The heart – the engine of life and a sign of love

The heart - the engine of life and a sign of love

The heart beats up to three billion times over a lifetime – we take it for granted and are usually unaware of it. Unfortunately, cardiovascular diseases are the most common cause of death – even if it is not that bad, a disease of this vital organ usually means a reduction in the quality of life.

Structure and function of the heart

The main task of the heart is to transport blood to all body regions. The blood is enriched with oxygen in the lungs and then pumped to all body parts via the main artery (aorta) and many other arteries. Fine nerve lines regulate the heart’s beating rate, and the heart’s blood vessels – the coronary arteries – supply the heart with oxygen and other nutrients.

Suppose calcium and other foreign substances are deposited in the arteries of the body due to arteriosclerosis. In that case, the blood flow is disturbed, and parts of the body are no longer sufficiently supplied with oxygen – this leads to insufficient oxygen supply (ischemia, in the heart this is called angina pectoris ) and finally to tissue destruction (infarction). ).

The heart consists mainly of muscle tissue with four ventricles and four heart valves. In the right half of the heart, blood flows from all body parts into the heart (and then on to the lungs) – in this area, diseases are rarer and usually not so life-threatening. Most diseases occur on the other left side of the heart. This is where the oxygen-rich blood from the lungs arrives and is pumped into the body at high pressure. The heart has to build up this pressure 60 to 80 times per minute – it is easy to imagine that an illness can have severe consequences and be life-threatening.

 

heart trouble

Typically, we do not perceive the heart activity – the heart adapts independently to different requirements such as physical exertion, fear or relaxed rest with the respective heart rate. It becomes disturbing when we become aware of our heart and its work. Heart palpitations or tachycardia – an indication of a cardiac arrhythmia – or tightness in the chest, shortness of breath when climbing stairs and heart pain – possibly coronary artery disease – can be typical heart symptoms.

Sometimes heart disease begins with a feeling of being less resilient – this can happen with myocarditis, a heart valve defect or heart failure. Many people mistakenly blame the stomach or back for pain in the heart area – the actual cause is not recognized.

investigation methods

Anamnesis (ask about medical history): All complaints can be further narrowed down by asking specific questions. Shortness of breath when climbing stairs can occur on the first floor but only on the fifth floor. The onset and duration of pain often indicate the severity of a heart attack.

Inspection (observing), percussion (tapping), and auscultation (listening): Foot oedema can be a visible sign of heart failure. The colour of the patient’s face also shows a trained doctor whether heart valve disease is present. The size of the heart is determined by tapping on the chest – but the most important thing is listening with a stethoscope. The doctor can hear the work of the four heart valves in the chest – are there noises that shouldn’t be, such as a heart valve defect or is the heart beating irregularly? Is the heartbeat loud or soft (as in pericarditis and pericardial effusion)?

ECG: An electrocardiogram (ECG) is performed to detect cardiac arrhythmia or insufficient oxygen supply. An ECG under stress (e.g. on an exercise bike) can document the shortness of breath described by the patient when climbing stairs. A long-term ECG records heart activity over 24 hours and helps with arrhythmias that only occur occasionally (or at night). It is now also possible to send an up-to-date ECG to an emergency unit by telephone – this is useful for patients with life-threatening heart problems.

Blood tests:  If a heart attack is suspected, a blood test for special heart enzymes such as troponin, creatine kinase (CK), and lactate dehydrogenase (LDH) can help confirm the diagnosis.

X-ray, ultrasound (heart echo): The heart can be seen as a shadow in the X-ray image. Size and shape allow conclusions to be drawn about the heart function – calcium on the heart valves is just as visible there as water accumulation in the lungs (in the case of heart failure). Ultrasonography of the heart shows the thickness of the heart muscle and how the valves are working – if they don’t close properly, it reveals a telltale blood flow!

Modern computer tomographs may soon replace cardiac catheters – but there is still no substitute for cardiac catheter diagnostics. This relatively young method shows precisely where there is a narrowing of the coronary arteries – even dilatation treatment or stenting is possible.

 

heart disease in children

Unfortunately, there are a variety of heart defects that can be congenital and often require immediate surgery. A defect in the heart septum is just one of the many heart defects, and a small hole can often be left without surgery because it does not restrict heart function.

heart disease in adults

Heart disease cannot be separated from vascular disease, as shown by coronary artery disease (CHD), with its consequences of angina pectoris and heart attack. CHD is a hardening of the coronary arteries – since arteriosclerosis does not occur in isolation in the heart. Still, in all arteries, there is also a risk of an infarction in other organs. Diseases such as diabeteshigh blood pressure or depression increase the risk of a heart attack – and men and women have very different heart attack symptoms. Women are particularly at risk after menopause.

Cardiac arrhythmias can have different causes – the nerve conduction is also affected by arteriosclerosis or diabetes. Inflammations of the individual heart layers are another group of diseases. Inflammation of the heart’s inner lining ( endocarditis ) can be due to a malfunction in the immune system. In contrast, inflammation of the heart muscle (myocarditis) occurs with many viral infections – it is also particularly feared as a complication of influenza flu.

Pericarditis (inflammation of the outer skin of the heart, the sac around the heart) can lead to a mechanical restriction of heart movement, in which the sac around the heart forms a rigid corset. Heart valve changes can occur after inflammation of the heart’s inner lining or in the case of heart muscle diseases. Heart failure is more a description of the condition than a disease – the heart does not manage to transport enough blood. You feel weak and tired, or you get short of breath. The extreme case is sudden heart failure, which usually leads to death.

treatment of heart diseases

Since heart disease often occurs together with the “deadly quartet”, reducing obesity, drug treatment of a lipid metabolism disorder with a statin and control of diabetes are the first therapeutic measures. Standard heart medications include hawthorn extracts, beta-blockers, and acetylsalicylic acid —to name a few. If an operation is unavoidable, there is now the possibility of proceeding minimally invasively.

A defibrillator is used to restart the heart in an emergency. Defibrillators are increasingly being installed in public places – however, handling them by the untrained is controversial. Of course, there is a particular procedure for medication or surgery for every illness – you will find more detailed information on the respective illness.

 

prevention of heart disease

To prevent CHD and heart attacks, healthy nutrition with sufficient magnesium, a conscious approach to cholesterol, lots of exercise and stress reduction should be a matter of course from a young age. Mediterranean food with olive oil and red wine (correctly dosed) is recommended.

Especially if you have a known heart disease, your lifestyle is crucial. Unfortunately, many heart attack patients fall back into “bad” behaviour patterns that promote heart attacks after a short time. Cardiac patients should also take special care of themselves in summer (keyword: drink a lot!). In winter, sudden cold attacks are hazardous.

It is best to always carry an emergency card with you so that everyone can see what medication the heart patient needs. A phrasebook with the most critical medical phrases helps when travelling, and a supervised vacation trip can increase travel security.

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