At first, only the performance is limited during heavy physical exertion, later breathing is difficult even at rest. The ankles swell, the night’s rest is disturbed by constant trips to the toilet. About two to three million Germans know the symptoms of chronic heart failure from their own painful experience.
The importance of the heart muscle
The heart is a hollow muscle and with its lifelong, permanent pumping power, it is the circulatory engine. The strength of the heart‘s muscles determines how effectively the cardiovascular system works and how well it can adapt to physical stress. If the heart muscle is no longer able to contract sufficiently, the cardiac output no longer meets the requirements – at first that during particular exertion, and later even the pumping action at rest can only be managed with difficulty.
Chronic heart failure is one of the most common diseases in Western nations; in terms of causes of death, it ranks third in Germany – after coronary heart disease (CHD) and myocardial infarction, and ahead of lung cancer.
Constant overload of the heart
Basically, similar to other muscles, the heart can be trained and thus become more efficient through regular strain. Physical stress, which is related to the increase in blood pressure and heart rate, challenges and promotes the heart muscle. However, chronic overstraining of the heart muscle, as can happen with certain diseases, exceeds its adaptive capacity in the long run. The body tries to regulate the heart’s output so that all organs are adequately supplied.
But this is like a weak engine driving a heavy car – it slows down at every incline. Then the driver has to shift down a gear and rev up to be able to get up the hill at all. But in the long run, high-speed driving damages the engine and performance continues to decline. Translated to the heart, this means it beats faster and blood pressure increases so that more blood can be transported per heartbeat.
Early detection is important.
If this overwork continues, the heart becomes even more damaged and can do even less than before. The heartbeat is increased even more to better supply the organs. This enlarges the heart muscle and weakens it even more.
Once underway, this vicious circle is almost impossible to stop. Therefore, it is important to counteract an incipient cardiac insufficiency as early as possible and to strengthen the heart again.
Causes of heart failure
A distinction is made between primary heart failure, which is caused by an independent, usually genetic disease of the heart muscle itself, and secondary heart failure, in which the reduced pumping capacity develops as a result of chronic overload of the inherently healthy heart.
Various diseases can affect the strength of the heart muscle. These include congenital anomalies of the cardiovascular system, chronic circulatory disorders in coronary heart disease, long-term effects of heart valve damage and heart muscle diseases such as dilated cardiomyopathy, a dilation of the ventricle that can occur as a result of heart muscle inflammation, among other things.
However, long-term high blood pressure or chronic alcohol abuse, hormonal disorders (for example, thyroid disease), diseases of the kidney or lungs, and permanent anemia can also lead to heart failure.