Diagnosis
For the physician, both externally detectable changes as well as physical, apparatus and laboratory chemical examinations are groundbreaking. Indications of heart failureHeart failure is indicated by breathing difficulties (tachypnea: accelerated breathing), edema, bluish discoloration caused by oxygen deficiency, e.g. of the lips or the end limbs of the extremities (acra) as well as congested neck veins. The auscultation performed during the physical examination, i.e. listening to the heart with a stethoscope, often characteristically shows the occurrence of an additional, third heart tone (normally, a first heart tone occurring before the contraction of the heart muscle and a second, which shows the conclusion of the aortic valve and pulmonary valve (both heart valves), so that the two heart tones mark the beginning and end of a heart muscle contraction).
Both a too fast heartbeat (tachycardia) and a too slow heartbeat (bradycardia) may be present. In patients with severe heart failure – heart weakness – the pulse is alternately accelerated or slowed down in rapid succession (medically: pulsus alternans). The most important instrumental examinations are an ultrasound image of the heart (echocardiography), an X-ray of the chest, and an electrocardiogram (ECG) taken under physical stress.A simple ECG is less suitable for the clear diagnosis of heart failure/heart failure, since the findings that can be detected there could be caused by a variety of diseases and are therefore too unspecific.
The ultrasound image, on the other hand, provides a precise representation of blood flow, wall movements of the heart and heart valves; the chest X-ray is used to assess the size of the heart (often the heart is greatly enlarged as an expression of the attempt to compensate for increased stress through increased growth; in principle, the same thing happens as with an athlete who trains his biceps to build up muscles). During the laboratory chemical examination, blood and urine are examined, but there are no 100% provable changes. The messenger substances “ANP” and “BNP” (abbreviations for “Atrial Natriuretic Peptides” and “Brain Natriuretic Peptides”, i.e. protein components that are increasingly produced and released into the blood in the case of heart failure) are a strong indication of the presence of heart failure.
