Heart: How to recognize heart diseasePeople with heart disease almost always remember creeping changes in the body in retrospect. On which alarm signs one should pay attention.
Creeping process: Heart diseases such as a heart attack often do not appear out of nowhere, but the body usually signals much earlier that something is not right.
In retrospect, people with heart disease almost always remember gradual changes in the body. Alarm signs to look out for.
Arteriosclerosis, coronary heart disease
Heart failure, cardiac insufficiency
Heart valve insufficiency
(To learn more about the symptoms and causes of the disorders, please click on the text link)
In retrospect, people diagnosed with heart disease almost always recall gradual physical changes that they have been aware of for some time but have not taken seriously enough. Some people have lost the ability to work under prere: If they exert themselves, a tugging in the chest becomes noticeable Breathing difficulties When the heart does not want to . Others complain of water in the legs or of sudden cardiac dropouts.
"Often, such symptoms are mistaken for a normal sign of aging – or a sign of physical untrainedness," warns Professor Peter Buser, cardiologist and deputy chief physician at Basel University Hospital. Even the vernacular speaks trivially of the "ageing heart. But the most common heart conditions, such as coronary heart disease, myocardial infarction, cardiac insufficiency (heart failure), valvular and arrhythmias or atrial fibrillation (see below for detailed descriptions of the conditions), as well as hypertension Silent Danger are chronic diseases. They do not occur overnight and – this is the only positive aspect – fortunately usually become noticeable at an early stage.
Only one in four infarctions comes as a real surprise in the form of "sudden cardiac death". In three out of four cases, on the other hand, the infarction is programmed and announces itself. "When the coronary arteries calcify and narrow, this soon manifests itself in mild angina pectoris Angina pectoris The constricted heart – attacks with intermittent shortness of breath and a pain in the chest that depends on the load," says Tobias Wettstein, cardiologist with his own practice in Zurich.
Such symptoms should always be discussed with the doctor – before the next supposed angina pectoris attack turns out to be a heart attack. If, on the other hand, the angina pectoris pain already occurs when lying or sitting, i.e. without physical exertion, the narrowing of the coronary arteries is often already very advanced: Then a heart attack is imminent.
Early warning signs are also noticeable in other heart conditions. If the heart slowly weakens in so-called cardiac insufficiency, almost all those affected experience a drop in performance, combined with shortness of breath: even when walking or after a few steps, they get out of breath and start sweating; the muscles become weak and ache because they do not receive enough blood from the heart. "Unfortunately, as a result, many sufferers simply narrow their radius of life," says Peter Buser, "instead of interpreting the symptoms as warning signals PAVK Schaufensterkrankheit is a warning signal and seeking medical treatment."
Cardiac arrhythmias can also be directly noticeable in some cases: The heart races or stumbles noticeably, the affected person feels dizzy Dizziness When the world suddenly turns around . "Arrhythmias are common and can be quite harmless," Buser says. However, if someone suddenly faints during physical exertion – especially at a young age – this should definitely be taken seriously: Sometimes there is a rhythm disturbance behind it, which can lead to a lack of blood supply in the brain and also to sudden cardiac death.
But there are also less conspicuous precursors. "An impending heart attack unfortunately doesn't always present itself as classically as it does in the textbook," says cardiologist Tobias Wettstein. Some complaints that can be traced back to the heart can easily be misinterpreted or misjudged. "Angina pectoris" is not always manifested only by a prere pain on the chest that radiates into the left arm. Sometimes sufferers also experience abdominal or back pain, shortness of breath, pain in the jaw or teeth."
Supposedly harmless symptoms do not usually lead you straight to the family doctor or cardiologist. "However, such non-specific symptoms should make people with certain risk factors wary," says Peter Buser. "Especially diabetics diabetes Have "the sugar" under control? , Smokers, people who are overweight, have elevated blood lipid levels, high blood prere, or a family history of cardiovascular disease should seek medical attention."
The heart can be strengthened, because changes such as abnormal thickening of the heart muscle or calcification of the coronary arteries can be partially reversed with medication, catheter and surgical interventions.
Even those who change their lifestyle, eat a Mediterranean diet, exercise regularly Exercise is a super pill and give up smoking can do a lot to cure their heart condition or at least slow its progression.
Cause of coronary heart disease
Arteriosclerosis (colloquially: hardening of the arteries) is a pathological change in the vessels: the veins that supply the heart muscle, the brain and the legs with blood are thickened or narrowed in places. In the vernacular this is also called arteriosclerosis. This is when fats accumulate in the body's arteries, calcify and, over time, lead to a thick, less elastic vessel wall and a narrowed blood vessel cross-section – including in the coronary arteries. Risk factors for atherosclerosis include: elevated blood lipids, smoking, high blood prere, obesity, diabetes mellitus, lack of exercise, and a family history of the disease.
As a result, the blood flow in the affected arteries decreases sharply. If coronary arteries are affected by arteriosclerosis, this is known as coronary artery disease. Their main symptom is painful chest tightness, in Latin angina pectoris.
Symptoms of arteriosclerosis
At the beginning no symptoms are noticeable. As the disease progresses, arteriosclerosis can lead to a feeling of tightness in the chest or left-sided chest pain, depending on which arteries are affected (an angina pectoris Angina Pectoris When the heart becomes a time bomb ). Angina pectoris may be manifested by a painful prere on the chest, a feeling of tightness or burning behind the breastbone. In the case of slight vasoconstrictions, the pain attacks only occur during physical exertion, whereas in the case of severe constrictions, they also occur during periods of rest. Other symptoms include shortness of breath and a feeling of heaviness in the arms and shoulders.
