Heart failure for a year and a half, why does it get worse at night, and what should I do?
Jun 02, 2023
Source: Cainiu Health
Dr. Tian Hongbo
Introduction
Heart failure refers to the condition of cardiac insufficiency. After a year and a half of heart failure, symptoms tend to worsen at night, which may be related to changes in body position, vagus nerve excitation, and sodium and water retention. Symptoms can be improved through adjustments in posture and medication. Besides these common causes, nighttime worsening could also be associated with allergic cough or pulmonary edema. If symptoms of heart failure are severe, timely medical consultation is recommended.
Heart failure refers to the condition in which the heart is unable to pump sufficient blood to meet the body's needs. If heart failure has persisted for a year and a half and symptoms worsen at night, this may be related to changes in body position, increased vagal nerve activity, or fluid and sodium retention. Symptoms can be improved through positional adjustments, medication, and other interventions. Specific explanations are as follows:
1. Change in Body Position
Patients with heart failure already have weakened cardiac function. During sleep, lying on the left side may increase the workload on the heart, potentially causing symptoms such as shortness of breath, rapid breathing, and a feeling of chest pressure. It is recommended that patients adopt a supine (lying flat on back) position during sleep, which may help alleviate these symptoms.
2. Vagal Nerve Excitation
At night, the activity of the vagus nerve in the body naturally increases, which may lead to arrhythmias such as tachycardia or bradycardia. This can result in symptoms like chest tightness, chest pain, and shortness of breath. Under medical guidance, patients may take medications such as metoprolol tartrate tablets or nitroglycerin tablets to manage arrhythmias.
3. Fluid and Sodium Retention
Due to reduced cardiac pumping function, patients with heart failure may experience fluid buildup in the body. During nighttime sleep, decreased kidney function in urine production reduces the body’s ability to eliminate excess fluid, potentially worsening fluid retention and thereby exacerbating symptoms. Patients may follow their doctor's instructions to take diuretic medications such as furosemide tablets or spironolactone tablets to help remove excess fluid.
In addition to the common causes mentioned above, nighttime symptom worsening may also be related to conditions such as allergic cough or pulmonary edema. If symptoms of heart failure are severe, it is advisable to seek timely medical evaluation at a hospital. After identifying the specific cause with the help of a physician, patients should follow medical advice for standardized treatment.
