Heart failure - symptoms, causes, treatment and prevention

Why does a heart suddenly stop beating??

Heart failure is a serious and dreaded complication of many heart diseases. In Germany alone, more than 100,000 people die every year from this complete loss of cardiac function, whereas improved early defibrillation as part of first aid measures could significantly reduce the mortality rate. And even in precaution, the high number of cases of heart failure could be corrected downwards significantly.

contents

• Why does a heart suddenly stop beating??
• The heart: structure and function
• Definition of heart failure
• Causes of acute heart failure
• Causes of chronic heart failure
• Symptoms of heart failure
• diagnosis
• Attention: Acute heart failure is an absolute emergency
• Therapy for acute heart failure
• Therapy for chronic heart failure
• Self-help for a healthy heart
• Prevention of heart failure through healthy eating
• medicinal herbs
• Operative treatment

The heart: structure and function

The heart (Cor) is the engine of our body. As the center of the blood circulation, besides the brain, it is the most important organ for the maintenance of vital functions. Of course, the pumping feature of the heart muscle is essential, thanks to which the blood is passed through the vessels throughout the body.

The heart continuously pumps blood through the body, supplying organs and tissues with vital oxygen and nutrients. (Image: abhijith3747 / fotolia.com)

The manifold tasks of the cardiovascular system include:

oxygen transport - Through regular breathing, the blood in the lungs is oxygenated. This then passes through the blood circulation in all parts of the body and supplies organs and tissue structures with the necessary "fresh air".

nutrient transport - Nutrients that enter the digestive tract through the digestive processes in the metabolism are also transported via the blood in large parts. Thanks to the nutrient-guiding function, vitamins and minerals, proteins and carbohydrates can quickly reach their place of use in the body.

material removal - Many metabolic waste products are also released from the body via the blood circulation. For example, urine-containing substances in the kidneys are filtered out of the blood and carbon dioxide, which is produced after the consumption of oxygen in the organs, is exhaled from the venous blood in the lungs

immune defense - The cells in the blood also include white blood cells called leucocytes. These have a special role in the immune function, either because they detect harmful foreign bodies such as infectious agents and forward appropriate information to the immune system, or even involved in the defense, because they produce specific antibodies against the body invaders.

hormone transport - Hormones are an important part of the signal line for certain bodily functions. Therefore, by distributing hormones through the bloodstream in the body, the heart also has an in-body "communication function" that controls hormone-based mechanisms.

thermoregulation - The heart is also involved in the development of body temperature. Because the blood circulation, the body is cooled steadily and defused local heat sources.

The pumping function of the heart comes about through regular muscular contractions of the heart muscle. The clock for this is the so-called sinus node (Nodus sinutrialis). This is located in the right atrium and is controlled by the sympathetic and parasympathetic. The impulses of the sine knot are over the atrioventricular (Nodus atrioventricularis, in short: AV node), a muscular connection between left and right ventricle, forwarded to the entire heart muscle.

The result is regular muscle contractions of the heart, which are perceived as heartbeats. This special control of the heart rhythm and kradialem pumping mechanism is referred to in medicine as the excitation line system. Comes

Definition of heart failure

Heart failure now describes the functional failure of this system of excitation conduction and pumping function. This condition, which can be triggered by various heart diseases, is always life-threatening. Physicians distinguish between two major forms of heart failure:

1. acute heart failure - the heart failure occurs suddenly and without any warning
2. chronic heart failure - Heart failure develops gradually and progresses along with an increasing deterioration in cardiac function

If the failure of the heart is treated in time, the heart function can be restored. However, it is often about a few minutes, which decide whether the excitation of the heart can be "brought back" or dried up forever and thus has a cardiac death.

Typical symptoms of acute heart failure are chest pain and respiratory distress. (Image: Robert Kneschke / fotolia.com)

Causes of acute heart failure

Acute heart failure can have many causes and is always a life-threatening situation. Often, the symptoms are completely absent or appear so short before the onset of unconsciousness that the person concerned and his environment are completely surprised by the event and accordingly overwhelmed with the situation are. For this reason, one speaks here of sudden heart failure or sudden cardiac death, if any help is unsuccessful.

