Heart failure

Heart failure is one of the most common cardiovascular diseases and, particularly in elderly patients, may lead to reduced physical and mental functioning. In its severest form, heart failure requires an individualized treatment plan, delivered by an interdisciplinary team.

What is heart failure?

Heart failure is the inability of the heart to supply the body with sufficient amounts of blood and oxygen. This situation may arise when the heart muscle is too weak, or when the ventricles become stiff and can no longer fill properly between beats. In both cases, the heart's ability to pump blood around the body is reduced, resulting in reduced exercise capacity and reduced cognitive functioning.

Usually a chronic, progressive condition, heart failure can affect primarily the left or the right side of the heart, or it can affect both sides equally. This is why physicians refer to left-sided heart failure and right-sided heart failure. Heart failure is common. In fact, it is one of the most common causes of hospitalization in Germany. Treatment for heart failure constitutes one of the areas of specialization of the Brandenburg Heart Center, and its expertise makes it one of the leading centers in the Brandenburg region and beyond.

What are the main symptoms?

Heart failure is categorized according to the severity of symptoms, and is usually divided into four classes. While patients with class I heart failure are not affected by any symptoms, patients with class IV disease are usually affected by their symptoms even when at rest.

  • Dyspnea (shortness of breath) is the main symptom of heart failure. Initially, patients only experience dyspnea during physical activity, such as e.g. when climbing stairs (exertional dyspnea).
  • In left-sided heart failure, patients also typically experience: an increased breathing rate, a persistent cough and restlessness.
  • Sometimes, patients may feel dizzy or faint.
  • The following symptoms are indicative of right-sided heart failure: Edema affecting the legs and the feet, increased frequency of night-time urination and, sometimes, lack of appetite and a feeling of fullness.
  • An irregular heartbeat (arrhythmia) is also a common symptom of heart failure.

What are possible causes?

Heart failure usually develops as a consequence of long-standing cardiovascular disease. Causes of heart failure include:

  • Coronary heart disease and heart attack
  • High blood pressure
  • Cardiac arrhythmias
  • Heart valve disease
  • Disorders of the heart muscle (cardiomyopathies)
  • Inflammation of the heart muscle
  • Certain lung disorders (COPD, emphysema)
  • Diabetes
  • Certain medications (e.g. cancer medications)
  • Tumors of the heart

Diagnosis of heart failure

Frequently, a physical examination is all that is needed to diagnose heart failure. Subsequent diagnostic steps may include: 

  • Echocardiography to examine the structure and function of the heart
  • X-ray examinations of the chest and lungs
  • ECG or an ambulatory ECG (mobile heart monitor) to assess the electrical activity of the heart
  • Blood tests, e.g. analysis of heart failure-specific markers (brain natriuretic peptide, BNP)
  • Cardiac catheterization to help assess the coronary arteries for disturbances in normal blood flow
  • Exercise challenge spirometry (measuring the amount of air that can be inhaled and exhaled following exertion) as an objective measure of exercise capacity and the impact that heart failure symptoms have on a person's ability to perform everyday tasks
  • If appropriate, additional specialist technologies such as MRI or CT scans, myocardial biopsy and nuclear imaging

Treatment for heart failure

Considerable improvements in the treatment of heart failure over the past 20 years have led to a much improved outlook for patients with heart failure. The introduction of electrophysiology procedures has made a particular impact in this regard. At Brandenburg Heart Center, we specialize in this type of treatment, and our reputation and expertise have made us one of the foremost referral centers in the Brandenburg region and beyond.

Treatment for heart failure follows a stepped care model that includes a number of different treatment approaches. Particularly in patients with severe symptoms, treatment follows an interdisciplinary approach. Treatment strategies include the following:

  • Measures aimed at modifying the patient's risk factors for heart failure and their lifestyle
  • Modern drug treatment
  • Electrophysiology - pacemaker systems including implantable defibrillators
  • Specialized catheter-based procedures (e.g. catheter ablation)
  • Surgical measures (e.g. ventricular assist devices)
  • Follow-up treatment at our "Herzinsuffizienzambulanz" (Heart Failure Outpatient Clinic)
Measures aimed at modifying the patient's risk factors for heart failure and their lifestyle

Therapy is based on general lifestyle measures including: weight reduction (where applicable), dietary changes, salt restriction, fluid restriction, reduction of coronary risk factors (nicotine, cholesterol), regular moderate-intensity physical exercise.

Modern drug-based treatment for heart failure

Modern drug-based therapy for heart failure consists of various medications including diuretics, beta blockers, ACE inhibitors and angiotensin II receptor blockers (ARBs). Even cardiac arrhythmias, a common feature of heart failure, can be treated with medication.

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Sources

 Kardiologie compact, Mewis/Riessen/Spyridopoulos

 
 
 
 
Relevant information

Emergency numbers

  • Emergencies only:
    112
    Our Emergency Department:
    +49 3338-69 45 21

Contact person

  • Univ.-Prof. Dr. med.
    Johannes Albes
    Head of Department of Cardiac Surgery at Brandenburg Heart Center

    PA to the Head of Department Gudrun Gaal
    Immanuel Hospital Bernau Brandenburg Heart Center
    Ladeburger Str. 17
    16321 Bernau bei Berlin
    T +40 3338 694-510
    F +49 3338 694-544
    send email
    download vcard

  • Univ.-Prof. Dr. med.
    Christian Butter
    Head of the Department of Cardiology, Immanuel Hospital Bernau Brandenburg Heart Center

    PA to Head of Department Christine Meinecke
    Immanuel Hospital Bernau Brandenburg Heart Center
    Ladeburger Str. 17
    16321 Bernau bei Berlin
    T +49 3338 694-610
    F +49 3338 694-644
    send email
    download vcard

Direct links

 
 

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