Diagnosis
The diagnosis of myocardial insufficiency is made by a doctor on the basis of various examinations. By questioning the patient and describing the symptoms typical for the disease, the physician can already obtain clues about cardiac events. In the subsequent physical examination, indications can also usually be found.The doctor may notice leg edema, congested neck veins, ascites, a pulse that is too fast (tachycardia) and an enlarged liver.
When listening to the patient, rales above the lungs may be noticed due to pulmonary edema, as well as a third heartbeat. Especially groundbreaking for diagnostics is the ultrasound examination of the heart (echocardiography). Here the physician can visualize the heart and check its shape and functionality. Enlarged heart chambers, thickened heart muscle walls or dysfunctional heart valves would be conspicuous in echocardiography. The same applies to the examination of the patient’s blood, where, among other things, sugar and kidney values can be examined.
Therapy
For the treatment of myocardial insufficiency it is important that risk factors that lead to the disease, or maintain it, are eliminated or well adjusted. This necessarily includes a modification of lifestyle. Patients should normalize their weight, drink less than 2 l a day to take the strain off the heart, consume little salt, avoid alcohol and nicotine if possible.
In early stages of the disease, light physical endurance training is recommended. In the late stages, this would put too much strain on the diseased heart and would no longer be of any benefit, so physical rest should be the main priority there. Since most patients do not only suffer from heart muscle weakness, but also have other cardiovascular diseases, blood pressure should be well adjusted. Coronary heart disease as the cause of heart failure should be monitored regularly and intervention should be carried out if necessary. If there is underlying heart valve disease, it should be treated surgically, depending on its severity.
Prognosis
The prognosis of a cardiac insufficiency depends mainly on its severity. If the disease is detected at an early stage and treated early and adequately, patients can often lead a largely unrestricted life. In late stages, the disease is often so far advanced that even with drug therapy there are still severe restrictions on quality of life.
Life expectancy with heart failure can vary greatly from patient to patient. It depends very much on the preconditions the patient brings with him/her. The patient’s age and lifestyle, as well as the severity of the disease and concomitant diseases, are important factors. Patients who suffer from very advanced heart failure and also have other cardiovascular diseases or other conditions die earlier than patients who have early heart failure without other conditions. On average, half of the patients die within four years of diagnosis, although the spread is very wide due to the different disease characteristics and concomitant diseases.
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