Cardiovascular diseases as the main cause

The triggers are mostly in one (undetected) Disease of the heart to find. By far the most common cases of patients show severe calcifications on their coronary arteries. The disease is in medical circles as Coronary heart disease and often the result of a previous atherosclerosis (arteriosclerosis), which is already very advanced. The calcification process is creeping and therefore often remains unrecognized until the onset of acute heart failure. Other cardiovascular diseases can also lead to acute heart failure. These include:

• Arrhythmia
  e.g. Tachycardia, heart stuttering, ventricular or atrial fibrillation
• Disturbances in the excitation line or arousal
  e.g. AV nodal blockage, AV nodal reentrant tachycardia, carotid sinus syndrome, sick sinus syndrome, Wolff-Parkinson-White syndrome
• congenital or acquired heart defects
  e.g. Aortic stenosis, Ebstein anomaly, valvular heart failure or Marfan syndrome
• other blood, heart and vascular diseases
  e.g. Hypertension, diabetes mellitus, endocarditis or cardiomyopathies

Untreated, these diseases are often accompanied by damage to the heart, which additionally increases the risk of acute heart failure. In addition, there are a number of other influencing factors that promote such a scenario. Is the heart, for example, by a previous one Heart attack The patient must continue to be hospitalized for a while to ensure that the infarct is not followed by another life-threatening cardiac function failure.

Other illness-related causes

Even after a surviving pulmonary disease (e.g., pulmonary embolism or pneumonia) or infection the heart is commonly struck and more prone to dysfunctions. In particular infections harbor in this context an increased risk. Because if the infectious agents are not completely controlled, they can spread through the bloodstream to the heart and there trigger severe inflammation with acute heart failure as a result. Likewise are Complicated operations not infrequently associated with the risk of heart failure.

An unhealthy diet with too much fat and sugar increases the risk of dangerous heart disease. (Image: happy_lark / fotolia.com)

Heart failure as a result of unhealthy lifestyle habits

Also important in the development of many cases of acute heart failure are the individual lifestyle habits of the patient. From unhealthy eating habits that promote illnesses such as obesity, atherosclerosis, or coronary heart disease through a diet that is too high in fat or sugar, to stress, to heart-wrenching addictions, there are many scenarios that promote heart failure. Overall, the following aspects are relevant in everyday life:

• unhealthy diet (especially with fatty foods)
• overweight
• lack of exercise
• everyday stress
• emotional distress
• lack of sleep
• exorbitant intoxication and stimulant consumption
• Drug abuse or doping

Substance abuse is particularly treacherous

Especially with regard to substance abuse should be mentioned that especially substances that increase the heart rate are particularly dangerous. In addition to nicotine and alcohol, heart failure is especially common in performance-enhancing drugs such as anabolic steroids and drugs such as Speed ​​or Crystal-Meth as a common, lethal side effect.

Furthermore, he warned of an increasingly fashionable and legally available drug called Spice ("Legal Highs"). Disguised as an alleged room freshener, countless herbal mixtures can be found under this name in the assortment of tobacco and pipe traders. The main ingredient is synthetically produced cannabinoids, which is already causing many medical professionals to raise the alarm bells, because the effect of synthetic drugs is usually even worse to control than that of "natural" drugs..

Which herbs are also still processed in the so-called New Psychoactive Substances (NpS), can rarely say exactly. On the other hand, the health risks of consumption are well documented, because the legal highs can lead to serious poisoning. In addition to unconsciousness and panic attacks, the threatening side effects include tachycardia and cardiac arrhythmias. Deaths with heart failure have not yet become public, but the risk of overdose is very high.

