Cardiac insufficiency is a disease where the heart no longer pumps as it normally would. The pump function of the heart is weakened. There may be different underlying diseases causing this. A coronary heart disease such as angina pectoris or heart disease or heart attack is the most common reason for cardiac insufficiency.
Cardiac insufficiency generally develops very slowly. The heart muscle becomes weaker in the process until it can no longer pump sufficient blood in the circulatory system. The reduced pump function causes the oxygen supply to important organs such as the brain, the kidneys and the muscles to drop. Depending on whether the left or right ventricle is affected by the insufficiency, this is known as right-sided cardiac insufficiency or left-sided cardiac insufficiency. If both ventricles are affected, this is known as global cardiac insufficiency. People develop a weakness in the heart muscle for different reasons. The most common of which are circulatory disorders of the heart (coronary heart disease). However, heart valve disease, heart muscle inflammation or lung disease can cause cardiac insufficiency.
Patients with cardiac insufficiency have very few symptoms initially, or the symptoms are almost imperceptible. Warning signs for the onset of cardiac insufficiency are increasing fatigue, loss of performance, swelling in the legs and ankles, and nightly coughs. However, shortness of breath, dizzy spells, chest pain or inexplicable weight fluctuations can also be an indication.
The earlier that cardiac insufficiency is recognised and treated, the better the prognosis will be. The diagnosis is made on the basis of the symptoms and with the help of various examinations. The most important of these is measurement of the pump function of the heart with an echocardiograph. Depending on its severity, cardiac insufficiency is classified into four stages, which were defined by the New York Heart Association. In Stage I, physical resilience is still normal. In Stage II, symptoms occur during intense physical strain, and in Stage III already during mild physical strain. Finally, Stage IV is characterised by symptoms even when the patient is resting.
Cardiac insufficiency is treated with different medications. Medication is used is to relieve the pressure on the heart (reduce the blood pressure) and increase the pump function. In certain cases, cardiac resynchronisation treatment can be used if the cardiac insufficiency is connected with an electrical conduction disorder. Find out more in the chapter entitled Surgery for cardiac arrhythmia.
If the cardiac insufficiency worsens despite all treatment efforts, a heart transplant is sometimes the final treatment option.