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All seven Medical Spheres ›Pressure in the chest, sudden shortness of breath, fluid in the legs and lungs: a heart attack and acute heart failure need help quickly. In an emergency, what counts is calling 112, followed by diagnosis, stabilisation and the right place for further treatment.
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Guide values based on guidelines. Your personal plan is agreed with you by the treatment team.
Heart attack and heart failure
In a heart attack, a coronary artery becomes blocked, usually by a blood clot at a point already narrowed by deposits. The heart muscle beyond it no longer receives oxygen and is damaged – the longer the blockage lasts, the more so. The ground is almost always prepared by coronary heart disease, promoted by high blood pressure, smoking, diabetes, raised blood lipids, excess weight, lack of exercise and a family predisposition.
Typical signs are pressure, tightness or burning behind the breastbone that lasts longer than five minutes and can spread to the arms, neck, jaw, back or upper abdomen. Shortness of breath, nausea, cold sweat and restlessness often occur as well. Anyone who notices such signs should call 112.
In heart failure – medically also called cardiac insufficiency – the heart no longer pumps enough blood around the body. Common causes are coronary heart disease or a previous heart attack, long-standing high blood pressure, heart valve disease, inflammation of the heart muscle or arrhythmias. It usually develops gradually: you can manage less, you become short of breath during exertion or when lying down, your ankles and legs swell, and your weight rises due to retained fluid.
Heart failure becomes acute when it worsens rapidly, for example due to an infection, a new arrhythmia, a heart attack or forgotten medication. Fluid then builds up in the lungs, and breathing becomes difficult even at rest. In both emergencies, the priority is to relieve the heart and find the cause. In a heart attack, the blocked vessel should be reopened as quickly as possible, as a rule by cardiac catheter at a centre with a cardiac catheter lab.
Acute treatment
An ECG right at the start, blood tests such as troponin and a heart ultrasound show whether a heart attack, heart failure or another cause lies behind the symptoms.
Monitoring, oxygen if needed, pain relief and medicines that inhibit blood clotting and ease the strain on the heart; for fluid in the lungs, medicines that remove excess fluid and, if necessary, breathing support via a mask.
If a cardiac catheter procedure is needed, transfer to a centre with a cardiac catheter lab is arranged promptly. There, the blocked vessel is widened with a balloon and usually kept open with a stent.
The path
With a heart attack, what counts is the time until the vessel is open again; with acute heart failure, it is rapid relief for the heart.
If a heart attack is suspected or with sudden severe shortness of breath, call 112 and do not drive yourself. Until help arrives: raise the upper body, loosen tight clothing, do not leave the person alone.
An ECG is taken on the spot. If it shows a clear heart attack, the ambulance usually goes directly to a centre with a cardiac catheter lab.
Initial assessment, ECG, blood tests, heart ultrasound and monitoring; at the same time, treatment to relieve the heart begins.
If a cardiac catheter procedure is needed, transfer to a centre with a cardiac catheter lab follows promptly. Acute heart failure is treated as an inpatient – in the intensive care unit if severe.
On the ward, your medication is adjusted; this includes talking about warning signs, daily weighing and physical activity.
Follow-on rehabilitation builds up fitness and confidence. After that, check-ups are carried out by your GP and cardiologist, and by the hospital if needed.
Insurance
Statutory health insurance
Emergency treatment, diagnostics and treatment on the ward or in intensive care are covered by German statutory health insurance, as is a medically necessary transfer. The hospital can arrange follow-on rehabilitation.
In Wertheim, patients with statutory insurance are cared for by the Bürgerspital, the hospital with a public healthcare mandate.
Private insurance or self-pay
In the emergency department, every patient receives the same care. Private health insurance and the Beihilfe allowance for civil servants cover medically necessary treatment according to their tariffs.
For the rest of the stay, privately insured and self-pay patients can also use the Main-Tauber-Klinik in the same building.
Specialists
In Wertheim, heart attacks and heart failure are treated by the Department of Internal Medicine. Listed here are a specialist in internal medicine from cardiology and a specialist in internal and emergency medicine from the central emergency department.
Locations
Each clinic shows on its own website how the treatment works there.
Germany
Central emergency department around the clock, intensive care unit and basic cardiac care at the Bürgerspital, a hospital with a public healthcare mandate, with coordinated transfer for cardiac catheter procedures; the Main-Tauber-Klinik under the same roof looks after privately insured and self-pay patients.
