Heart failure: information & specialists for heart failure

In heart failure, the heart is unable to supply the body with sufficient blood. The condition is therefore also known as heart failure. Typical symptoms are shortness of breath, edema and reduced performance. Treatment involves medication and invasive procedures. In severe cases, a heart transplant is required.

Below you will find further information and selected specialists for heart failure.

What is heart failure?

Heart failure is a functional disorder of the heart due to various causes. As a result, the heart is no longer able to pump blood through the blood vessels into the body with sufficient speed or force.

Classification of heart failure

Doctors classify heart failure into different forms based on various characteristics:

• acute or chronic,
• left or right heart failure,
• systolic or diastolic heart failure,
• different degrees of severity based on the symptoms.

If heart failure begins suddenly within a few hours or days, it is acute heart failure.

Anatomy of the human heart © bilderzwerg | AdobeStock

Heart failure ischronic if the condition develops over months or even years. The body can compensate to a certain extent for the reduced performance of the heart in chronic heart failure. For example, the heart muscle can thicken in order to develop a higher pumping capacity. An increased heart rate can also compensate for heart failure.

Patients with compensated heart failure often only experience symptoms during heavy physical exertion. Decompensated heart failure, on the other hand, causes symptoms even at rest or during light physical exertion.

If the left side of the heart is responsible for the heart failure, there is left heart failure. In this case, the blood accumulates in the pulmonary circulation. In right-sided heart failure, the right side of the heart is affected by the disorder. This results in blood congestion in the systemic circulation.

Global heart failure shows symptoms of both forms.

If the pumping function of the heart muscle is reduced, there is systolic heart failure (heart muscle weakness). If, on the other hand, the heart does not fill up sufficiently with a normal pumping capacity, this is known as diastolic heart failure.

The New York Heart Association (NYHA) has developed criteria for classifying heart failure into stages / degrees of severity:

• In stage I, there are no symptoms with normal physical exertion
• In stage II, there are mild symptoms(shortness of breath and weakness) with normal physical exertion and reduced performance
• In stage III, there is a considerable reduction in performance during normal physical exertion
• In stage IV there is shortness of breath even at rest

Causes of heart failure

The development of heart failure is caused by diseases that damage the heart in the long term. The most common cause is coronary heart disease (CHD). CHD is also often the cause of a heart attack, in which the heart is no longer supplied with sufficient oxygen via narrowed heart vessels.

High blood pressure is also a common cause. In this case, the heart has to work harder, which the body is unable to do in the long term.

Other causes can also be

• Heart valve diseases,
• cardiac arrhythmia and
• heart muscle inflammation and
• some other diseases of the heart muscle and lungs.

Symptoms of heart failure

The symptoms depend on the stage and cause of the heart failure.

Typical symptoms of left heart failure are

• Coughing and shortness of breath and
• water retention (edema) in the lungs.

Right-sided heart failure typically causes edema in the tissues, especially the legs and abdomen. Shortness of breath is also possible. In advanced stages, symptoms such as severe shortness of breath occur even at rest. Resilience is reduced and frequent urination at night is also a typical symptom.

Diagnosis of heart failure

The medical history (patient interview) and physical examination provide the doctor with initial indications of existing heart failure.

Further examinations are

• ECG (e.g. stress ECG or long-term ECG),
• blood pressure measurement,
• determination of blood values,
• X-ray examination of the chest and
• ultrasound examination of the heart.

A doctor performs an ECG at rest. An ECG records the heart pulses and shows pathological changes © Gennadiy Poznyakov / Fotolia

Treatment of heart failure

Heart failure cannot be cured. The aim of treatment is therefore to alleviate the symptoms and prevent complications. Even without symptoms, the patient must start heart failure therapy.

The treatment depends on the cause and severity of the heart failure.

Depending on the underlying disease, medication is often used:

• ACE inhibitors lower blood pressure,
• Beta blockers prevent cardiac arrhythmia,
• diuretics promote the excretion of water and
• digitalis preparations improve the heart's pumping power.

In patients with life-threatening cardiac arrhythmias, an implantable cardioverter defibrillator (ICD) can be used. A biventricular pacemaker can also help to compensate for the cardiac insufficiency.

If the condition continues to deteriorate despite drug and invasive heart failure therapy, a heart transplant may be necessary.

Prognosis of heart failure

If

• the heart failure responds to treatment,
• the patient follows the doctor's instructions and
• reduces any risk factors, for example by changing their lifestyle

the prognosis for heart failure is good.

Which specialists and specialist clinics treat heart failure?

Specialists in heart failure are specialists in cardiology (heart disease). For further diagnosis or specific treatment of heart failure, it may be necessary to consult other specialists such as

• Radiologists,
• vascular and cardiac surgeons and
• transplant specialists

may need to be consulted. Specialized clinics for heart failure are usually cardiology clinics.