Heart Failure

What is heart failure?

In heart failure, the heart is no longer able to supply the body with enough blood and oxygen. Nevertheless, there are various treatment options available that can help maintain quality of life.

What are the different types of heart failure?

Heart failure is divided into right-sided heart failure, left-sided heart failure and global heart failure, in which both sides of the heart are affected. The starting point is usually damage to the heart muscle, as a result of coronary heart disease, for example.

Left-sided Heart Failure

In the case of left-sided heart failure, the oxygen-rich blood from the pulmonary circulation is not pumped into the systemic circulation fast enough. It backs up in the chest, causing fluid to build up in the lungs. This symptom can be life-threatening as it can lead to shortness of breath.

Right-sided Heart Failure

In the case of right-sided heart failure, the oxygen-poor blood from the systemic circulation is no longer passed on quickly enough to the lungs to be re-oxygenated. It backs up in the vessels leading to the heart, which can lead to swelling in abdominal organs and under the skin. Patients particularly notice swelling of the arms and legs. In addition, patients with right-sided heart failure have less physical capacity. They experience shortness of breath more quickly, for example when climbing stairs.

Global Heart Failure

In the case of global heart failure, both factors come together. Patients run out of breath faster and lose stamina, especially during physical work. This effect can be exacerbated by water retention in the lungs. Heart failure that has been present for a long time is called chronic heart failure.

If you experience these symptoms, be sure to see your doctor. They can, for example, measure the ejection fraction of your heart by means of a painless ultrasound.

If heart failure is left untreated, a vicious cycle develops:

The body's reaction to the symptoms makes the disease increasingly worse.

This process often begins when the weakened heart can no longer supply the limbs with sufficient blood. The body then tries to restore the supply by producing substances which cause the vessels of the body to constrict. The blood then flows faster despite the heart failure. However, this also increases blood pressure and the already weakened heart has to work even harder to cope with the pressure.

The body reacts to this complication by making the heart muscle thicker.

This causes the heart muscle to become abnormally thickened, so it needs more oxygen, and leads to a reduction in the size of the heart’s chambers which pump out blood with every heartbeat. As a result, less blood is pumped per heartbeat and the heart has to beat faster. The extra effort further weakens the heart.

Any damage to the heart muscle reinforces this vicious cycle and makes the heart failure worse in the long term.

In general, this reduces life expectancy. If other diseases such as poor kidney function or diabetes are also present, the heart can eventually become so weakened that surgical procedures can only be carried out with a great deal of risk. This explains why there are high-risk patients who have so far been denied life-prolonging open-heart surgery.

What should be done in case of heart failure?

Treating heart failure always starts with stopping this downward spiral. The symptoms can be minimised with well-designed treatment, which makes a good life possible. It is important to stop the spiral of symptoms and worsening of the disease before the heart becomes even more damaged.

Circulatory problems and shortness of breath can usually be treated successfully, especially in the early stages of heart failure. High blood pressure often causes circulatory problems. Therefore, special drugs are used that reduce the vascular constriction and thus lower the blood pressure. Diuretics can help to combat shortness of breath. Your GP or cardiologist can provide you with more information about the use of medication for heart failure.