Cardiac insufficiency

Overview

Weakness of the heart muscle (cardiac insufficiency) can have many causes. Symptoms such as shortness of breath, fluid retention in the legs and a deterioration of physical performance can occur suddenly or gradually over a longer period of time. A healthy lifestyle with exercise, no smoking and a healthy diet can have a preventive effect.

Symptoms

Main symptoms

• Shortness of breath, fast breathing
• Coughing (mostly at night)
• Weakness, deterioration of physical performance
• Fluid retention in the legs (oedema)

Other symptoms

• Increased urination at night
• Elevated pulse
• Dizziness
• Loss of appetite
• Fluid in the abdomen (ascites)

Causes and treatment

Causes

Acute (develops within hours / days)

• Pulmonary embolism
• Heart attack
• Inflammation of the heart muscle (myocarditis)
• Pericardial tamponade (collection of fluid in the heart sac)
• Heart arrhythmia

Chronic (develops slowly over months / years)

• Long-standing high blood pressure
• Heart valve defect
• Coronary heart disease (increasing build-up of plaque in the coronary arteries)
• Advancing age

Classes of severity

• NYHA stage 1
  • Cardiac insufficiency can be diagnosed with medical tests, but the person has no symptoms (yet).
• NYHA stage 2
  • Mild symptoms during ordinary activity (e.g. feeling weak when climbing stairs)
• NYHA stage 3
  • Marked limitation in activity due to symptoms (e.g. getting out of bed)
• NYHA stage 4
  • Symptoms such as shortness of breath even while at rest

Further treatment by your doctor / in hospital

Possible tests

• ECG
• Heart ultrasound (echocardiogram)
• Ergometry (cardiac stress test on a treadmill or stationary bicycle)
• Blood test (“cardio levels”)
• Chest x-ray
• Cardio MRI (special magnetic resonance imaging of the heart)

Possible therapies

• Treatment of an underlying cause (e.g. high blood pressure, heart arrhythmia, etc.)
• Medication (e.g. diuretic pills)
• Bypass or stent operation for coronary artery sclerosis
• Heart transplant (rarely)

What can I do myself?

• Follow a healthy diet (e.g. Mediterranean diet)
• Regular exercise
• Reduce overweight
• Stop smoking
• Slightly elevate the head of the bed (or use extra pillows)

When to see a doctor?

• Growing deterioration of physical performance
• Growing shortness of breath
• Fluid retention in the legs that doesn’t go away

Further information

Schweizerische Herzstiftung (Swiss Heart Foundation)
www.swissheart.ch