Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure

Peng Weihang; Zheng Shuxin; He Zhiling

doi:doi:10.11648/j.sr.20261405.17

Research Article |

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Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure

Peng Weihang

, Zheng Shuxin

, He Zhiling

Published in Science Research (Volume 14, Issue 5)

Received: 17 July 2026 Accepted: 27 August 2026 Published: 4 September 2026

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Abstract

Chronic heart failure (CHF) represents the terminal stage of various cardiac diseases and is characterized by high prevalence, high rehospitalization rates and high mortality. Home-based management of patients in the stable phase of CHF is essential for slowing disease progression, reducing rehospitalization risk and improving quality of life. Based on domestic and international heart failure management guidelines, expert consensus documents and specialty nursing practice, this paper summarizes and systematically discusses ten key symptoms that require attention in home-based management of stable CHF, including dyspnea, rapid weight gain, lower-extremity or generalized edema, fatigue and reduced exercise tolerance, nocturnal cough and pink frothy sputum, palpitations and arrhythmias, chest pain or discomfort, decreased appetite and gastrointestinal symptoms, dizziness, blackout and syncope, and mood disorders. Clinical significance, home monitoring methods, coping strategies and indications for medical consultation are addressed for each symptom. Overall strategies including symptom diaries, standardized medication, diet and fluid management, moderate exercise, trigger prevention, tiered follow-up systems and caregiver training are also proposed. Recognition of these warning symptoms may facilitate early detection, early intervention and early management, providing a reference for a patient–family–community–hospital integrated management model. It should be noted that this "top ten" framework is derived from a synthesis of guidelines and clinical experience, and its relative weighting and applicability warrant further research; specific thresholds, dosages and frequencies mentioned herein are general principles, and patients should follow individualized advice from their physicians.

Published in	Science Research (Volume 14, Issue 5)
DOI	10.11648/j.sr.20261405.17
Page(s)	314-318
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Chronic Heart Failure, Stable Phase, Home-Based Management, Symptom Monitoring, Self-Management, Health Education

1．引言

心力衰竭是各种心脏结构或功能性疾病导致心室充盈和/或射血功能受损而引起的一系列临床综合征

[1]

。随着人口老龄化及冠心病、高血压、糖尿病等基础疾病负担的增加，心衰患病人数持续增长（具体患病率因研究人群和方法学而异）

[2, 3]

。心衰患者的再住院率较高，其中相当一部分再入院事件可能与可预防因素相关，包括饮食不当、药物依从性差、感染未及时控制、症状识别延迟等

[4]

。

慢性心衰稳定期通常指患者经规范化治疗后，症状与体征相对平稳、无需静脉用药、活动耐量维持在一定水平的阶段。然而，此阶段患者的心脏结构与功能异常仍持续存在，容易在诱因作用下发生急性失代偿。因此，稳定期患者及其照护者掌握居家症状识别与监测方法尤为重要。

本文基于《中国心力衰竭诊断和治疗指南》、欧洲心脏病学会（ESC）及美国心脏协会/美国心脏病学会/美国心力衰竭学会（AHA/ACC/HFSA）心衰管理指南的相关建议

[1, 5, 6]

，结合心衰专科护理实践，归纳慢性心衰稳定期居家管理中需重点关注的十大症状。需要说明的是，"十大症状"的具体划分并非严格来自单一指南的明确列举，而是本文作者基于文献及实践的综合归纳，供参考使用。

2．慢性心衰稳定期居家管理的十大症状

2.1．呼吸系统与循环相关症状

2.1.1．呼吸困难

呼吸困难是心衰最具特征性的症状之一，可表现为劳力性呼吸困难、夜间阵发性呼吸困难和端坐呼吸，其发生与肺静脉压升高、肺淤血及气体交换功能受损相关。居家监测建议：记录发生的诱因、时间、持续时长及缓解方式；关注日常活动耐量的变化，如夜间睡眠所需枕头高度、平卧是否舒适。若出现静息状态下呼吸困难、需强迫端坐位或咳粉红色泡沫痰，提示可能存在急性肺水肿，应及时就医。

2.1.2．夜间咳嗽与咳粉红色泡沫痰

夜间平卧可能加重肺淤血，从而诱发咳嗽，常表现为干咳或咳白色泡沫痰。需与其他原因引起的咳嗽鉴别，如上呼吸道感染、慢性阻塞性肺疾病、支气管哮喘、胃食管反流以及血管紧张素转换酶抑制剂（ACEI）相关性咳嗽等。咳粉红色泡沫痰通常被视为急性肺水肿的重要临床表现，应视为紧急情况处理，建议立即就医。

