Cardiology is the science of heart disease and its treatment. This includes both surgical procedures and the administration of medication. Heart disease can have many different causes. The most common is coronary heart disease, which is characterized by a gradual "calcification" of the coronary arteries and can lead to angina pectoris or a heart attack. Here you will find further information and selected doctors for heart disease.
The symptoms of heart disease can be very varied. Symptoms do not always occur at all. High blood pressure, for example, is often only detected by measuring blood pressure.
The most common symptoms of heart disease are
Some heart conditions are acutely life-threatening and require treatment by an emergency doctor. These include, in particular, heart attacks and cardiogenic shock.
High blood pressure (hypertension) does not hurt and is otherwise very difficult to notice. In most cases, high blood pressure is a classic accidental diagnosis during a medical examination.
However, constantly elevated pressure in the blood vessels can lead to damage to the vessel walls or even to heart disease. If the coronary arteries are impaired, there is a risk of a heart attack.
At high blood pressure, the heart has to fight against a very high resistance in the vessels when ejecting blood. The heart muscle therefore has to work harder and harder to maintain the same pumping capacity. The muscle, and therefore the heart itself, enlarges, especially in the area of the left ventricle.
At the same time, the oxygen supply to the muscle cells suffers as a result of this enlargement. The heart can become "tired", resulting in heart failure(cardiac insufficiency).
On the other hand, high blood pressure is also a consequence of vascular and heart disease. For example, vasoconstriction(arteriosclerosis) can cause the pressure in the blood vessels to rise.
High blood pressure can usually only be diagnosed by measuring blood pressure © Andrey Popov | AdobeStock
Functional heart diseases are often not organic heart diseases. The psyche very often plays a major role. Symptoms of functional heart disease include
The associated anxiety can escalate into fear of death. They earned this cardiac symptomatology the name "cardiac neurosis". In around 15 percent of patients with heart disease, the symptoms cannot be explained organically.
Nevertheless, organically caused heart disease should first be ruled out by a doctor. Only then can one speak of functional heart complaints.
Common heart medications such as beta blockers and sedatives are often ineffective in functional heart disease. They can even make the symptoms worse.
Cardiac neuroses are caused by mental imbalance and restlessness. They occasionally respond very well to conversation and relaxation techniques.
The inner lining of the heart (the endocardium) is a very thin epithelial layer that lines the inside of the heart. The heart valves also emerge from the endocardium. Bacteria can colonize the inner lining of the heart after operations or a protracted cold.
Rheumatic fever is a very common cause of heart disease of the inner lining of the heart. It occurs as a result of a streptococcal infection in childhood. The resulting inflammation leads to endocardial defects (e.g. scarring) and can also impair heart valve function. Heart diseases with endocardial involvement therefore often result in heart valve defects .
The symptoms of endocardial heart disease can be very dramatic. These include
Embolisms are caused by the formation of blood clots in the small vessels of the body. After such a blood clot becomes detached, it can travel to the brain, for example, and block smaller capillaries there. The result is a stroke.
Heart valve defects can be congenital or develop over the course of a lifetime as a result of an infection of the inner lining of the heart.
The inflammation of the inner lining of the heart(pericarditis) initially heals with scarring. If this happens to the heart valves, they can shrink, become distorted or even partially fuse. As a result, the function of these heart valves is restricted.
Heart valve defects can occur as stenosis or insufficiency.
In the case of valve insufficiency, the heart valves do not close properly. With every heartbeat, the blood is still pushed out through the affected valve. However, it then flows back into the ventricle as the heart valve closes incompletely. This so-called pendulum blood flow causes a flow noise that the doctor can hear using a stethoscope.
Valve stenosis, on the other hand, prevents the affected heart valve from opening completely. As a result, the opening for the blood to pass through is narrowed. This means that the heart can eject less blood with each heartbeat.
The blood builds up in the heart in front of the valve. This blood congestion can continue in the long term and, depending on the affected heart valve, can lead to other heart diseases, including
The pericardium is also called the pericardium. Diseases of the pericardium are therefore also referred to as pericardial diseases or pericarditis.
Heart diseases involving the pericardium often occur as a result of infections with
Also
can also lead to pericardial diseases.
A distinction is essentially made between acute and chronic pericarditis.
Both forms are characterized by severe pain behind the sternum and breathing difficulties. The cause of these two main symptoms is the occurrence of so-called dry or wet pericarditis.
Dry inflammation often occurs in the early stages of pericarditis. As it progresses, it changes to wet inflammation. The two epithelial surfaces of the pericardium (inner and outer pericardial leaflet) are affected.
In dry pericarditis, the two epithelial surfaces of the pericardium rub dry against each other. This causes severe pain and rubbing noises reminiscent of leather creaking.
In wet pericarditis, a fluid-filled space, known as an effusion, develops between the two pericardial sheets. The heartbeat increases to counteract the pressure. At the same time, breathing disorders increasingly occur, as the effusion also restricts the space for the lungs to expand when breathing.
If left untreated, pericarditis leads to manifest heart disease such as heart failure. The outflow of blood to the heart is increasingly restricted. As a result, massive restrictions in heart function occur and edema forms throughout the body.
The heart muscle is medically called the myocardium. Inflammation of the heart muscle is therefore referred to as myocarditis. Myocarditis is a life-threatening heart disease, as the inflammation can lead to
can occur.
