Heart Failure - Causes And Forms

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Heart Failure - Causes And Forms
Heart Failure - Causes And Forms
Video: Heart Failure - Causes And Forms
Video: Types of Heart Failure – Cardiology | Lecturio 2023, February
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Heart Failure: Causes & Forms

Almost all chronic heart diseases can lead to heart failure (cardiac insufficiency). The most common causes are heart attacks, high blood pressure and diabetes mellitus, often in combination with one another. Heart failure is categorized mainly according to the cause, the impairment of physical performance and the ejection fraction of the left ventricle. The ejection fraction describes the proportion of blood that is ejected with each heartbeat. At least one to two percent of the adult population have heart failure, although up to 300,000 Austrians are actually likely to be affected. Heart failure can develop at any age, but is clearly more common with age. 80 percent of heart failure patients are over 65 years old.

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A damaged heart muscle is unable to supply the body with the required amount of blood. The heart tries to compensate for this weakness by countermeasures: the heart rate increases (tachycardia), the size of the heart increases (cardiac dilation), the heart muscle becomes thicker. Over time, these mechanisms lead to increasing damage and weakening of the heart, so that it can work worse and worse.

What are the causes of heart failure?

Various diseases that damage the heart muscle can lead to weak pumping of the heart and thus to heart failure. The main causes are:

  • Coronary artery disease (coronary heart disease, especially myocardial infarction)
  • longstanding high blood pressure,
  • Diabetes mellitus,
  • Inflammation of the heart muscle (myocarditis), e.g. due to a viral disease,
  • Damage to the heart muscle, e.g. from chemotherapy, radiation therapy or long-term excessive alcohol consumption or from drug addiction,
  • Cardiac arrhythmias, especially with a fast pulse, e.g. with atrial fibrillation,
  • Heart valve disorders (valves do not close completely or are too narrow)
  • genetic or familial heart disease,
  • congenital heart defects: can lead to heart failure even in young people,
  • rare causes.

Further risk factors for the development of heart failure are kidney failure, high cholesterol levels, a high-fat diet, obesity, sedentary lifestyle and smoking.

How can heart failure be prevented?

To prevent heart failure, its most common causes - coronary artery disease, high blood pressure and diabetes - must be treated quickly and effectively with drugs. A change in lifestyle is also essential. The following are particularly recommended:

  • Balanced nutrition,
  • Avoid or reduce obesity,
  • regular exercise,
  • little or no alcohol,
  • do not smoke.

What types of heart failure are there?

Heart failure can be classified according to various criteria. The most important classifications are based on the cause, the course (acute versus chronic), the extent to which the load capacity is restricted and the ejection fraction.

The main types are acute and chronic heart failure:

  • The acute heart failure quickly, sometimes suddenly develops, and the symptoms are pronounced from the beginning strongly. This condition is considered life-threatening and requires immediate evaluation and treatment. Acute heart failure therefore usually requires hospitalization. Acute heart failure can be caused by a new, often easily treatable problem, such as a massive rise in blood pressure, heart attack, cardiac arrhythmia, pulmonary embolism or worsening chronic heart failure. In the latter case, one speaks of decompensation, the most common causes of which are the inadequate use of heart failure medication, the use of medication that is unfavorable for heart failure, infections or new atrial fibrillation.
  • Of chronic heart failure is usually speaks when it is for three months or more. Chronic heart failure can initially develop without any significant symptoms, while the heart function slowly deteriorates until the patient suddenly presents with acute heart failure. In this situation, those affected usually have to be admitted to hospital urgently. However, the symptoms can also develop insidiously - over the course of days, months or even years - so that the patients usually turn to their family doctor first.

A distinction is made between left and right heart failure and global heart failure:

  • The left half of the heart pumps oxygen-rich blood from the lungs to the body. If this no longer works adequately, the body is undersupplied, initially only with the increased demands under load, but in an advanced stage also at rest. The consequences of this include reduced performance, dizziness, shortness of breath, and low blood pressure. At the same time, the blood backs up in the lungs. This causes additional shortness of breath, especially when fluid escapes from the blood vessels into the lung tissue.
  • The right half of the heart pumps the deoxygenated blood, which flows back from the organs, muscles and other tissues, into the lungs, where it is again enriched with oxygen. If the right half of the heart is weak (right heart failure), the backflow of blood into the body's circulation causes fluid to accumulate in various tissues, especially in the legs, chest, abdominal cavity and liver. As a result, a belt is sometimes felt to be oppressive and uncomfortable. A feeling of fullness and loss of appetite can also be caused by backlogs in the stomach and intestines.
  • Often both halves of the heart are affected, in these cases one speaks of global or biventricular heart failure. Those affected can suffer from the symptoms of left and right heart failure at the same time.

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