2.1.3．胸痛或胸部不适

心衰患者中相当比例合并冠心病，缺血性心脏病是心衰常见病因之一。因此，稳定期新出现的胸痛或原有胸痛发作特征改变，均需高度重视。典型心绞痛多表现为胸骨后或心前区压榨感、紧缩感，可放射至左肩、左上肢、下颌等部位，常由体力活动或情绪激动诱发。若胸痛持续时间较长、休息或含服硝酸甘油不能缓解，或伴大汗、恶心、呼吸困难，应警惕急性冠脉综合征，建议立即拨打急救电话。硝酸甘油的使用需注意血压水平及禁忌证，应在医生指导下使用。

2.2．容量与运动耐量相关症状

2.2.1．体重快速增加

体重变化被广泛认为是液体潴留较敏感的居家监测指标，通常可能早于明显水肿及呼吸困难的出现

[7]

。多部指南建议心衰患者每日监测体重。监测方法：每日晨起、排空膀胱、空腹条件下使用同一体重秤测量；建立体重记录，便于观察变化趋势。一般建议若短期内（数日至一周）体重出现较明显增加，应联系医生评估是否需要调整利尿剂剂量。具体阈值在不同指南中略有差异，患者应遵循主管医生的个体化建议。

2.2.2．下肢或全身水肿

体循环淤血可引起组织间液潴留，常表现为双下肢对称性凹陷性水肿，长期卧床者可见于骶尾部。严重时可出现腹水、胸腔积液。居家评估要点：观察袜口、鞋子是否变紧，皮肤是否紧绷发亮；用拇指按压胫骨前区数秒，观察凹陷程度及回弹情况；水肿明显加重伴腹胀、尿量减少时，应及时就诊。

2.2.3．疲乏与运动耐量下降

疲乏是心衰患者常见但易被忽视的症状，其发生机制涉及心输出量下降、骨骼肌代谢异常、慢性炎症、贫血、睡眠障碍及药物影响等多方面因素，其中铁缺乏是重要可治疗因素

[8]

。老年患者可能将其误认为"年龄相关的体力下降"而延误识别。评估建议：参照NYHA心功能分级进行自我评估；记录日常活动能力的变化，如爬楼层数、连续步行距离；若运动耐量出现较明显下降，应及时就诊评估。

2.3．心律与神经系统相关症状

2.3.1．心悸与心律失常

心衰患者由于心肌重构、电重构及神经内分泌激活等因素，易并发多种心律失常，其中心房颤动较为常见。临床表现可包括心跳加快、心跳漏跳感、胸闷、头晕等。居家监测：定期测量并记录静息心率；有条件者可使用家用心电设备协助监测；若心率出现较明显异常，或心悸伴头晕、黑蒙、晕厥、胸痛，应及时就诊。关于目标心率的具体数值，不同指南和临床情境下建议略有不同，患者应遵循主管医生的个体化建议

[9]

。

2.3.2．头晕、黑蒙与晕厥

心衰患者头晕、黑蒙、晕厥的原因多样，包括药物相关性低血压、心律失常、心输出量下降、电解质紊乱、体位性低血压及脑血管疾病等。预防措施：起床时采取渐进方式，避免体位骤变；避免长时间站立、饱餐后立即起身及饮酒；家庭环境注意防跌倒（如卫生间扶手、地面防滑）。若首次发生晕厥、反复发作头晕黑蒙，或伴胸痛、心悸等，应及时就诊评估

[10]

。

2.4．消化系统与心理相关症状

2.4.1．食欲下降、恶心与腹胀

心衰患者出现消化道症状的原因较为复杂，可能与胃肠道及肝淤血、利尿剂相关电解质紊乱、药物副作用等相关

[11]

。持续食欲下降和体重进行性下降还可能提示心源性恶病质，其预后相对较差。服用地高辛的患者若出现恶心、呕吐、视物模糊等表现，需警惕洋地黄中毒的可能，应及时就诊评估。居家管理原则：少食多餐，清淡饮食；限盐（具体摄入量遵循医生建议）；关注体重及营养状况；若消化道症状持续或加重，应及时就诊。

2.4.2．情绪障碍：焦虑与抑郁

情绪障碍在慢性心衰患者中较为常见，可能影响自我管理依从性、生活质量及临床结局。相关研究提示，抑郁与心衰患者不良预后可能存在关联，但具体影响幅度因研究设计而异

[12]

