The heart is a hollow organ that mainly consists of muscle mass. It is the blood circulation pump and motor for transport into the blood vessels. In regular relaxation and contraction, the blood pumps into all organs and tissues. The heart and cardiovascular system can be damaged in various ways, but often, for example, constricted coronary arteries or cardiac muscle weakness are the cause of the symptoms.
Anatomy of the heart
A heart weighs around 300 grams in a man, in average 260 grams in a woman. It lies in the middle of the chest, left and right of the breastbone, framed by the lungs, ends at the front of the breastbone, at the back at the air and esophagus and at the bottom at the diaphragm. The tip of the heart extends approximately to the left nipple.
The heart is divided into a right and left half of the heart, which are separated by the cardiac septum. Both halves of the heart each contain two chambers, on the one hand the atrium, i.e. the atrium, and on the other hand the main chamber. The surrounding heart wall consists of the inner skin of the heart, the heart muscle and the outer skin of the heart.
The blood flows back into the heart via the atria, then it continues into the main chambers. This is where the main pumps of the heart sit and pump the blood back into the bloodstream through an artery. The heart chambers can be closed with heart valves and consist of the inner skin of the heart.
The heart valves
The heart valves organize the blood transport in the cardiovascular system as biological valves. They open and close so that the blood can only flow in one direction.
The heart and cardiovascular system can be damaged in many ways. However, most of the heart problems are based on three causes: narrowed coronary arteries, irregular heartbeat and cardiac muscle weakness.
Symptoms of heart disease
As diverse as the heart diseases are, some symptoms often appear. These include chest pain that radiates from the back and arms, rapid heartbeat, the feeling of chest tightness, breathing problems, loss of performance, weakness and exhaustion.
Coronary heart disease
Coronary artery disease (CHD) refers to constricted coronary arteries. The narrowing increases the risk of a heart attack because it arises when a coronary artery closes completely. Then blood can no longer flow into the heart and part of the heart muscle dies.
However, sudden cardiac death is even more dangerous. When there is no more blood in the heart, the heart rhythm stops and the result is ventricular fibrillation.
Today, a heart attack can be treated, doctors then open the coronary arteries with catheters, and drugs dissolve blood clots. In this way, the cardiologists not only prevent sudden cardiac death, but also the long-term consequences that arise when the heart muscle dies.
In angina pectoris, the vessels that supply the heart muscle are severely constricted. During exertion, the blood vessels can no longer supply the heart muscle with sufficient oxygen. Areas in the heart muscle no longer get blood for up to 20 minutes. The consequences are a typical heart prick, chest tightness and shortness of breath. Those affected are treated with nitroglycerin spray and have to rest. If the number of heartbeats drops while at rest, there is enough blood again to supply the muscle.
Further information can be found in the article: Coronary Heart Disease (CAD).
Signs of a heart attack
A heart attack often results in pain around the breastbone and the left side of the chest. These take more than 5 minutes. But beware: An infarction can also cause pain in other areas of the chest, even in the neck, left arm or back - or in women, especially in the upper abdomen. There are even heart attacks that are not preceded by pain.
Further information can be found in the article: Heart attack (myocardial infarction) - signs, symptoms, causes, therapies.
With heart failure, the heart does not pump enough blood into the body. This disease can be chronic or acute. Acute heart failure must be treated immediately, as it can lead to a fatal heart attack or stroke.
The causes are chronic high blood pressure, heart valve defects or coronary artery disease, but also arteriosclerosis and an inflammation of the heart muscle. These infections trigger viruses as well as bacteria or parasites.
A left heart weakness stems from the fact that less and less blood gets into the circulation. Therefore, the blood builds up back in the lungs, the consequences are pulmonary hypertension and edema. Shortness of breath, cardiac asthma, pulmonary edema and rapid breathing (gasping) are typical.
A right heart weakness usually follows a left heart weakness. Now the blood builds up in the right half of the heart. The jugular veins are blocked, as are the liver, spleen and kidneys. The patients gain a lot of weight, have to urinate more and edema is formed.
Further information can be found in the article: Heart failure: signs, causes and treatment.
Inflammation of the heart muscle can be fatal. If the inflammation interferes with the heart functions, this can impair the heart rhythm. Symptoms of myocarditis include shortness of breath and a fast pulse, as well as chest pain.
The cardiogenic shock
This is one of the "killers" among heart diseases. If an acute heart failure, for example due to an inflammation of the heart muscle, the heart can no longer pump enough blood into the body, there is an acute lack of oxygen. The skin on the neck, arms, legs and chest looks marbled. Affected people need immediate medical attention, otherwise they die.
Further information can be found in the article: Cardiovascular shock - causes, first aid and treatment.
When the heartbeat is irregular, we call it an arrhythmia. There is a too slow heartbeat (bradycardia), in which a pacemaker is the right solution and a too fast heart rhythm (tachycardia). Heartbeats that are too fast occur primarily in the atrium or ventricle and are dangerous. Heart fibrillation in the atrium is the main cause of strokes.