When poor blood flow to the heart impairs the electrical impulse generation and propagation that control the heartbeat, cardiac arrhythmias occur (see also 5. cardiac arrhythmias). If a blood clot forms at a narrowed spot and completely blocks the vessel, this can lead to a heart attack. Arteriosclerosis affects the entire vascular system of the body; vascular occlusions can also occur in other organs (cerebral stroke or smoker's leg).
If a carotid artery is calcified, this can lead to a stroke, which often manifests itself in paralysis and speech disorders. Narrowed leg and pelvic arteries, on the other hand, are noticeable by severe muscle pain after walking short distances PAVK Schaufenststerrankheit is a warning signal (the so-called window-shopping disease). Erectile dysfunction can also be a consequence of arteriosclerosis.
Therapies for arteriosclerosis
Angina pectoris: Beta-blockers, antiplatelet drugs, calcium antagonists, nitrate preparations.
Therapy of risk factors: Angiotensin II antagonists, ACE inhibitors, lipid-lowering drugs, diabetes treatment.
Interventions: Bypass surgery, coronary angioplasty.
What happens during arteriosclerosis
The veins that supply blood to the heart muscle, brain and legs are thickened or narrowed in places.
In an infarction, a blood clot (thrombus) blocks an arteriosclerotic coronary vessel. As a result, the blood flow in the affected part of the heart muscle is reduced-. Oxygen supply impaired or interrupted. Without immediate restoration of blood supply, muscle cells die off. The result is scarring with corresponding impairment of cardiac output. If the heart muscle is severely affected, heart failure, cardiac arrhythmias or sometimes even valve defects remain. Occlusions can also occur in other organs: In a cerebral stroke, for example, the blood supply to the brain is interrupted. A heart attack is usually preceded by arteriosclerosis. Coronary artery disease precedes.
symptoms of a heart attack
There are different degrees of severity: from a small, not very dangerous infarction to a fatal one. The severity of the heart attack depends on the size of the occluded coronary artery: the larger the vessel, the greater the damage. The chance of surviving a heart attack is quite good (more than 90 percent) if the blocked coronary vessel can be reopened in less than four hours in the hospital.
precursors of the infarction: Strain-dependent feeling of tightness or pain in the chest, sometimes radiating to the shoulder, arm, neck or upper abdomen.
Acute symptoms: Usually a sudden, severe pain behind the breastbone that can radiate to the left arm, neck and shoulders, possibly shortness of breath, fear of death, "heart palpitations," tightness, nausea and profuse sweating. Sitting down and resting, as well as taking the drug nitroglycerin, do not bring any improvement – in contrast to the angina pectoris attack (see "Coronary heart disease"). Important to know: In diabetic, elderly people or in women, the heart attack often proceeds atypically Heart attack in women Women's hearts beat differently or "silently," i.e., without the described symptoms.
Therapy in the event of a heart attack
Acute therapy: Balloon dilatation, stent.
Later: See "Coronary artery disease," "Cardiac arrhythmias," and "Heart failure.".
How a heart attack develops
In an infarction, a blood clot blocks an arteriosclerotically altered coronary vessel. As a result, the affected part of the heart muscle is no longer supplied with oxygen properly. As a result, the muscle cells die.
Causes of heart failure
In cardiac insufficiency, the heart is not (or no longer) able to provide full pumping power. The heart no longer has sufficient strength to pump blood through the circulatory system and to supply the body with blood in the best possible way. The blood backs up in front of the heart. Chronic heart failure is a progressive disease: the wall of the left ventricle thickens and the heart chambers dilate – the heart's performance becomes progressively worse. The heart becomes larger over time. At the same time powerless. The blood circulation threatens to fail. Half of the patients die of sudden cardiac death due to a cardiac arrhythmia. Reasons can be a heart attack, a congenital heart defect, cardiac arrhythmias or heart muscle diseases.
Causes of heart failure include: high blood prere, a previously suffered heart attack, a heart valve defect, coronary artery disease, heart muscle disease, lung disease, and others.
Symptoms for heart failure
The symptoms vary depending on the degree: Initially, there is shortness of breath, shortness of breath on heavy, then light exertion. If the heart failure is already far advanced, pulmonary edema (water in the lungs) occurs. Sufferers can then no longer lie flat on their back without a feeling of oppression overcoming them. Edema often forms in the lower legs as well. Frequent urination at night can also be a symptom. This is because when the patient is lying down, the accumulated water in the body (via the blood) shifts more from the legs to the chest cavity. The kidney then tries to excrete this water. The sick heart has trouble carrying the extra volume of water, which hinders oxygen uptake in the lungs and further increases shortness of breath.
If the left ventricle is affected by the insufficiency, patients often breathe faster, sit upright in bed to breathe better. You suffer from coughing fits, have cold sweats and are very restless. Rales can be heard on the lungs when breathing.
If the right ventricle is affected, water accumulates in the ankles and shins. If the disease is advanced, skin edema appears on the flanks, genitals and buttocks.
Therapies for heart failure
ACE inhibitors, beta blockers, diuretics, angiotensin II antagonists, digitalis drugs, pacemakers, defibrillators, heart transplants.
Causes of valvular heart disease or heart failure
In valvular insufficiency, the heart valves are leaking. One speaks of a valve stenosis if the heart valve is narrowed. Then the heart valve can no longer fulfill its valve function, and the blood pumped through the valves either flows insufficiently into the chambers (stenosis) or back into the atrium (insufficiency).