Cardiac insufficiency

Heart failure

A heart failure, also known as cardiac insufficiency, is a sickness of the heart, which can be roughly explained as a heart muscle, that is too lazy to pump adequate blood through the blood vessels. The heart fails to sufficiently provide the body with blood, which contains oxygen and nutriments, vital for the body's well-being.

Heart failure is categorized into:

• acute heart failure (e.g. sudden heart attack)
• chronic heart failure
• left heart failure
• right heart failure
• global heart failure (both sides of the heart)

An approximated 10 Million Europeans suffer from heart failure, there from around 750,000 people in the UK. 10% of the above 80 year-olds and only 1% of those aged between 44 and 55 are subject to this cardio condition. Men 1.5 times more often than women.

What causes heart insufficiency?

A heart insufficiency has various causes.

• coronary heart disease - insufficient coronary circulation
• arterial hypertension - High blood pressure
• cardiac conditions - e.g. heart attack, valvular heart disease
• myocarditis - inflammation of the heart muscle
• atherosclerosis - accumulation and swelling of the artery walls

right heart failure is usually caused by an

• advanced diseases of the lung, e.g. COPD (Chronic obstructive pulmonary disease), Emphysema

Generally, a heart failure is the result of a prior sickness (underlying disease) weakening the heart and making it insufficient in providing the body with essentials. But not only sicknesses lead to a heart failure; leading an unhealthy lifestyle may have the same effect. By just reducing following factors, the number of heart failure patients could be cut down by half.

• smoking, being overweight, lack of exercise
• high blood pressure (arterial hypertension)
• diabetics
• hypercholesterolemia (high cholesterol level in blood)

What makes the heart fail?

Left heart failure:

The hearts failing pumping causes a blood congestion of the pulmonary vasculature, leading to a  blood accumulation in front of the left heart chamber. The results are edema (water retention) in the lung tissue and pleural cavity. This means for the patient, that any sort of physical strain will trigger breathing difficulties, which in the worst of cases could turn into a chronic condition, accompanied by coughing and a railing lung.

Right heart failure:

This category of heart failure takes after the same procedure as the left heart failure. However, edemas can develop in various body parts. Usually, fluid accumulates in the leg, abdominal area and jugular vein. In severe cases the liver may swell.

During nighttime the accumulated water is usually shed out; a frequent go to the toilet is therefore typical for right heart failure patients, as well as weight gain and an increased abdominal girth.

Global heart failure:

A failure of both heart sides, equally show up left- and right heart failure symptoms.

The body reacts to the insufficient blood supply of the organs by increasing the heart rate (tachycardia). Thereby a cardiac arrethmia may occur. In nearly all cases the heart muscle enlarges (hypertrophy). A sudden cardiac arrest is the sign that the body failed to react to the heart failure.

Classification

The New York Heart Association (NYHA) classifies heart failure in four internationally recognized categories:

• NYHA 1: Patient is not limited in his physical abilities
• NYHA 2: Patient is slightly limited in his physical abilities. No complaints when body at rest.
• NYHA 3: Patient is profoundly limited in his physical abilities. No complaints when body at rest.
• NYHA 4: Patient feels constant discomfort (adynamia and dyspnea)