More information can be found in the articles:
- Heart stumbling: causes and therapy,
- Cardiac fibrillation - signs, causes and treatment,
- Rapid heart rate - tachycardia: causes, treatment and self-help,
- Fluttering of the heart - causes, therapy and symptoms.
High blood pressure
Chronic high blood pressure can lead to heart failure. The heart muscle must now continuously use more energy to pump blood. The heart muscle grows, but a larger muscle needs more blood to be supplied, while it now receives less blood. Possible consequences are coronary heart disease or stroke.
Further information can be found in the article: Hypertension: causes and treatment.
Causes of heart disease
Heart disease is one of the main causes of death in western societies, while it is a minor problem in traditional cultures. This is related, among other things, to the opportunities and consequences of post-industrial cultures: obesity, diabetes mellitus and smoking. Obesity is associated with other risk factors for heart disease such as lack of exercise and high blood pressure.
Congenital heart defects
The heart diseases caused by a lifestyle are opposed to congenital heart defects. This includes valve defects or vascular disorders. Every 100th child who is born has a heart defect.
If there is a defect in the atrial septum, the partition between the left and right atrium in the heart is open. Overpressure occurs and blood flows into the right atrium with a lot of oxygen. However, this is a reaction of the body to a lung that is not yet functional, and doctors therefore speak of a "short-circuit defect", but not of a disease. Such an open oval foramen normally closes in the months after birth, but it rarely remains and must be closed surgically.
However, a defect in the chamber septum is a disease. Here the partition between the heart chambers does not close, and blood from the left chamber pushes into the right chamber. One of the consequences is pulmonary hypertension with shortness of breath.
Children are also born with narrowed aortic arches as well as with narrowed lung valves, and the aorta and pulmonary artery can also be interchanged.
Heart Failure Failure
The number one mistake in a heart emergency is hesitation. As soon as you notice the first signs of a relative, you should immediately contact an emergency doctor: it counts every minute. If ventricular fibrillation occurs, resuscitation and resuscitation must begin immediately.
Do not under any circumstances wait for the symptoms to go away on their own because you are afraid of a false alarm. Call the ambulance service with an emergency doctor. The emergency doctor determines whether there is a false alarm - not you.
Do not call the neighbor or the family doctor first, but the emergency services immediately: 112.
Under no circumstances should you drive the car yourself. If ventricular fibrillation sets in, only an emergency doctor can help.
The heart in myth and history
One of the crucial findings of human cultures is the fact that a person whose heart beats lives. A person whose heart is not beating is dead. Consequently, the heart was the seat of life.
Egypt - the heart in the balance
The ancient Egyptians saw in the heart the core of the personality, an organ that held not only the body but also the soul together, that is, what psychology calls the psyche. Since the Egyptians believed in life after death, they embalmed the hearts and put them in the mummified corpses. The other organs did not have this meaning, and the priests buried them separately from the body in their own vessels.
When the dead man arrived in the other world, Anubis weighed his heart, the god of death with the body of a man and the head of a jackal. The feather of the mate determined whether the deceased had lived righteously. If there was an imbalance, a monster would eat the heart.
The Egyptians tried to persuade the hearts that acted as independent personalities in the hereafter to testify well about their bearer. So they wrote inscriptions on graves like: "O heart that belongs to my being! Do not stand up against me as a witness, do not resist the judges. ”
The Egyptians, however, were not superstitious fools, but their medicine was one of the most advanced in early antiquity. They recognized that the heartbeat determined the pulse and called the heartbeat "the heart speaks". They measured the pulse and derived the health status of the patient from its regularity. They already knew about heart diseases such as vascular calcification or heart failure.
In contrast to modern knowledge, however, they considered the heart and not the brain as the seat of the soul, which characterized the essence of man, the place of feelings, thoughts, talents and intelligence.
The heart in ancient China
The Taoist teaching in ancient China also mistakenly saw the heart as the seat of emotions and minds. That is why the teaching of Daodejing was important, which said how a person could develop a good and noble heart.
The heart sacrifice of the Aztecs
The Mexica in today's Mexico considered the heart to be the center of man. Their heart sacrifices were notorious, in which they cut prisoners of war alive on the pyramid of the capital Tenochtitlan (now Mexico City) with an obsidian knife from the chest and offered them to the sun god Huitzilopochtli as a victim.
Today's research considers the scale of these human sacrifices described by the Spanish conquistadors to be far exaggerated, more precisely, to propaganda that should justify the terrorist conquest.
The pulse of God
In medieval Christianity, the heart was considered a connection between God and man and thus had a kind of life of its own. Many superstitions spread: it was considered a remedy for epilepsy to bite the heart of a wolf that was still alive. The hearts of saints were valuable relics.
Sacred Heart Church designated Roman Catholic churches dedicated to the heart of the Messiah as the most sacred sacrament of the Church. Body parts are first-class relics in the Catholic Church, and among them hearts are the most desirable, for example the heart of Teresa of Avila. The king was considered the “heart of the people”, the pope the “heart of Christianity”.
In Germany, cutting up the body and removing parts of the body is prohibited and is considered a desecration of the body, or at least a disturbance to the rest of the dead.
