Heart fail­u­re

The tissues of the organs are no longer adequately supplied with blood and oxygen.

Heart failure can be caused by various heart diseases.

Angina pectoris is characterised by seizure-like chest pain with severe pressure, tightness or burning behind the breastbone during exertion or in cold weather. The pain can radiate to the neck, jaw, arms, shoulders or abdomen and be associated with shortness of breath.

• Measurement of the heart rate at rest (resting ECG)
• Exercise ECG (ergometry)
• Cardiac ultrasound examination (echocardiogram)
• Blood test
• Medical history of the affected patient (family history)

Additional further investigations:

• Myocardial scintigram
• MRI with visualisation of the coronary vessels (angio-MR)

Cardiac catheterisation (coronary angiography) provides precise information about the existing stenoses in the coronary arteries and the performance of the heart.

Conservative
Acute chest pain is treated with nitrates (nitoglycerin). If a heart attack is suspected
heart attack, aspirin and heparin are administered to "thin the blood".
In long-term therapy, drugs with different modes of action are used to relieve the heart (beta blockers, calcium channel blockers)
The causes of arteriosclerosis are treated by changing the diet (balanced, low-fat, low-salt), exercise therapy, stopping smoking, weight regulation and optimising blood pressure and blood sugar control in diabetics in order to prevent or slow down the progression of the disease.

Interventional
A cardiac catheterisation can be used to determine whether significant constrictions in the coronary vessels are impairing blood flow. Such constrictions can usually be treated by widening and inserting a stent.

Surgical treatment
If there are constrictions in all three coronary arteries, these are bridged with a piece of vein or artery during bypass surgery.