The use of drugs increases the risk of heart failure in otherwise healthy people. (Image: Štěpán Kápl / fotolia.com)

Causes of chronic heart failure

Also, chronic heart failure often has its causes in the previously described pre-existing conditions and unhealthy everyday habits. The major difference here is that the pumping power of the heart is not stopped abruptly, but slowly gradually loses its function over a sometimes long-lasting course, until it finally comes to complete functional failure. In addition, chronic heart failure can still cause some specific health problems. Which includes:

• chronic lung diseases (e.g., COPD or pulmonary fibrosis)
• sleep disorders (e.g., sleep apnea syndrome)
• hormonal diseases (e.g., hyperthyroidism)

Symptoms of heart failure

The harbingers of a heart failure occur at least in acute cases, relatively immediately before the loss of function of the heart. Fast action is therefore extremely important. Typical symptoms are mainly respiratory problems and pain and discomfort in the upper body. But also alleged gastrointestinal complaints such as nausea or vomiting may occur in the course of a heart failure. Below is an overview of possible symptoms:

• Respiratory problems or respiratory distress up to respiratory arrest
• Choking feeling in the area of ​​the ribcage
• chest pain
• Pain in the chest, neck or jaw
• Radiation pain in the arms
• dizziness
• Nausea and vomiting
• Epigastric pain (especially in female patients)
• pallor
• dilated pupils
• dry pulse
• unconsciousness

diagnosis

In case of acute heart failure, an emergency doctor is always required. The determination of the fatal health complaint is usually done on the spot by diagnosing a pumping failure or complete cardiac arrest. However, if countermeasures are taken in good time and the patient survives, further surveillance and in-depth in-hospital examinations are common. For this purpose, imaging techniques such as ECG, echocardiography, cardiac catheterization are used. It is also common to take blood samples for heart enzymes, blood electrolytes, blood coagulation values.

Attention: Acute heart failure is an absolute emergency

The acute heart failure is an absolute emergency situation and can lead to the death of the patient within a very short time. The heart stops abruptly and stops pumping, causing the entire circuit to fail. If the affected person does not receive adequate treatment immediately, he dies within a few minutes. And even with speedy and appropriate treatment, the chances of surviving without consequential damage are not good, since the heart and the body have already suffered considerable damage in most cases.

In the case of sudden heart failure, immediate resuscitation must be initiated to increase the patient's chances of survival. (Image: spkphotostock / fotolia.com)

Therapy for acute heart failure

Essential for patients with acute cardiac arrest is the permanent implementation of a Cardiopulmonary resuscitation until the arrival of the emergency doctor. It ensures the maintenance of circulatory functions and thus greatly increases the patient's chances of survival. After the arrival of the medical staff, they take over the stabilization of the patient by means of defibrillation and, if necessary, also measures for artificial respiration and take him to the nearest hospital as quickly as possible.

Therapy for chronic heart failure

Chronic heart failure is a slowly progressive process that manifests itself later in obvious symptoms. This alone makes it easier for medicine to apply adequate treatment strategies. However, it should be noted that heart failure associated with the chronic form is rarely completely cured. But at least the emerging symptoms can be treated and the risk of heart failure mitigated.

Medical therapy

Drug therapy for chronic heart failure relies on several pillars that can be used alone or in combination. Relief of the heart activity by lowering the blood pressure and pulse and reducing the fluid volume in the blood can be achieved in this regard, for example, by antihypertensives and diuretics. To strengthen the heart's activity by stabilizing the heart rhythm and strengthening the heart muscle, supplements such as digitalis or beta-blockers are used.

Attention: It is a fallacy to believe that the discontinuation of treatments such as antihypertensive drugs after normalization of blood pressure could be carried out without further concerns. The blood pressure is in the normal range because the drugs work, not because it would have normalized by itself. Substituting appropriate drugs so unauthorized, so usually increases the blood pressure again. Therefore, it is important to adhere to the prescription scheme in the treatment of heart failure and also to go regularly to the check-ups.

Self-help for a healthy heart

Heart failure is a chronic disease that, while not cured, can still be treated well. It is also important that the patient develops an awareness of what is good for his heart and what is not. Heart damaging everyday activities and habits should be urgently stopped. First and foremost, this means a heart-healthy diet and stress-free everyday planning. Relaxation and healthy sleep hygiene are equally important.

