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HEART WEAKNESS – DETERIORATION


Cardiac weakness, deterioration or insufficiency is the inability of the heart to provide sufficient tissue supply with oxygen and nutrients. It is the result of numerous primary and secondary diseases that lead to impaired cardiac function as a pump and to reduced cardiac stretching.

The NYHA classification of cardiac insufficiency is based on the severity of symptoms and physical activity:

Class I – The patient has no restrictions on physical activity, usually physical load does not lead to fatigue, suffocation or palpitation (heart beats).

Class II – There is smaller restriction of physical activity, the patient feels good when standing still, but the usual activities cause fatigue, suffocation, or palpitations.

Class III – The patient has significant restrictions on physical activity, he feels well at rest, but small common physical activities lead to symptoms (problems).

Class IV – Symptoms of heart failure are present at rest and are worsened with the slightest physical effort.

 

Causes:

  • Coronary heart disease
  • Arterial hypertension
  • Cardiac valves failure
  • Irregular cardiac rhythm (arrhythmias)
  • Heart muscle infections (myocarditis)
  • Heart muscle disease
  • Congenital heart defects
  • Excessive consumption of alcohol
  • Consequences of another illness such as severe anemia, infection, pulmonary diseases, thyroid disease, diabetes, accumulation of iron (hemochromatosis) or protein (amyloidosis)
  • Unknown cause in individual cases

 

Symptoms:

  • Intolerance of physical effort, breathlessness, fatigue, choking while lying on a flat surface, accelerated heartbeat, disorders of consciousness, swelling of the legs and abdomen and chest pain

Diagnosis:

  • Anamnesis, clinical examination, ECG, cardiac ultrasound, cardiac catheterization, and ergometry and Holter ECG provide additional information on the severity of the disease, RTG, CT and MRI of heart, laboratory blood tests.

 

Treatment:

  • Treatment of the underlying disease that has led to heart failure (arterial hypertension, coronary disease, heart valve diseases, etc.) and the implementation of general prevention measures.
  • Medication treatment (ACE inhibitors, angiotensin II receptor blockers, beta-blockers, diuretics, aldosterone antagonists, inotropic medicines, digoxin, nitrates, statins, anticoagulant therapy)

Surgical Treatment: Surgery of bypassing narrowed blood vessels of the heart (Coronary bypass surgery) in coronary heart disease, cardiac valve surgery for heart failure, ventriculoplasty, implantable cardioverter defibrillator (ICD), Resynchronization therapy (CRT) or biventricular pacing, Mechanical devices (balloon pump, VAD – ventricular assist device, artificial heart), heart transplantation in the final stage of the disease.


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