Heart failure - symptoms and diagnosis

Symptoms of heart failure are classified into four stages, depending on their severity, so the physician can determine the severity of cardiac output weakness. Read all about the signs of heart failure, their history and diagnostics.

Symptoms of heart failure

Often the limitation of cardiac muscle strength can already be measured before the patient feels discomfort. Only when a - critically different - critical point is exceeded, symptoms such as:

  • inefficiency
  • Tiredness and languor
  • Cough irritation during physical activity such as climbing stairs, later also in peace and especially when lying down
  • difficulty in breathing
  • Herzstolpern
  • Water retention on the ankles and lower legs
  • nocturnal urination

Development of symptoms during the course of the disease

Characteristically, complaints in the initial stage of heart failure only occur with greater physical exertion. With increasing progression of the disease, it then comes to rest.

An end-stage patient becomes increasingly bedridden, lapses, and is usually able to get enough air only in an upright sitting position. The weak heart no longer fulfills its function as a circulation pump. As a result, increasingly accumulates water in the lungs and legs and the kidney function suffers increasingly.

Depending on the underlying disease, other symptoms such as chest pain in coronary heart disease, headache in high blood pressure or fainting in certain forms of cardiomyopathy occur. In case of unclear discomfort a doctor should be consulted early, as effective therapy should start as early as possible. If the diagnosis is delayed for years, the treatment options are often severely limited.

Stages of heart failure

Depending on how severe the symptoms are and when you feel the first symptoms, there are four stages of cardiac output weakness. This classification was proposed by the American Heart Disease Society, the New York Heart Association, NYHA. Therefore one speaks also of the NYHA stadiums.

NYHA description
NYHA Stadium 1Slight restriction of cardiac output. Symptoms only occur when there is considerable effort.
NYHA Stadium 2Complaints such as tachycardia, weakness or shortness of breath are noticeable even with average normal, everyday stress such as climbing stairs over one or two floors or gardening.
NYHA Stadium 3The symptoms mentioned occur even under very light load as when getting up from a chair.
NYHA Stadium 4The heart is so severely limited in its ability to suffer from wheezing and weakness while lying down or sitting down.

Diagnosis of heart failure

The limited cardiac muscle strength is essentially diagnosed on the basis of the typical symptoms in conjunction with objective examinations such as X-ray of the chest, ECG, ultrasound examination of the heart or cardiac catheter.

The contractually measurable contraction force of the heart muscle and the subjective complaints of the affected person are not always the same. Shortness of breath or diminished exercise capacity may already occur with only moderately pronounced cardiac insufficiency. However, cases are also known in which patients lead a largely symptom-free life even with a severely limited pumping capacity of the heart.

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