cardiology

introduction

The word "cardiology"Is Germanized from the Greek and means"Teaching of the heart“.
This medical discipline deals with the study of the human Heart in its natural (physiological) and morbid (pathological) Condition and function, as well as with the diagnosis and treatment from Heart disease.

There are numerous overlaps between cardiology and other medical specialties such as angiology, pulmonology and nephrology. In Germany, pediatric cardiology as a sub-area of ​​paediatrics (especially congenital heart problems) isPediatrics) responsible. There is often close cooperation with vascular and cardiac surgery.
In Germany, due to an aging society and the ever more frequent occurrence of the metabolic syndrome (increased sugar and fat levels in the blood, obesity, high blood pressure) on the one hand, and the development of new interventional cardiological methods on the other, cardiology has significantly increased in recent decades gained in importance.

Clinical pictures

In a narrower sense, cardiology deals with Diseases of the heart itself. This includes innate and acquired Malformations such as pathological connections between the two Atria (Artrium) or Chambers (Ventricle) (so-called Cardiac vitia), or errors in the heart valves, Inflammation (Endocarditis, Myocarditis, Pericarditis), Cardiac arrhythmias, Heart muscle disease and Heart failure (Heart failure), as well as injuries. In a broader sense, cardiology also deals with those that supply the heart itself Vessels (Coronary arteries/Coronary arteries), the big ones close to the heart Veins and Arteries (Vena cava/right atrial and aortic arch), as well as the blood circulation (especially high blood pressure) in general.
Cardiology also includes clinical pictures that include Heart damage can, or even through a malfunction of the heart (due to a cardiac cause) arise.

Diagnostic methods

In addition to an exact medical interview (anamnese) plays the physical exam plays a major role in cardiology. So can Poor circulation and Heart failure (Heart failure) with numerous characters such as Pale or blue in color (cyanosis) or but Water retention in the legs, stomach and lung as well as simple diagnostic tests.

A prominent example here is the so-called Hepato-Jugolar Reflux to call. The examiner takes care of the blood soaked by applying pressure liver for an increased blood return to the Heart. If this is overwhelmed with the blood that is suddenly to be pumped, the excess volume builds up into the Neck veins back, which then impress by an obvious protrusion and indicate the weak heart.

Can also be done by a simple Wiretapping (Auscultation) a lot of information can be obtained from the heart. Abnormalities in Pulse rate and Rhythm regularity are to be grasped here by the trained medical ear as well as any valve defects or one that is revealed by a rubbing noise Gluing the heart sac in the event of inflammation of the same.

The electrocardiogram (EKG) records the electrical activity of the heart derived from the chest wall at rest, under stress or in everyday life and is simple, fast, cheap and for many cardiological questions diagnostic agent free of side effects essential. Especially with cardiac arrhythmias, insufficient supply of the Heart muscle (acute through Infarct or creeping through one Coronary heart disease (CHD)), but also at Electrolyte shifts the preparation of an EKG is of great diagnostic importance.
Due to its advantages mentioned above and the fact that many heart diseases can be proven or at least proven by changes in the EKG, this examination method belongs to diagnostic standardif a patient has an emergency or routine heart-related (cardiac) Problem is suspected.

In some cases the laboratory examination A blood sample from the patient may be necessary, for example if heart muscle damage is suspected, for example in the context of insufficient supply.
With the Ultrasound machine can either come from the outside or from the esophagus (transesophageal) The activity of the heart can be examined. Especially malformations and Flap failure can be displayed so well, and the cardiac output can also be measured. With the help of the Doppler effect, blood streams can be made visible, including those entrusted with internal care Wreath vessels.

It is often based on a simple X-ray image of the upper body (thorax) the Heart size determined (which increases with prolonged overload), and individual enlarged areas of the heart can also be identified and thus provide an indication of the underlying problem.

Less often it is necessary to use a CT or MRI Device to take three-dimensional images of the heart.

As part of a small intervention it is possible by introducing a probe into the vascular system via this on site Contrast media in the Bloodstream to discharge and then through a brief X-ray fluoroscopy Vascular course (for example the coronary arteries) and to discover possible problems such as bottlenecks.
While performing this so-called Catheter examinationswhich either via the venous system into the right heart, or via the arterial vascular path against the direction of flow through the Main artery (aorta) occur in the left heart, therapeutic intervention is also possible.

Therapeutic methods

Depending on the disease, a different procedure is indicated in cardiology. In general, however, a few therapy classes are in the foreground.

A lot of cardiac diseases - such as high blood pressure, Heart failure or Cardiac arrhythmias - often require lifelong treatment with medication, whereby this so-called pharmacological approach is usually combined with other measures.

Especially with "angiological“Problems like that Coronary artery disease (CHD) A major focus in treatment is on the conversion of the Way of life of the patient; Above all, increased exercise, a healthy diet and abstaining from Tobacco use can make a significant contribution to preventing the disease from progressing or even to improving the symptoms.

Above all, it may be necessary in emergency situations through well-measured power surges to bring a rhythmic heart back into rhythm. This so called cardioversion respectively Defibrillation can also, as well as a permanent basic clock, of small, implanted devices (Pacemakers, Cardioverters or defibrillators).

Even as part of a Catheter examination various interventions can be carried out. Be with a little balloon Narrow points stretched (Coronary angioplasty) and if necessary by a so-called Stent kept open permanently, wall defects or atrial appendage can even be closed with small umbrellas artificial heart valves can be inserted and fixed in this way.

Sometimes, however, one gets involved surgical intervention not prevent. Depending on the situation, with or without Life-support-machine does the necessary work with an open heart or with keyhole technology. This can be about a Valve replacement or a Bypass insertion (a bridging of a narrowed point in a coronary vessel with one taken from another part of the body) be. In rare cases, too Heart transplants (Heart transplants) carried out.

Prevention in cardiology

Preventive action In Western countries, cardiological diseases do not receive the individual or social attention they need. The average western way of life in his Sedentary lifestyle and lacking Nutritional attention favors together with one Smoking biography the development of various heart and circulatory diseases is immense.

History

Cardiology has proven to be one of its essentials Sub-areas from general internal medicine developed. Most of the diagnostic and interventional methods were not developed until the 20th century. This is what became like that EKG Developed around the turn of the century, the first heart operation was only a few years ago. As early as 1929, Werner Forßmann showed the possibility of in a self-experiment Catheter examinations on.
Major surgical interventions were not made until the development of the Life-support-machine possible in 1953. In the following three decades, the overwhelming majority of the essential procedures, devices and drugs that shape today's cardiology were developed. Interventional catheter operations, for example, have only become widespread in the last two decades.