Heart failure means that the heart is no longer efficient enough to pump as much blood through the body as the organism needs to function. Experts also speak of cardiac insufficiency. The main symptoms are shortness of breath, weakness and exhaustion. If the symptoms appear within a few days or even hours, it is an acute cardiac insufficiency, which must be treated immediately as a medical emergency.
Chronic heart failure, on the other hand, develops slowly over months or years. In addition, a distinction is made between left and right heart failure depending on the area in which the heart failure occurs. If both parts of the heart are affected, it is called global heart failure.
How heart failure is treated depends primarily on the severity of the heart failure. In addition to drug therapy, doctors advise reducing excess weight and integrating more exercise into everyday life. In severe cases, a pacemaker or heart transplant may be necessary.
Heart Failure Causes And Risk Factors
There can be several reasons why a heart is no longer working properly. Deoxygenated blood from the body enters the right side of the heart to be transported further to the lungs, where it is enriched with new oxygen. This oxygenated blood flows back into the heart, now in the left half, from where it is pumped further into the systemic circulation. If the heart can no longer pump sufficiently, the left ventricle ejects less blood. As a result, the organs are no longer supplied with enough blood (systolic heart failure).
If the dysfunction is in the so-called relaxation phase of the heart, the heart continues to pump happily, but the left ventricle is no longer sufficiently filled with blood. As a result, less blood can flow into the systemic circulation (diastolic heart failure).
In right heart failure, the pressure in the lungs is increased (often due to weakness in the left heart muscle). In order to pump blood into the lungs against this pressure, the right ventricle has to expend more force. Over time, this extra effort leads to overload and damage to the heart. The blood backs up in the vessels and water builds up in the legs and abdomen.
Risk factors
Before cardiac insufficiency becomes apparent with symptoms, many future sufferers will have risk factors. Above all, the underlying diseases coronary heart disease and high blood pressure lead to the development of heart failure.
- High blood pressure: With high blood pressure, the heart has to pump harder all the time. However, it cannot withstand this load for a long time - the pumping capacity decreases.
- Coronary heart disease, cardiac arrhythmia, heart muscle inflammation and diseases, heart valve defects
- Infections
- Alcohol, drug and medication abuse
- Metabolic diseases such as diabetes mellitus and thyroid dysfunction
- Genetic factors
- Pulmonary emphysema and COPD
- Pathologically increased blood flow requirements, e.g. in the case of anemia or hyperthyroidism
Heart Failure Symptoms
Do you suffer from shortness of breath at the slightest exertion?
Does fluid collect on your legs and abdomen during the day?
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| heart failure symptoms |
These symptoms indicate heart failure. The main symptoms are shortness of breath, poor performance and tiredness or exhaustion. Those affected often notice the first signs during physical exertion such as sport, climbing stairs and gardening, while the heart continues to perform as required when it is at rest.
If the cardiac insufficiency progresses, shortness of breath occurs even with minor exertion or even at rest. Other complaints are restlessness, insomnia, tachycardia, paroxysmal coughing during exertion and at night.
The symptoms differ, whether it is left heart failure, right heart failure or global heart failure, depending on which heart chamber is affected by the reduction in performance. If both chambers are affected, doctors speak of global heart failure.
Symptoms of left ventricular failure
The left part of the heart is the part that receives blood that has been oxygenated in the lungs. If the pumping capacity of the left ventricle decreases more and more, the following symptoms are the result:
- Shortness of breath, i.e. accelerated breathing (technical term: tachypnea), coughing up to shortness of breath (technical term: dyspnea), initially only during exertion, in later stages even at rest and at night, can lead to spasm of the bronchi and whistling lung noises (heart-related asthma , technical term: cardiac asthma). It is typical that those affected often instinctively sit up straight and raise their upper body at night.
- Inefficiency and exhaustion
- Periodically recurring increase and decrease in breathing depth and breathing noise (technical term: Cheyne-Stokes breathing)
- Permanent tiredness and lack of concentration up to drowsiness, dizziness and clouding of consciousness due to insufficient supply of blood to the brain
- Accumulation of water in the lungs (technical term: oedema) in advanced left heart failure with rales when breathing
- Blue discoloration of the mucous membranes (technical term: cyanosis) due to the constant lack of oxygen
- Sharp decrease in fluid excretion
- Cold hands and feet and cold sweat
Symptoms of right heart failure
If the right side of the heart can no longer pump properly, the blood backs up in the veins of the body. Therefore, those affected have the following complaints, for example:
- Increased urge to urinate at night (technical term: nocturia), because the blood flow to the kidneys increases when lying down and at the same time the accumulated fluid flows back
- Accumulation of water in the legs
- Accumulation of water in the abdomen (technical term: abdominal dropsy, ascites)
- Leg edema on lower legs and ankles
- Eczema and open sores because the swelling of the tissue causes the skin to dry out, crack and become inflamed
- Edema in the flanks, genitals and buttocks
- Pain in the area of the right costal arch because the liver is filling up with blood due to the backflow (technical term: congested liver)
- Loss of appetite, feeling of fullness and subsequent inflammation of the gastric mucosa (technical term: stasis gastritis)
- Jugular vein congestion
Symptoms in global heart failure
In rare cases, there is only left or right heart failure with individual symptoms, usually the performance of both ventricles is restricted. Then the doctors speak of global heart failure with symptoms of both right and left heart failure.
Forms of cardiac insufficiency
Depending on the criteria used (area of the heart affected, course, functional disorder), different forms of heart failure can be distinguished:
- Acute and chronic heart failure: If the first symptoms appear very quickly within a few hours or a few days, it is acute heart failure. If it develops over several months or years, it is a question of chronic cardiac insufficiency.
- Compensated heart failure and decompensated heart failure: If the heart continues to perform at rest, the diagnosis is compensated heart failure. If symptoms occur even at rest and with the slightest exertion, doctors speak of decompensated heart failure.
- Systolic Heart Failure and Diastolic Heart Failure: To diagnose and treat heart failure, it is important to be able to assess how well the left ventricle can pump and eject blood. The amount of ejection is determined by the ejection fraction (technical term: left ventricular ejection fraction, LVEF). If the LVEF is below 40%, systolic heart failure is present. In diastolic heart failure, the ability to pump is largely preserved (LVEF > 50%). More recently, medical specialists have also defined mid-range heart failure, which bridges the gap between systolic and diastolic.