart function is improved, the edema of patients can subside, and the symptoms of chest tightness and shortness of breath can be gradually alleviated.
Why should heart patients limit drinking water? The most common heart disease diet restriction is heart failure caused by poor heart function, which leads to insufficient circulating blood flow, edema of lower limbs, chest tightness and shortness of breath. When chest tightness and shortness of breath occur, a large amount of fluid can not be discharged in the later period, and the burden on the heart will increase, indicating that it has all happened. Diseases leading to heart failure may be caused by the following reasons.
Infection, lung infection induced by long-term infection, pulmonary heart disease with pulmonary congestion and decreased cardiac function.
Too much liquid enters, especially in some intravenous fluids. If the liquid is too fast, it will increase the circulating blood volume, the blood volume will be too full, and the liquid volume will not be discharged, which will induce self-absorption.
Arrhythmia, the most serious arrhythmia, ventricular premature beats, atrial premature beats, atrial fibrillation, long-term arrhythmia will aggravate the decline of cardiac function, bleeding, edema and shortness of breath in both lower limbs.
Hypertension, long-term hypertension will cause the heart to become fat, and then enlarge the atrium. The change of ventricular structure will affect the inflow and outflow of the ventricle, and then affect the decline of cardiac function.
Why do patients with heart failure limit their drinking water?
A large amount of liquid enters the body, and when the blood circulation is disturbed, especially when the pulmonary function circulation is disordered and the pressure is relatively high, right ventricular hypertrophy will occur. To guide sexual dysfunction and edema of both lower limbs, in addition to calculating intake, we should also calculate inflow and outflow. If the amount of liquid input by the patient is greater than the output, it means that the liquid cannot be discharged, so it is necessary to control the inflow.
This is why patients with heart failure must be based on 24-hour input. According to the evaluation of liquid inlet and liquid inlet, the ideal state is that the liquid inlet is less than the liquid outlet. This state basically keeps the balance of body fluids and reduces the Chu Liuxiang of the liquid.
In addition to calculating the 24-hour in-and-out volume, patients also need to monitor the daily weight changes. Generally, the weight of liquid will increase rapidly when stored, so it is best to keep the weight stable or lighter than usual.
Heart failure is a complex disease, which requires standardized long-term drug treatment, regular review of indicators and changes in inflow and outflow, and monitoring of renal function and liver function. At the same time, we should also monitor the changes of blood pressure, control the indexes of hypertension, hyperglycemia and hyperlipidemia, review one needle regularly, adjust the dose according to the indexes, and review the indexes in time to improve the prognosis of the disease.
Why should heart patients limit drinking water?
There are many kinds of heart diseases, including congenital heart disease, rheumatic heart disease, hypertensive heart disease, coronary heart disease, cardiomyopathy, arrhythmia, infective endocarditis and myocarditis. No matter which disease develops to the end stage, it will lead to the decline of heart function and heart failure. At this time, patients need to limit drinking water to varying degrees. What is the reason?
What is heart failure? Heart failure is the abbreviation of heart failure or heart pump failure, which refers to the decline of the pumping function of the heart, which shows that the pumping capacity of the heart in unit time is insufficient and can not meet the needs of the body.
A series of neurohormonal changes will occur in heart failure, which will lead to the activation of renin-angiotensin-aldosterone system and the retention of water and sodium in the body.
Water and sodium retention will lead to increased blood volume and further aggravation of cardiac preload, which is contrary to the treatment principle of heart failure.
Heart failure indicates that the heart is overloaded. At this time, it is necessary to reduce the burden on the heart, including both the front load (volume load) and the back load (peripheral vascular resistance).
If drinking water is not restricted during heart failure, the body will store too much water due to its own regulation mechanism, which will increase the blood volume and the burden on the heart, which is not conducive to the treatment of heart failure.
To sum up, patients with heart disease need to limit drinking water when they have heart failure, because drinking too much water will aggravate heart failure.
Heart disease is a general term for all heart diseases. I estimate that many heart patients still don't know which heart diseases need to limit drinking water, but there is indeed a disease in heart diseases that needs to limit drinking water. Today, we will go into heart disease and see which heart diseases need to limit drinking water.
First of all, not all heart diseases should limit drinking water.
In fact, for most heart diseases, there are no strict restrictions on water distribution, especially arrhythmia and many patients with coronary heart disease. However, for patients with acute heart failure, it is necessary to strictly limit the amount of drinking water, because if the amount of drinking water is not limited, a large amount of water will enter the circulatory system through digestion and absorption after drinking, resulting in an increase in capacity load, which in turn leads to an increase in the patient's heart load and heart failure. So strictly speaking, heart rate patients need to limit drinking water.
Second, not all heart failure should strictly limit drinking water.