However, separate heart burials were not only widespread in the Christian context, not only for saints. Rulers were often buried at the place of their death, but the heart was brought to their place of birth and kept in a special container. This custom continued until modern times. In 1822 the dead politician Karl-August Fürst von Hardenberg's heart was taken and is still in the altar of a church in Neuhardenberg near Berlin.
The biological heart
In the juices theory of the Middle Ages, which goes back to antiquity, the heart ennobled the blood produced in the liver and also maintained the body heat and "vitality". The function of the hollow muscle as a blood pump, which was already known in ancient China, was alien to the medieval thinking of Europe.
It was only Leonardo da Vinci (1452-1519) who used the term pump for the heart, and Miguel Seveto (1509-1553) discussed the pulmonary cycle; shortly thereafter, William Harvey (1578-1657) demonstrated that the blood does not “seep” in the body, but flows back to the heart. This was a shock to spiritual thinking, because it was clear that the body did not have a separate existence and therefore could not serve as the seat of God in man.
The symbolic heart
To this day, however, the heart has retained this spiritual meaning in symbolism, namely as an organ of love and great feelings, for which the real heart has no meaning - our feelings and thoughts arise in the brain, not just the systematic thinking of the "head people" but also empathy and intuition. Even those who "think with the heart" actually think with the head.
Thousands of years in which the heart was the seat of the soul cannot be banished from culture. In the history of myths, faith as a set reality becomes a myth, the myth becomes a fairy tale and from there a metaphor in literature, and so our western society today is overloaded with heart metaphors.
This goes hand in hand with complaints of "the heart": when we are excited, the blood pressure rises, heartbeat, irregular pulse, shortness of breath and even cardiac arrest can be a result of extreme emotions. Those who feel fear are "pounding their hearts", those who keep a low pulse even in the face of objective danger are considered "cold-blooded".
We perceive psychological conflicts in the unconscious as pressure in the chest. If something is "close to our heart" we actually feel it "in the heart"; "A stone falls from our hearts", we felt a real load on the chest beforehand.
We therefore show significant physical reactions of the heart or blood circulation to psychological and emotional problems. No wonder our ancestors believed that these feelings would arise here. In reality, however, the signals that the heart receives come from the brain and are carried on by nerves.
Modern heart medicine
The discovery of the bloodstream turned cardiology upside down. It was only when science separated the supposed unity of soul and body that progressive treatment of heart diseases was possible. In 1733, blood pressure was measured for the first time.
In the 20th century, cardiac medicine progressed rapidly. In 1923 the heart valve was successfully operated for the first time, and in 1929 the heart catheter was used. In 1954, the heart-lung machine was used to temporarily switch off the heart and lungs, making open-heart surgery possible; just four years later, a human was wearing an artificial pacemaker for the first time, and in 1967 a human heart was transplanted for the first time. (Dr. Utz Anhalt)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch
- American Heart Association, Inc .: What is Cardiovascular Disease? (Accessed: 09.07.2019), heart.org
- German Heart Foundation V .: Do you have a heart disease? (Call: 09.07.2019), herzstiftung.de
- National Institute of Diabetes and Digestive and Kidney Diseases: Diabetes, Heart Disease, and Stroke (accessed: July 9, 2019), niddk.nih.gov
- Dr. med. Marianne Koch: The Heart Book: How we can protect our heart and keep it healthy, dtv Verlagsgesellschaft, 2015
- Steffel, Jan / Luescher, Thomas: Cardiovascular system, Springer, 2nd edition, 2014
- Professional association of German internists e.V .: cardiovascular diseases (accessed: 09.07.2019), internisten-im-netz.de
- German Society for Cardiology - Cardiovascular Research: Pocket guideline: Management of arterial hypertension, status 2018, leitlinien.dgk.org
- NVL program from BÄK, KBV, AWMF: S3 National Care Guideline Chronic CHD, as of April 2019, detailed view of guidelines
- Mayo Clinic: Heart disease (accessed: July 9, 2019), mayoclinic.org
- National Health Service UK: Cardiovascular disease (accessed: 09.07.2019), nhs.uk
- World Health Organization: Cardiovascular diseases (CVDs) (access: July 9, 2019), who.int
- World Heart Federation: Different heart diseases (accessed: 09.07.2019), world-heart-federation.org
- National Heart, Lung, and Blood Institute: Heart Attack (accessed: July 9, 2019), nhlbi.nih.gov
- Merck & Co., Inc .: Overview of Congenital Cardiovascular Anomalies (accessed: July 9, 2019), merckmanuals.com
- Noble, Alan / Johnson, Robert / Thomas, Alan / u .: Understanding organ systems - cardiovascular system: integrative foundations and cases, Urban & Fischer Verlag / Elsevier GmbH, 2017
- Dietz, Armin: Eternal Hearts: Small cultural history of the burials, Urban and Vogel, 1998
ICD-Codes for this illness: F45, I10, I11, I24, I25, I27, I40, I49-I52, Q24, R57ICD-Codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.