。识别与干预：可使用PHQ-9、GAD-7等筛查量表进行自我评估；家庭成员的情感支持和陪伴具有积极作用；中重度焦虑抑郁应及时转诊精神心理科评估；抗抑郁药物的选择需考虑其对心血管系统的影响，应在专科医生指导下使用。

3．居家管理的整体策略

3.1．建立症状与指标记录

建议心衰患者建立日常记录，内容可包括体重、血压、心率、症状变化、饮食与液体摄入、用药情况等。记录形式可为纸质日记或应用移动健康工具。系统的记录有助于识别病情变化趋势并为随访提供依据。

3.2．规范化药物治疗

慢性心衰稳定期患者应遵循指南推荐，坚持长期规范化药物治疗。射血分数降低的心衰（HFrEF）患者的核心药物包括：ARNI/ACEI/ARB、β受体阻滞剂、醛固酮受体拮抗剂（MRA）和钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）。用药原则包括从小剂量起始、逐步滴定、不建议患者自行停药或调整剂量、关注药物副作用等。具体方案应根据患者个体情况由医生制定。

3.3．饮食、液体、运动与诱因预防

指南普遍建议心衰患者限制钠盐摄入，具体限盐幅度存在一定差异，患者应遵循医生的个体化建议。液体摄入方面，一般稳定期患者不需严格限水，重度心衰或合并低钠血症者可能需要限制液体摄入。同时应戒烟、限酒（酒精性心肌病患者建议戒酒）。稳定期心衰患者在评估后可进行适度的有氧运动，具体方式、频率、强度应由医生或康复治疗师制定；急性失代偿期、不稳定心绞痛及严重心律失常等情况下应避免运动

[13]

。诱因预防方面，呼吸道感染是心衰急性加重的常见诱因之一，建议根据医生建议接种流感疫苗和肺炎球菌疫苗；避免使用可能加重心衰的药物（如部分非甾体抗炎药），如需使用应咨询医生；保持情绪稳定、规律作息，注意保暖。

3.4．分级随访体系与家庭照护者培训

建议构建"患者-家庭-社区-心衰中心"的分级随访体系，患者及家属承担日常自我监测，社区医院负责基础随访，心衰中心提供专科评估与治疗优化

[14]

。远程医疗、可穿戴设备等新技术在心衰管理中的应用日益增多，其长期效果仍需更多研究验证

[15]

。家庭照护者在心衰居家管理中扮演重要角色，应对其进行必要的健康教育，内容可包括心衰基础知识、症状识别、药物管理、饮食准备、紧急情况的初步处理等。

4．讨论

本文提出的"十大症状"框架旨在为慢性心衰稳定期患者的居家管理提供实用参考，其价值主要体现在：一是覆盖了心衰患者常见的多系统临床表现；二是提供了可操作的监测建议和应对策略；三是将情绪障碍纳入监测框架，体现了心身整合管理的理念。

同时，本框架亦存在一定局限性：其一，"十大症状"的选择基于指南推荐和临床经验的综合归纳，其相对重要性排序缺乏严格的循证依据；其二，射血分数降低的心衰（HFrEF）、射血分数保留的心衰（HFpEF）及射血分数轻度降低的心衰（HFmrEF）患者在症状表现和管理重点上可能存在差异，本文未作细致区分；其三，不同患者的教育背景、经济条件、社会支持等因素会影响居家管理的可行性，"一刀切"的方案难以适用于所有人群；其四，本文所引用的部分流行病学表述较为概括，具体数据因研究人群、时间和方法而异，读者在参考时应结合具体来源。未来研究方向可包括：探索基于人工智能与可穿戴设备的智慧化心衰居家管理模式、针对不同类型心衰患者的个体化症状管理方案，以及分级随访体系的实际效果与卫生经济学价值评估等。

5．结语

慢性心衰稳定期的居家管理是心衰全程管理的重要组成部分，对延缓疾病进展、降低再住院率、改善预后具有积极意义。本文归纳的十大症状为患者及其照护者提供了较为系统的居家监测参考。需要强调的是，本文提出的建议为一般性参考，不能替代医生的个体化诊疗意见。患者在实际管理中应与主管医生保持密切沟通，根据个人具体情况调整管理方案。医护人员应加强对患者及家属的健康教育，提升其自我监测能力，同时依托信息化手段完善随访体系，共同促进心衰管理水平的提升。

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Weihang, P., Shuxin, Z., Zhiling, H. (2026). Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure. Science Research, 14(5), 314-318. https://doi.org/10.11648/j.sr.20261405.17

