Introduction
Heart failure is one of the most common internal diseases worldwide. It describes the inability of the heart to pump enough blood through the body to supply it with oxygen. Diagnostic evidence of cardiac insufficiency is provided by ultrasound and an X-ray.
However, the ECG also shows changes typical for heart failure. Heart failure can be classified and differentiated according to various parameters. In most cases, a distinction is first made according to the part of the heart affected, i.e. whether it is a right heart, left heart or a global insufficiency (entire heart). Depending on the localization, there are specific changes in the ECG. A further distinction can be made between a compensated or decompensated cardiac insufficiency and whether it is a cardiac insufficiency with reduced performance or simply with a requirement that is far too high, which the heart can no longer meet due to its functional weakness.
Causes
Typical causes of right heart failure are pressure changes in the small pulmonary circulation. If, for example, one or more pulmonary arteries become blocked, the pressure in the pulmonary circulation increases many times over. The right heart has to fight against this sudden, very high pressure in order to continue to deliver sufficient blood to the lungs.
In most cases, the right heart does not succeed in doing this, resulting in pronounced cardiac insufficiency with right heart failure. These changes lead to clear signs in the ECG, also known as “right heart hypertrophy signs”. Other causes of right heart weakness include cardiac arrhythmia or defects of the pulmonary valve. Typical causes of left heart weakness would be valve defects (aortic valve, mitral valve), cardiac dysrhythmia or permanently high blood pressure. These causes and changes would also be seen in the ECG.
Symptoms of heart failure
Heart failure manifests itself primarily through an increasing intolerance to stress. This can manifest itself in rapid fatigue and shortness of breath. In addition, right heart failure leads to massive water retention, especially in the legs, dry coughing, congested neck veins and digestive problems such as nausea, a feeling of fullness and liver pain.
