Introduction
Elderly people often suffer from cardiac insufficiency or heart failure. Almost 20% of >60-year-olds and almost 40% of >70-year-olds in Germany suffer from heart failure, with women being affected less frequently than men. Heart failure cannot be cured and is one of the most common causes of death. Early diagnosis and consistent therapy is crucial for prolonged life expectancy. A physician should be consulted at an early stage and specific tests should be performed.
These tests are available
There are various online questionnaire tests circulating on the Internet, which test the various symptoms that indicate heart failure. The stronger the symptoms and the more symptoms that occur simultaneously, the more likely it is that heart failure will be diagnosed. There are now standardized and scientifically evaluated questionnaires that doctors use in their everyday practice.
Each question corresponds to a certain point value. If a certain amount is exceeded at the end, for example, a blood test (BNP test) and a referral to a cardiologist are arranged. The BNP blood rapid test is a newer method to estimate the load on the heart.
BNP (=B-natriuretic peptide) is released from cells of the heart chambers. The more the chambers are stretched (= loaded), the more BNP is in the blood. In addition, the physician will always perform a physical examination, during which the heart and lungs are listened to and the body is examined for possible signs of congestion (leg edema, neck vein congestion).
However, in order to be able to reliably exclude or confirm a cardiac insufficiency, an echocardiography (heart ultrasound) is always performed. The ventricular system is examined from different angles. Here, heart movements, heart muscle thickness, heart valves, blood flow and ejection volume can be determined and interpreted. In the further course of the examination, ECG, X-ray or blood tests may be useful to uncover possible causes.
How useful are online tests?
The quality of online tests varies greatly. In all variants, symptoms are queried to varying degrees. However, the symptoms of heart failure are often very unspecific.
Breathlessness, for example, can have many causes and quickly leads to the wrong conclusions. It is therefore advisable to first ask a broad range of questions in order to then go into more detail about certain symptoms in the next step. However, this is difficult to implement in a standardized online tool.
Scientifically evaluated questionnaires usually have a larger scope and are more differentiated in their analysis. In principle, online questionnaires can be a first step to sensitize affected persons to the topic. If an online test is positive, one should not immediately assume that one really suffers from heart failure.
A visit to the doctor and further tests are indispensable! The heart ultrasound is usually performed on a lying patient in a supine and left-side position. A special ultrasound probe is guided along the left rib cage and the lower edge of the rib.
The heart chambers, heart walls and valves are shown from different perspectives. In addition, the Doppler effect allows the blood flow through the heart to be made visible. During the examination, the physician can assess the contraction of the heart muscle and detect any wall movement disorders.
A scar in the heart muscle after a heart attack, for example, causes the heart muscle in the affected area to move hardly at all or unevenly. The thickness of the heart muscle and the volume of the individual chamber can also be measured. If the heart is heavily loaded, the heart muscle becomes thicker (hypertrophy) and the volume in the ventricle increases.
The Doppler effect shows if there is a leakage in the heart lobes and if blood is flowing back into the heart. Finally, the volume that the heart ejects per beat can be determined (LVEF left ventricular ejection fraction). This is the most important measure for classifying cardiac insufficiency. Normally the value should be above 54%.