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Weihang, P.; Shuxin, Z.; Zhiling, H. Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure. Sci. Res. 2026, 14(5), 314-318. doi: 10.11648/j.sr.20261405.17

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AMA Style

Weihang P, Shuxin Z, Zhiling H. Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure. Sci Res. 2026;14(5):314-318. doi: 10.11648/j.sr.20261405.17

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@article{10.11648/j.sr.20261405.17,
  author = {Peng Weihang and Zheng Shuxin and He Zhiling},
  title = {Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure},
  journal = {Science Research},
  volume = {14},
  number = {5},
  pages = {314-318},
  doi = {10.11648/j.sr.20261405.17},
  url = {https://doi.org/10.11648/j.sr.20261405.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sr.20261405.17},
  abstract = {Chronic heart failure (CHF) represents the terminal stage of various cardiac diseases and is characterized by high prevalence, high rehospitalization rates and high mortality. Home-based management of patients in the stable phase of CHF is essential for slowing disease progression, reducing rehospitalization risk and improving quality of life. Based on domestic and international heart failure management guidelines, expert consensus documents and specialty nursing practice, this paper summarizes and systematically discusses ten key symptoms that require attention in home-based management of stable CHF, including dyspnea, rapid weight gain, lower-extremity or generalized edema, fatigue and reduced exercise tolerance, nocturnal cough and pink frothy sputum, palpitations and arrhythmias, chest pain or discomfort, decreased appetite and gastrointestinal symptoms, dizziness, blackout and syncope, and mood disorders. Clinical significance, home monitoring methods, coping strategies and indications for medical consultation are addressed for each symptom. Overall strategies including symptom diaries, standardized medication, diet and fluid management, moderate exercise, trigger prevention, tiered follow-up systems and caregiver training are also proposed. Recognition of these warning symptoms may facilitate early detection, early intervention and early management, providing a reference for a patient–family–community–hospital integrated management model. It should be noted that this "top ten" framework is derived from a synthesis of guidelines and clinical experience, and its relative weighting and applicability warrant further research; specific thresholds, dosages and frequencies mentioned herein are general principles, and patients should follow individualized advice from their physicians.},
 year = {2026}
}

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TY  - JOUR
T1  - Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure
AU  - Peng Weihang
AU  - Zheng Shuxin
AU  - He Zhiling
Y1  - 2026/09/04
PY  - 2026
N1  - https://doi.org/10.11648/j.sr.20261405.17
DO  - 10.11648/j.sr.20261405.17
T2  - Science Research
JF  - Science Research
JO  - Science Research
SP  - 314
EP  - 318
PB  - Science Publishing Group
SN  - 2329-0927
UR  - https://doi.org/10.11648/j.sr.20261405.17
AB  - Chronic heart failure (CHF) represents the terminal stage of various cardiac diseases and is characterized by high prevalence, high rehospitalization rates and high mortality. Home-based management of patients in the stable phase of CHF is essential for slowing disease progression, reducing rehospitalization risk and improving quality of life. Based on domestic and international heart failure management guidelines, expert consensus documents and specialty nursing practice, this paper summarizes and systematically discusses ten key symptoms that require attention in home-based management of stable CHF, including dyspnea, rapid weight gain, lower-extremity or generalized edema, fatigue and reduced exercise tolerance, nocturnal cough and pink frothy sputum, palpitations and arrhythmias, chest pain or discomfort, decreased appetite and gastrointestinal symptoms, dizziness, blackout and syncope, and mood disorders. Clinical significance, home monitoring methods, coping strategies and indications for medical consultation are addressed for each symptom. Overall strategies including symptom diaries, standardized medication, diet and fluid management, moderate exercise, trigger prevention, tiered follow-up systems and caregiver training are also proposed. Recognition of these warning symptoms may facilitate early detection, early intervention and early management, providing a reference for a patient–family–community–hospital integrated management model. It should be noted that this "top ten" framework is derived from a synthesis of guidelines and clinical experience, and its relative weighting and applicability warrant further research; specific thresholds, dosages and frequencies mentioned herein are general principles, and patients should follow individualized advice from their physicians.
VL  - 14
IS  - 5
ER  -

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Author Information

Peng Weihang

Department of Cardiology, The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China

Contact Email

http://orcid.org/0009-0007-3987-1232
Zheng Shuxin

Department of Cardiology, The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China

Contact Email

http://orcid.org/0000-0002-4272-1856
He Zhiling

Department of Cardiology, The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China