In fact, many patients have a misunderstanding that heart failure strictly restricts drinking water, and think that all heart rates need to be strictly controlled. However, the guidelines are not so stipulated and restricted. The guidelines only recommend strict water restriction for patients with acute heart failure, and there are no strict water restriction requirements and suggestions for patients with stable heart failure. However, for patients with stable heart failure, it is still necessary to pay attention to drinking water, otherwise heart failure will easily recur.
Third, water restriction is only a point of attention for patients with heart failure.
In fact, for patients with heart failure, there is no need to limit water and sit back and relax. Water restriction is only one aspect that heart rate patients need to pay attention to, and there are many other matters that need to be paid attention to. For example, avoid catching cold and fatigue, such as avoiding infection, such as strict medication compliance and so on.
Why should heart patients limit drinking water? This topic involves many patients. In fact, not all patients with heart disease need to limit their drinking water, but some patients with heart disease need to limit their drinking water, especially when heart failure is serious, and more attention should be paid to avoiding excessive drinking water. If all patients with heart disease should limit drinking water, it is actually misleading to many people.
We all say that drinking more water is good for health, and there is no special restriction. Doctors also encourage many people to drink more water every day.
Heart disease is a general term for all people with bad hearts, including cardiovascular diseases, such as coronary heart disease; There are also myocardial diseases, including myocarditis; In addition, arrhythmia diseases, including atrial fibrillation, etc. There are valvular heart disease, dilated heart disease and so on.
These acute heart diseases are not all very serious diseases, such as premature ventricular contractions and arrhythmia in young people. Although it is an abnormal state without symptoms, it can also be called heart disease. At this time, most of them do not need treatment, and there is no need to have special taboos on water.
But when the heart function declines, especially when the heart function is damaged and heart failure occurs, we should pay attention to avoid drinking too much water.
In fact, heart failure is the decline of cardiac ability caused by various reasons, which is manifested in the decline of cardiac systolic and diastolic functions.
The decline of cardiac function brings about the decline of myocardial contractility, which will reduce the blood supply capacity of the heart and the blood perfusion of the artery is insufficient. At the same time, the decrease of diastolic ability brings about the decrease of blood flow back to the heart, and the blood in the venous system will be filled with congestion.
After a long time, it will bring obvious symptoms of heart failure, such as feeling flustered, chest tightness and shortness of breath after a little activity or labor; Sometimes I feel suffocated after lying flat, and I cough after lying flat. When the patient is standing or sitting, there is no relief of wheezing or coughing. Sometimes I feel irritable, anxious or afraid. The most important sign is the appearance of body edema.
Therefore, when heart failure occurs, patients should reduce the amount of drinking water, especially when such patients transfuse blood, and they should not input too much liquid too quickly, which will aggravate the occurrence of heart failure. Hypertension, coronary heart disease, myocarditis, dilated cardiomyopathy, valvular disease, etc. They are all high-risk groups of heart failure, so these people should pay attention to the intake of liquid when infusion.
Daily normal people, the daily intake of water and the discharge of water are balanced. When they consume more water, the discharge of water will increase accordingly.
If you are a patient with heart failure, blood can easily accumulate in veins because of the decreased circulation ability of the body. Therefore, if a large amount of water is ingested and cannot be metabolized effectively, it will cause water intake to be greater than discharge, which will aggravate heart failure. Excessive water will cause edema in the body and obviously aggravate the symptoms of heart failure.
Furthermore, patients with heart failure are prone to "water and sodium retention", sodium salt restriction and hyponatremia, and sodium is needed to store water for the maintenance of body water. With the decrease of sodium, the body needs less water, and excessive water intake will also aggravate heart failure.
Furthermore, take part in exercise as much as possible. Many heart diseases occur, so we should be fully aware of them during rest and exercise. Don't exercise completely, let alone exercise excessively, which will increase the burden on the heart. Therefore, it is necessary to exercise as much as possible according to your own situation to improve your physical fitness and heart function.
Furthermore, for diet, patients with heart disease should actively participate in diet management, eat with low salt, low fat and low oil, avoid overeating, balance diet, and appropriately increase the intake of vegetables, fruits and bean products. At the same time, eat regularly to avoid overeating.
Furthermore, for water, except for patients with heart failure, others should fully replenish water, but not too much. Under normal circumstances, 1500-2000ml is enough.
Furthermore, keep a regular schedule and avoid staying up late for a long time. Heart disease in particular is very important for adequate and regular rest.
Moreover, a good mood is an important part of controlling heart disease. Don't be too angry and nervous, avoid long-term stress increase, and learn to release bad emotions.
To sum up, for patients with heart disease, if heart function declines and heart failure occurs, we should pay attention to limiting drinking water, and even record intake and output, which are necessary links to prevent and treat heart failure, but not all patients with heart disease should limit drinking water. Patients with heart disease must control their condition every day to prevent heart failure.
Indeed, when our patients are admitted to the hospital, they usually prescribe doctors' orders: record the amount of admission and drug withdrawal, and weigh them.