Frequently asked questions
Usually by persistent pressure or burning in the chest, often spreading elsewhere, with shortness of breath, nausea and cold sweat. In women, older people and people with diabetes, it more often shows as shortness of breath, upper abdominal or back pain and unusual exhaustion. If in doubt, calling 112 is the right thing to do, even if the cause later turns out to be harmless.
Not if a heart attack is suspected – not even by taxi. The ambulance crew records an ECG on the way, relieves symptoms, can treat a dangerous arrhythmia immediately and chooses the hospital that suits the findings.
Not at present. The Bürgerspital provides initial diagnostics, stabilisation and monitoring; if a cardiac catheter procedure is needed, transfer to a specialised centre is arranged. If the ambulance ECG already shows a clear heart attack, the ambulance usually goes directly to such a centre.
Angina pectoris is a feeling of tightness in the chest during exertion that eases after a few minutes of rest – a sign of narrowed coronary arteries that should be checked by a doctor. If it occurs for the first time, more and more often, at rest or persistently, a heart attack may be imminent: then call 112.
If you become short of breath even at rest or when lying down, your breathing rattles, or chest pain, fainting or a severely racing heart occur: then call 112. If your weight rises significantly within a few days or your legs swell more, have this checked by a doctor promptly.
Weigh yourself daily, take your medication regularly and change it only after consulting your doctor, stay active, use salt in moderation and do not smoke. Your doctor will set the right amount of fluid for you; vaccinations against flu and pneumonia are also recommended.
Usually follow-on rehabilitation with exercise, education and counselling. Medicines to protect the heart and blood vessels are often taken long term and should never be stopped on your own. When you can return to work, sport and driving depends on how your recovery goes. Anxiety or low mood afterwards are common; it helps to talk about them.
Consultation
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Reviews
CGCE GroupVerified
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Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin rundum begeistert von meiner Erfahrung in dieser Haartransplantationsklinik. Von der ersten Kontaktaufnahme bis zur Nachsorge war alles hervorragend organisiert und professionell. Das gesamte Team war unglaublich freundlich, hilfsbereit und zuvorkommend. Man hat sich jederzeit gut aufgehoben und ernst genommen gefühlt. Besonders positiv fand ich, dass sich alle Mitarbeiter ausreichend Zeit genommen haben, um meine Fragen zu beantworten und jeden Schritt verständlich zu erklären. Auch der Service war erstklassig. Die Organisation, die Betreuung vor und nach dem Eingriff sowie die Kommunikation waren wirklich hervorragend. Das gesamte Team hat einen sehr kompetenten und gleichzeitig menschlichen Eindruck gemacht. Die Klinik selbst ist modern, sauber und sehr gut ausgestattet. Während der Behandlung wurde äußerst sorgfältig und professionell gearbeitet, und ich hatte zu jedem Zeitpunkt das Gefühl, in guten Händen zu sein. Ein großes Dankeschön an das gesamte Team für die tolle Betreuung und den freundlichen Umgang! Ich kann die Klinik absolut weiterempfehlen und bin mit meiner bisherigen Erfahrung sehr zufrieden. Wer Wert auf Professionalität, Qualität und einen hervorragenden Service legt, ist hier meiner Meinung nach bestens aufgehoben.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanBisher war es nur ein Beratungsgespräch aber es war sehr gut.
Weight Doctors Group · Original in GermanIch fand, dass der Arzt gut und verständlich erklärt hat. Ich habe diese Woche noch einen Termin in einer anderen Klinik, da ich mich gründlich informieren möchte; auch der Preis wird dabei eine Rolle spielen – darüber bin ich ganz offen.
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Alster-Klinik Hamburg · Original in GermanÜber die ehrliche Einschätzung
Alster-Klinik Hamburg · Original in GermanIch habe mich sehr wohl geführt, das Gespräch war sehr gut, die Ärztin hat mir sehr ausführlich alles erklärt und bin mit einem sehr guten Gefühl nach Hause gegangen.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin eine sehr ängstliche Person. Bei Herrn Dr. Neis habe ich mich sofort wohlgefühlt. Behandlungsgespräche, Umgang, Freundlichkeit – es passt alles. Ich kann ihn ohne Bedenken und Einschränkung nur weiter empfehlen. Dankeschön Herr Dr. Neis für die tolle Arbeit.
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