Contact Email

http://orcid.org/0009-0003-5892-170X

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APA Style

Weihang, P., Shuxin, Z., Zhiling, H. (2026). Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure. Science Research, 14(5), 314-318. https://doi.org/10.11648/j.sr.20261405.17

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ACS Style

Weihang, P.; Shuxin, Z.; Zhiling, H. Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure. Sci. Res. 2026, 14(5), 314-318. doi: 10.11648/j.sr.20261405.17

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AMA Style

Weihang P, Shuxin Z, Zhiling H. Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure. Sci Res. 2026;14(5):314-318. doi: 10.11648/j.sr.20261405.17

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@article{10.11648/j.sr.20261405.17,
  author = {Peng Weihang and Zheng Shuxin and He Zhiling},
  title = {Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure},
  journal = {Science Research},
  volume = {14},
  number = {5},
  pages = {314-318},
  doi = {10.11648/j.sr.20261405.17},
  url = {https://doi.org/10.11648/j.sr.20261405.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sr.20261405.17},
  abstract = {Chronic heart failure (CHF) represents the terminal stage of various cardiac diseases and is characterized by high prevalence, high rehospitalization rates and high mortality. Home-based management of patients in the stable phase of CHF is essential for slowing disease progression, reducing rehospitalization risk and improving quality of life. Based on domestic and international heart failure management guidelines, expert consensus documents and specialty nursing practice, this paper summarizes and systematically discusses ten key symptoms that require attention in home-based management of stable CHF, including dyspnea, rapid weight gain, lower-extremity or generalized edema, fatigue and reduced exercise tolerance, nocturnal cough and pink frothy sputum, palpitations and arrhythmias, chest pain or discomfort, decreased appetite and gastrointestinal symptoms, dizziness, blackout and syncope, and mood disorders. Clinical significance, home monitoring methods, coping strategies and indications for medical consultation are addressed for each symptom. Overall strategies including symptom diaries, standardized medication, diet and fluid management, moderate exercise, trigger prevention, tiered follow-up systems and caregiver training are also proposed. Recognition of these warning symptoms may facilitate early detection, early intervention and early management, providing a reference for a patient–family–community–hospital integrated management model. It should be noted that this "top ten" framework is derived from a synthesis of guidelines and clinical experience, and its relative weighting and applicability warrant further research; specific thresholds, dosages and frequencies mentioned herein are general principles, and patients should follow individualized advice from their physicians.},
 year = {2026}
}

Copy | Download

TY  - JOUR
T1  - Identification and Management Strategies for Ten Common Symptoms in Home-Based Care of Stable Chronic Heart Failure
AU  - Peng Weihang
AU  - Zheng Shuxin
AU  - He Zhiling
Y1  - 2026/09/04
PY  - 2026
N1  - https://doi.org/10.11648/j.sr.20261405.17
DO  - 10.11648/j.sr.20261405.17
T2  - Science Research
JF  - Science Research
JO  - Science Research
SP  - 314
EP  - 318
PB  - Science Publishing Group
SN  - 2329-0927
UR  - https://doi.org/10.11648/j.sr.20261405.17
AB  - Chronic heart failure (CHF) represents the terminal stage of various cardiac diseases and is characterized by high prevalence, high rehospitalization rates and high mortality. Home-based management of patients in the stable phase of CHF is essential for slowing disease progression, reducing rehospitalization risk and improving quality of life. Based on domestic and international heart failure management guidelines, expert consensus documents and specialty nursing practice, this paper summarizes and systematically discusses ten key symptoms that require attention in home-based management of stable CHF, including dyspnea, rapid weight gain, lower-extremity or generalized edema, fatigue and reduced exercise tolerance, nocturnal cough and pink frothy sputum, palpitations and arrhythmias, chest pain or discomfort, decreased appetite and gastrointestinal symptoms, dizziness, blackout and syncope, and mood disorders. Clinical significance, home monitoring methods, coping strategies and indications for medical consultation are addressed for each symptom. Overall strategies including symptom diaries, standardized medication, diet and fluid management, moderate exercise, trigger prevention, tiered follow-up systems and caregiver training are also proposed. Recognition of these warning symptoms may facilitate early detection, early intervention and early management, providing a reference for a patient–family–community–hospital integrated management model. It should be noted that this "top ten" framework is derived from a synthesis of guidelines and clinical experience, and its relative weighting and applicability warrant further research; specific thresholds, dosages and frequencies mentioned herein are general principles, and patients should follow individualized advice from their physicians.
VL  - 14
IS  - 5
ER  -

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