Literally, output: generally refers to the amount of urine discharged, and sometimes it is counted when there is loose stool. Entry: it is the amount of liquid entering the body. Including oral water, milk, porridge, intravenous infusion, etc. We will ask patients to measure the amount of liquid with a measuring cylinder or other graduated containers before drinking water or after urinating. Finally, write it down on a piece of paper like this:
Recording the amount of in-and-out is very common in other departments, but only cardiac surgery and cardiology really pay attention to the amount of in-and-out as a treatment guide.
Then why are we so concerned about patients' rights?
First of all, simply put, whether you drink water or excrete urine affects the blood volume in the blood vessels. Drinking water, absorbed through the intestine, enters the blood, leading to an increase in blood volume; Blood enters the kidney, and through the filtration of the kidney, some water is filtered out, and various metabolic wastes are dissolved to form urine, and the blood volume will be reduced accordingly. For a normal person, the cardiac function reserve is very good, and it doesn't matter whether the blood volume is more or less. However, for a patient with poor heart function, the heart reserve is very small, and he will be sensitive to changes in blood volume. It is manifested as blood pressure fluctuation, heart rate change and sometimes even arrhythmia. Therefore, when we make rounds, we will make a thousand reminders, so we must remember the quantity of imports and exports accurately and not perfunctory. Then what do we rely on to judge whether the patient's access is accurate? Doctor's Order 2: Weigh. It stands to reason that if a person exports for a long time >; If you spend enough, you will definitely lose weight. Once before, a patient had a negative balance of about 500ml every time he made rounds in a week, but he weighed himself every day and didn't lose much weight. Even a week later, he was 2 kg heavier than when he was admitted to the hospital. Thirdly, when measuring liquid, it is estimated by eyes, and there is no measuring tool at all. The error is so big that people can't believe it, which makes the director angry to death.
What level of traffic should be maintained?
To tell the truth, water, as the source of life, plays an irreplaceable role in human metabolism. Too little water intake is not enough to metabolize human waste, and it will also lower blood pressure because of the decrease of blood volume. Therefore, it is necessary to avoid a misunderstanding. Drink less water, the better. We usually think that the daily water intake that can satisfy a person's normal life is 30~40ml/kg, and if an ordinary person's normal weight is about 60kg, the daily water intake is 1800~2400ml. Because most inpatients do not have much activity and the amount evaporated by sweat is less than usual, we usually take the lower limit of this value as 1500~2000ml. Adjust the output according to the patient's own situation. If the patient has acute cardiac insufficiency, cardiac overload and rapid diuresis, there may be a negative balance of 1000ml (about 3000ml urine) a day. For patients with chronic cardiac insufficiency, the heart has been relatively adapted to the current work intensity, and gradually dehydrated, -300~-500ml per day, which is more conducive to blood pressure stability. For patients with coronary heart disease and cardiac insufficiency, we should pay attention to negative balance to prevent acute myocardial infarction caused by high blood viscosity.
This is actually a misunderstanding. Not all patients with heart disease need to limit their drinking water. Only when the heart disease has progressed to the point of "functional failure", that is, patients have so-called "cardiac insufficiency" or "heart failure", it is necessary to limit the daily drinking water to a certain extent.
The survival, development and maintenance of all physiological activities of life need the support of energy and nutrients, but these energy and substances are transported to all tissues and organs of the body through the flow of blood, and the reason why blood can continuously transport energy and substances to all parts of the body is the power provided by the constant beating of the heart. For normal people, it doesn't matter much to drink more water to make the blood volume slightly larger. A healthy heart can provide more power for the normal supply of blood through strong beating.
The heart function is greatly weakened, which makes the patients with heart failure unable to bear more load. Therefore, reducing water intake to maintain the stability of blood volume is also an intervention method to reduce the heart load and alleviate the disease.
Generally speaking, the heart of patients with heart failure is difficult to maintain the status quo and basically cannot bear more loads. Therefore, it is necessary to keep the relative measurement of water in the patient's body as much as possible to avoid excessive fluctuation of blood volume, so as to ensure that the heart is in a stable state for a long time, thus preventing the disease from worsening due to the sudden increase of heart load. Therefore, it is necessary to monitor the water intake and excretion of patients with heart failure.
However, it should be noted that restricting drinking water is not to prevent drinking water. Water is the source of life and the basic material guarantee for maintaining various physiological activities of the body. Therefore, water can be drunk and must be drunk, but it is not necessary to drink more deliberately. Of course, doctors will tell patients what to do, how much to eat and how much to drink, which can be calculated;
In fact, as mentioned in the title, the easiest way to monitor the relative determination of water content is to record the daily water consumption and urine volume of patients, and see a doctor in time if there is any abnormality;
In addition, patients with heart failure have obvious physical changes during their illness, such as weight. If conditions permit, it is best to measure and record their weight every day to prevent them from taking too much water without knowing it. Then there is edema of the lower limbs, which also suggests that the patient has fluid retention and needs interventional treatment as soon as possible.