Bacterial or viral infections are very often the cause of myocarditis. In rare cases, however, medication (e.g. penicillin) and allergies can also trigger these heart diseases.
The symptoms of myocarditis include
and arrhythmias.
A rare complication of myocarditis is cardiogenic shock. This is the result of an imminent pumping failure of the heart.
The heart is no longer able to pump a sufficient amount of blood into the body due to the myocarditis. The person is anxious and suffers from an acute lack of oxygen due to the reduced blood flow.
Cardiogenic shock is one of the cardiac diseases with an emergency character. The affected person must be kept in an elevated position until the emergency doctor arrives.
Cardiogenic shock is characterized by the gradual onset of marbling of the skin on the neck, extremities and chest.
Heart diseases with arrhythmias can be divided into three large groups:
These disorders are usuallycaused by conduction disorders or problems with the generation of excitation for the heartbeat. Metabolic physiological processes such as hyperthyroidism can also cause cardiac arrhythmias.
Cardiac arrhythmias are always dangerous if they severely restrict the heart's pumping capacity. Heart rates above 160 or below 40 beats per minute lead to a noticeable reduction in the amount of blood ejected. As a result, the brain lacks oxygen, so that
can occur.
Cardiac arrhythmias can be detected by ECG © Kzenon | AdobeStock
In the case of severe heart disease and heart attacks
can occur, leading to complete ventricular arrhythmias. These are life-threatening.
Coronary heart disease is a complex of different heart diseases. Together they cost the lives of around one in five people. The diseases include
The main risk factors for these heart diseases are
Smoking,
In arteriosclerosis, substances are deposited on the inside of blood vessels. This is also known colloquially as vascular calcification. The cross-section of the vessels is reduced until, in the worst case, the vessel is completely blocked.
Arteriosclerosis gradually reduces the cross-section of the vessel © Axel Kock | AdobeStock
Angina pectoris refers to a feeling of "tightness in the chest". This occurs when the coronary arteries (blood vessels that supply the heart muscle) are already severely constricted by arteriosclerosis. Particularly under stress (e.g. climbing stairs, fast walking), the blood flow through the blood vessels is no longer sufficient to supply the heart muscle with enough oxygen.
As a result, parts of the heart muscle are no longer supplied with blood for three to 20 minutes. The heart muscle reacts to this with pain, which is felt as a "tightness in the chest" with heart palpitations and shortness of breath.
A resting phase and nitroglycerine spray lead to rapid relief of the symptoms. During the resting phase, the blood flow in the constricted vessels is once again sufficient to meet the oxygen requirements of the muscle.
Angina pectoris attacks are always regarded as a harbinger of an impending heart attack, so that constant medical monitoring is necessary.
In the case of a heart attack, the lack of blood flow to the heart muscle lasts even longer. This leads to irreversible tissue destruction in the heart muscle.
In most cases, one branch of the coronary arteries is completely blocked so that the area supplied with blood is no longer supplied with blood. As a result, heart muscle cells die.
The symptoms do not differ significantly from an attack of angina pectoris, but usually last for more than 30 minutes. The pain of a heart attack is classically felt in the left chest area, radiating into the left arm. In women, however, a heart attack is very often accompanied by pain in the upper abdomen. This is why a heart attack in women is too often not recognized.
A heart attack is a life-threatening emergency and requires immediate emergency medical treatment.
Heart failure (cardiac insufficiency) is one of the heart diseases with insufficient cardiac capacity. This means that less and less blood is ejected into the circulation.
The causes of heart failure are numerous and include
A distinction is made between left heart failure and right heart failure.
Left heart failure affects the left side of the heart. In this case, the blood backs up in front of the left heart. This blood filling causes the blood to back up into the lungs, resulting in pulmonary hypertension and edema.
The main symptoms of left heart failure therefore include
Right heart failure usually occurs as a result of previous left heart failure. The backlog of blood continues through the lungs into the right heart. There it leads to the full picture of "congested" right heart failure.
Typical for these heart diseases are
Congenital heart diseases include all prenatal valve and septal defects as well as
Congenital heart disease occurs in around one percent of newborns.
In an atrial septal defect, the septum between the right and left atrium in the heart is not closed. The excess pressure in the left atrium causes oxygen-rich blood to enter the right atrium.
A naturally occurring atrial septal defect is the ductus botalli, which all unborn children have. It fulfills the function of a short-circuit defect to bypass the lungs, which are not yet functional. This means that the ductus botalli in the neonatal environment is not a cardiac disease.
The second most common defect in congenital heart disease is the ventricular septal defect. In this case, the dividing wall between the right and left ventricle is not closed. As a result, blood pushes from the left ventricle into the right ventricle.
The symptoms depend on the size of the defect and can range from oxygen deficiency symptoms to shortness of breath.
Other congenital heart diseases usually affect the large blood vessels leading from the heart. The aorta and the pulmonary artery can be reversed in their origin. This leads to deoxygenated blood in the circulatory system and is life-threatening for the newborn.
Constrictions (stenoses) can also occur in the area of the pulmonary valves or the aortic arch. In tetralogy of Fallot, four heart diseases occur simultaneously:
The more severe the heart defect, the more likely it is that only heart surgery can help.
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