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| Clinic for Thoracic and Cardiovascular Surgery |
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21st February 2005
Background information: terminal cardiac insuffiency
So-called "cardiac insufficiency" means a weakness of the heart muscle which is usually chronic. The blood can no longer be pumped in sufficient quantities into the vessels, the organs or the muscles.
At rest, a healthy heart pumps 5 to 6 liters of blood through the body per minute, whereas an insufficient heart sometimes only manages 2 liters per minute. The resulting inadequate supply of oxygen and nourishment leads to a drop in physical performance. In addition, the fact that the blood is not transported onwards can lead to congestion (edemas) inside the body. During the advanced stages of cardiac insufficiency, patients are often so restricted in their movements that they are forced to give up their normal lives and stay in bed.
Approx. 22.5 million people suffer from cardiac insufficiency worldwide
Causes include constriction of the coronary arteries (coronary artery disease – CAD) and cardiac arrest, genetic and inflammatory myocardial diseases, hypertension, heart valve defects and in particular age-related degenerative processes. Chronic cardiac insufficiency is now the no. 1 cause of death in the industrial nations. Worldwide it affects approx. 22.5 million people. Every year approx. 2 million new cases are diagnosed. In Germany approx. 1.3 million people suffer from cardiac insufficiency, with 116 000 new cases every year.
The number of patients with cardiac insufficiency who have to be admitted to hospital has more than tripled in the past 15 years. The reason for this is partly steadily increasing life expectancy and the growing proportion of elderly people within society, and partly the high standards of medical care within the industrial nations. Thanks to medical progress, e.g. in the acute treatment of cardiac arrest, more and more patients are surviving, left with a cardiac pumping deficiency.
Methods of treating terminal cardiac insufficiency
Standard therapies today include treatment with dehydrating drugs (diuretics), cardiac strengthening drugs (digitalis), betablockers and/or ACE inhibitors. Depending on the primary disease, therapeutic strategies can also involve surgical measures, such as heart valve surgery, expansion or dilatation of the coronary arteries and stimulation with special biventricular pacemaker systems (cardiac resynchronization).
The only hope for many severely sick patients with advanced heart disease is heart transplantation. The lack of donor organs means that this can only be realized in a very small number of cardiac insufficiency patients, however. Mechanical ventricular assist devices (VAD) and artificial hearts can serve to bridge the wait to heart transplantation.
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