Regular exercise is important for a healthy heart. (Image: ARochau / fotolia.com)

Regular exercise and abstinence from aggressive intoxicants and stimulants are essential if cardiac insufficiency is to be alleviated. In addition, regular exercise helps to strengthen the heart muscle again, with appropriate sports offers are best discussed with the doctor or a professional trainer. Too much can foster failure rather than strengthening the heart.

Prevention of heart failure through healthy eating

There is no special heart failure diet, but there are a few easy-to-implement dietary tips that can relieve or even strengthen the heart:

Low-salt diet: Salt binds water in the body, which is why a too high-salt diet means that the heart has to do too much to pump the entire fluid volume. But that does not mean that you generally have to do without salt - the amount makes the poison. The Sunday egg may still be salted sparingly, but should be paid to the diet on the hidden salts, for example in sausages or ready meals.

Proper handling of edible fats: Saturated fatty acids, such as those found in sausages, red meats, fatty cheeses and whole milk products, have a negative effect on cholesterol levels and can therefore be heart-damaged in the long-term. On the other hand, unsaturated fats have a positive effect on the cholesterol level. Especially after omega-3 fatty acids, high-risk patients should look out here, because they are considered the healthiest fats ever and can even strengthen the heart. These fatty acids can be found, for example, in poultry, fish and edible oils such as sunflower oil, thistle oil, olive oil, hemp oil or linseed oil. However, use the oils mentioned sparingly, because the right amount is also important here.

Sufficient hydration: The fluid volume in the body is an important factor in patients with heart failure. Therefore, the physician will make a recommendation as to how much fluid the patient is allowed to consume throughout the day. It is important enough, but still not to drink too much, so as not to burden the heart even more.

Heart strengthening foods: There are some foods that are particularly helpful to heart health. These include, in particular, dark berry fruits such as blueberries, blackcurrants or blackberries, which contain a wealth of anthocyanins. It is a plant-derived dye with antioxidant effect, which cleanses the blood vessels and protects them from arteriosclerotic deposits. Very healthy for the heart and vessels are also water-rich fruits and fruits such as watermelons, tomatoes, cucumbers and salads. The high liquid content of these foods dilutes the blood naturally and can thus prevent hypertension and thus additional heart stress.

Sausages contain many hidden salts and saturated fats. Therefore, patients with heart failure should look particularly well here. (Image: Alex / fotolia.com)

medicinal herbs

Also antioxidant, blood-thinning and sometimes even lower cholesterol and blood sugar levels onions, garlic and ginger. Garlic and ginger as a herbal component for the treatment of heart and vascular diseases come from a centuries-long application philosophy of Traditional Chinese Medicine and are thus well-proven for the prevention of heart failure.

In addition, treatment with hawthorn preparations, such as hawthorn tea, has gained acceptance as a supporting measure in the treatment of heart failure patients. The phytochemicals contained in hawthorn cause increased blood flow to the coronary arteries. As a result, the heart muscle is better supplied with blood and supplied with nutrients, which improves its power and performance.

Operative treatment

If all the above measures are exhausted and no longer lead to the desired success, an operation is often unavoidable. There are several techniques that can be used depending on the cause and severity of heart failure. This includes, for example, the implantation of a pacemaker or mini-defibrillator. If the latter were used more often preventively, numerous deaths attributable to heart failure could be avoided, which is why patients with chronic heart failure in particular should consider the option of an implanted defibrillator early on.

Furthermore, it is possible to use a so-called artificial heart. But it does not come to the replacement of the entire heart, as the name may suggest. Rather, the damaged heart elements are replaced and replaced by artificial, supporting systems. However, a complete heart transplant is still possible. It should be noted, however, that the donor center waiting list is extremely long and it is not always possible to find a suitable donor.

Important: The indication for surgery is provided by the treating physicians. In doing so, they also thoroughly examine the risk of surgery and the benefits of the procedure, because operations on the heart always carry a great deal of risk. (Ma)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)