Introduction
Heart muscle weakness, often called cardiac insufficiency, is a widespread disease that particularly affects older people, but it can also occur in young people. Medically, the disease is also known as heart failure. This is a condition in which the pumping capacity of the heart decreases over time and eventually leads to pump failure. Heart failure can have various causes and vary in severity. Patients with a certain degree of heart failure often suffer greatly because their physical performance is greatly reduced.
Causes
The causes of cardiac insufficiency are manifold. For example, the heart muscle can be damaged directly and thus lose its performance capacity. This can be the case after a heart attack, coronary heart disease or as a result of heart muscle inflammation.
In addition, the heart muscle is weakened if it always has to pump against too high a pressure, for example in cases of high blood pressure (arterial hypertension) or a narrowed aortic valve or pulmonary valve. If the aortic valve is leaking – doctors also speak of aortic valve insufficiency in this context – part of the expelled blood volume flows back into the heart during the heart’s relaxation phase. This increases the volume and the ventricles are excessively stretched.
This condition can also lead to cardiac insufficiency in the long term. If there is fluid in the pericardium (pericardial effusion), the heart is constricted and its function is impaired. This can also cause heart failure. It has also been found that people with sleep disorders are more likely to suffer from heart muscle weakness.
Symptoms
The heart muscle weakness usually first becomes noticeable under physical stress. It manifests itself differently depending on whether the right or the left ventricle is mainly affected. In the case of weakness of the left ventricle, known as left ventricular insufficiency, patients suffer above all from shortness of breath (dyspnoea respiratory distress with cardiac insufficiency) during physical exertion.
In advanced stages of the disease, shortness of breath can also exist under resting conditions, in which case one also speaks of dyspnea at rest. The shortness of breath usually worsens when lying down, as more blood volume flows back to the heart and a higher pressure is applied to the chest. Those affected often sleep with a raised upper body, for example by placing several pillows under their head and back.
Due to the inability of the heart to transport the entire blood volume sufficiently quickly, fluid can leak into the lungs. This is known as cardiac pulmonary edema. It is characterized by shortness of breath, rattling noises when breathing and possibly foamy sputum when coughing.
In left heart failure, water preferentially collects in the lungs. In right ventricular failure, known as right heart failure, water collects mainly in the legs. These leg edemas lead to a feeling of heaviness and tension in the legs.
They are swollen and often painful. The leg edemas decrease when the patient is lying down because the water can then flow more easily from the tissue back to the heart. This also explains why patients with heart failure often have to urinate at night.
Fluid often collects in the free abdomen, which is called ascites. In severe cases, the abdomen is thick and very fluid-filled. In this case, when the abdominal wall is pushed, a wave can be observed which is triggered by the sloshing fluid.
The heart muscle weakness is manifested by characteristic symptoms such as shortness of breath, reduced physical resilience, leg edema and frequent urination at night (nocturia). As patients become increasingly restricted over time by the disease, they often seek medical attention sooner or later. Since the prognosis of the disease is better the earlier it is detected and treated, a doctor should be consulted at an early stage if the symptoms mentioned above occur. This doctor can usually reach a diagnosis quite quickly through a specific examination and initiate the appropriate therapy.
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