The heart beats in the course of a life up to three billion times - this is natural for us and is usually not aware. Unfortunately, cardiovascular disease is the leading cause of death - even if it does not get that bad, a disease of this important organ usually means a reduction in the quality of life.
Structure and function of the heart
The main task of the heart is the blood transport to all regions of the body. The blood is oxygenated in the lungs and then pumped through the main artery (aorta) and many other arteries into all body parts. Heart rate is controlled by fine nerve conduction, and internal blood vessels - the coronary arteries - supply the heart itself with oxygen and other nutrients.
When atherosclerosis deposits lime and other foreign substances in the veins of the body, the blood flow is disturbed and parts of the body are no longer sufficiently supplied with oxygen - it comes to oxygen depletion (ischemia, the heart is called angina pectoris) and finally tissue destruction (infarction ).
The heart consists mainly of muscle tissue, has four heart chambers and four heart valves. In the right half of the heart blood runs from all parts of the body into the heart (and then into the lungs) - in this area, illnesses are less common and usually not as life-threatening. Most diseases occur on the other, the left half of the heart. There, the oxygen-rich blood from the lungs arrives and is pumped into the body with strong pressure. The heart has to build up this pressure 60 to 80 times per minute - well conceivable that a disease has serious consequences and can be life-threatening.
Normally, we do not perceive the heart activity - the heart adapts itself to different requirements such as physical exertion, anxiety or relaxed rest with the respective heart rate. It is all the more worrying when we become aware of our heart and work. Heart stuttering or tachycardia - an indication of cardiac arrhythmia - or tightness in the chest, shortness of breath when climbing stairs and heart pain - possibly coronary heart disease - can be typical heart problems.
Sometimes, heart disease also starts with feeling less resilient - this can happen with myocarditis, valvular heart failure or heart failure. Many people mistakenly blame the stomach or back for pain in the heart environment - the real cause is not recognized.
Anamnesis (ask the medical history): All complaints can be further limited by specific questions. For example, shortness of breath can occur when climbing stairs, even on the first floor, but only on the fifth floor. The onset and duration of pain often indicates the severity of a heart attack.
Inspection, percussion and auscultation: A visible sign of heart failure may be foot edema. A trained doctor will also see the patient's face color to see if he has heart valve disease. By tapping the chest, the size of the heart is determined - but of course the most important thing is listening to the stethoscope. The doctor can hear the work of the four heart valves on the chest - are there any sounds that should not be like a heart valve defect or is the heart beating irregularly? Is the heartbeat loud or quiet (as in the pericarditis and the pericardial effusion)?
ECG: To detect cardiac arrhythmias or an oxygen deficiency, an electrocardiogram (ECG) is made. An ECG under load (eg on a trim wheel) can document the respiratory distress described by the patient when climbing stairs. In case of arrhythmia, which only occurs occasionally (or at night), a long-term ECG helps to record heart activity over 24 hours. In the meantime, there is also the option of sending a current ECG to an emergency unit by telephone - this is useful for patients with life-threatening heart problems.
Blood tests: If you suspect a heart attack, a blood test for specific heart enzymes such as troponin, creatine kinase (CK) and lactate dehydrogenase (LDH) may help confirm the diagnosis.
X-ray, ultrasound (heart-to-heart): The x-ray shows the heart as a shadow. Size and shape make it possible to draw conclusions about cardiac function - lime on the heart valves is just as visible there as water retention in the lungs (in heart failure). The ultrasound examination of the heart shows the thickness of the heart muscle and the function of the valves - if they do not close properly, reveals a telltale blood flow!
Modern CT scanners may soon replace the heart catheter - yet there is no substitute for cardiac catheterization. This relatively young method shows exactly where there is a constriction of the coronary arteries - even an extension treatment or a stent insert is possible.
Heart disease in children
Unfortunately, there are a variety of heart defects that can be innate and often require immediate surgery. A defect of the cardiac septum is just one of the numerous heart defects, while a small hole can often be left without surgery, because it does not restrict the heart function.
Heart disease in adults
Heart disease is not separable from vascular disease as shown by coronary heart disease (CHD) with its consequences of angina and myocardial infarction. CHD is an arteriosclerosis of the coronary arteries - as arteriosclerosis does not occur in an isolated manner at the heart but all over the arteries, there is also a risk of an infarct on other organs. Diseases such as diabetes, high blood pressure or depression increase the risk of heart attack - and men and women show very different heart attacks. Women are particularly at risk after menopause.
Cardiac arrhythmias can have different causes - so the nerve leads are also affected by atherosclerosis or diabetes. Inflammations of the individual heart layers are another disease group. Inflammation of the heart's lining (endocarditis) may be due to a malfunction of the immune system, while myocarditis (myocarditis) occurs in many viral infections - especially feared as a complication of influenza.
Pericarditis (inflammation of the heart's outer skin, the pericardium) can lead to a mechanical restriction of movement of the heart, in which the pericardium forms a rigid corset. Heart valve changes can occur after an inflammation of the heart's lining or also in heart muscle diseases. Heart failure is more a description of a condition than a condition - but the heart does not manage to deliver enough blood. You feel limp and tired or you get breathless. The extreme case is the sudden heart failure, which usually leads to death.
Treatment of heart disease
Since heart disease often occurs in conjunction with the "deadly quartet", reduction of obesity, drug treatment of a lipid metabolism disorder with a statin and discontinuation of diabetes are the first therapeutic measures. Common cardiac medications include hawthorn extracts, beta-blockers and acetylsalicylic acid - to name but a few. When surgery is inevitable, there is now a chance to be minimally invasive.
In order to restart heart activity in an emergency, a defibrillator is used. Defibrillators are increasingly installed in public places - however, the handling by inexperienced is controversial. Of course, there is a special procedure for each disease with medication or surgery - you can find more information on the particular disease.
Prevention of heart disease
To prevent CHD and myocardial infarction, a healthy diet with sufficient magnesium, a conscious use of cholesterol, a lot of exercise and stress relief should be a matter of course even in adolescence. Here, Mediterranean food with olive oil and red wine (properly dosed) is particularly recommended.
Especially with known heart disease is the lifestyle crucial. Unfortunately, many heart attack patients soon fall back into "bad" infarctive behavior patterns. Even in summer heart patients should pay special attention to themselves (keyword: drink a lot!). In winter, sudden cold attacks are extremely dangerous.
It is best to always carry an emergency card with you, so that everyone can see what medicines the heart patient needs. When traveling, a phrasebook helps with the most important medical phrases; a supervised vacation trip can increase travel security.