Glossary

Sclerosis of the abnormal electrical impulses of the heart through the release of e.g. heat by means of a cardiac catheter to eliminate e.g. atrial fibrillation.

ACE inhibitors are drugs that are used, for example, to treat high blood pressure or heart failure. ACE inhibitors can also be used in people who have already suffered a heart attack in order to prevent a repeat attack. The name “ACE inhibitor” comes from the fact that these drugs inhibit an enzyme called angiotensin converting enzyme (ACE), which plays an important role in the regulation of blood pressure. By lowering blood pressure, ACE inhibitors reduce the strain on the heart, as the heart does not have to work as hard to pump blood around the body when blood pressure is low. Typical active ingredients are captopril, enalapril, lisinopril and ramipril.

Bridging of a narrowed coronary artery using a vein.

Collective term for various life-threatening phases of coronary heart disease until a definitive diagnosis can be made.

Aldosterone antagonists belong to the group of diuretics. They block the so-called mineralocorticoid receptor in the kidney and thus ensure that the body's own hormone aldosterone can no longer work. As aldosterone antagonists, unlike other diuretics, prevent too much potassium from being excreted together with the urine, they are classed as potassium-sparing diuretics. Typical areas of application for aldosterone antagonists are the excessive formation of aldosterone (hyperaldosteronism), potassium deficiency, high blood pressure (hypertension) and heart failure (cardiac insufficiency). Aldosterone antagonists include the active ingredients eplerenone and spironolactone, for example.

Angina pectoris is the medical term for chest pain that occurs suddenly and can be of varying severity, e.g. as a dull or stabbing pain, pressure, burning or discomfort. The term angina pectoris is derived from the Latin “angere” meaning “to constrict, to choke” and “pectoralis” meaning “affecting the chest”. An attack of angina pectoris is felt as oppressive and can be accompanied by shortness of breath, a feeling of suffocation and fear of death. The cause of angina pectoris is a temporary circulatory disorder of the heart, for example because the coronary arteries are narrowed by deposits (coronary heart disease). If you experience this symptom for the first time, call the emergency services immediately, as severe angina pectoris can be a sign of a heart attack. Recurrent attacks of angina pectoris can usually be relieved quickly by administering nitroglycerin.

An X-ray of the blood vessels or heart chambers, which are filled with contrast medium at this point. It allows the doctor to see moving images of the heart.

Also known as balloon dilatation. A catheter is inserted into the coronary arteries via an artery in the groin. A balloon is deployed there, which dilates the vessel. A stent (vascular support) is often inserted to keep the site permanently open.

An X-ray of the blood vessels or heart chambers, which are filled with contrast medium at this point. It enables the doctor to see moving images of the heart.

Medication for the treatment of cardiac arrhythmia.

Medicines used to lower blood pressure.

Treatment with medication that inhibits blood clotting.

Anticoagulants - just like antiplatelet agents - are commonly referred to as ‘blood thinners’. However, anticoagulants are active substances that influence blood clotting, which is why anticoagulants are the more appropriate term. Anticoagulants prevent blood clots (thrombi) from forming, which could break away and block vital blood vessels (thromboembolism), thus helping to prevent strokes and heart attacks. At the same time, however, inhibiting blood clotting also increases the risk of bleeding, which is why the doctor carefully weighs up the benefits and risks in each case. Depending on their mechanism of action, anticoagulants can be divided into two groups, namely direct anticoagulants such as hirudin and the active substances known as new oral anticoagulants (NOACs) apixaban, dabigatran and rivaroxaban, and indirect anticoagulants such as heparins and coumarins (vitamin K antagonists).

With ATP, the tachycardia is treated by stimulating at a higher frequency than the tachycardia itself.

Ring for ‘repairing’ a heart valve.

The largest blood vessel in the body. The aorta is connected to the left ventricle and supplies the body with oxygen-rich blood.

Visualisation of the aorta on an X-ray monitor using injected contrast media.

The aortic valve is located in the left side of the heart and controls the flow of blood from the left ventricle back into the aorta and thus into the systemic circulation.

Two important diseases are aortic valve stenosis, in which the heart valve at the exit of the left ventricle is hardened and narrowed so that oxygen-rich blood has to be pumped into the body with more force, and aortic valve insufficiency, in which the aortic valve no longer closes properly and some of the blood that the heart pumps from the left ventricle into the aorta runs back again.

In the case of aortic valve insufficiency, the aortic valve no longer closes properly. Some of the blood that the heart pumps from the left ventricle into the aorta therefore flows back again and is pumped back and forth between the left ventricle and the aorta (so-called ‘shuttle blood’). This additional strain causes the left ventricle to stretch and its walls to thicken. In the long term, this can lead to generalised heart failure (cardiac insufficiency). Aortic valve insufficiency can be caused, for example, by rheumatic fever, which can also affect the heart valves, but also by an inflammation of the aortic valve caused by bacteria (endocarditis) or a disease of the aorta, which subsequently also damages the aortic valve.

In aortic valve stenosis, the heart valve at the exit of the left ventricle is hardened and narrowed. As a result, the heart has to exert more force to pump oxygen-rich blood into the aorta and into the body. This can lead to an enlargement of the heart muscle and weakness of the left side of the heart (left heart failure). Depending on the severity of the disease, not enough oxygen-rich blood reaches the body's circulation, which can lead to dizziness or even circulatory collapse. If the enlarged heart muscle is also no longer supplied with sufficient oxygen, this can cause chest pain (angina pectoris).

Aortic valve stenosis is the most common heart valve defect, especially with increasing age. It is caused by wear and calcification of the heart valve.

Temporary respiratory arrest.

Cardiac arrhythmia, irregular heartbeat.

Blood vessels that transport oxygen-rich blood away from the heart and to other body tissues.

Deposits, so-called plaques, on the vessel walls of the arteries.

Acetylsalicylic acid. Blood clotting inhibitor. ASA reduces the risk of stroke.

The valves between the atria and the ventricles. The tricuspid valve is the valve between the atrium and the ventricle on the right side. The mitral valve lies between the left atrium and the left ventricle.

One of the two atria (left and right atrium).

The dividing wall between the two upper chambers of the heart.

An opening between the two upper chambers of the heart (atria).

Blockage of conduction between the atrium and ventricle. The heart can no longer beat properly.

Arrhythmia of the atria with disorganised atrial activity. Atrial fibrillation usually originates from the left atrium and often leads to frequent, irregular conduction of the atrial impulses to the ventricles.

Bronchial asthma, usually simply called asthma, is an often chronic disease of the airways. The airways are temporarily or permanently constricted, making it difficult for those affected to breathe. People with asthma suffer from attacks of symptoms such as coughing or shortness of breath and even breathlessness (dyspnoea). Asthma is often caused by an overreaction to foreign substances or physical stimuli, often in connection with an allergy.

Doctors differentiate between allergic asthma and non-allergic asthma. Triggers for allergic asthma include plant pollen, animal dander, excrement from house dust mites, food components or certain chemicals. Non-allergic asthma, on the other hand, is triggered by non-specific stimuli, such as a bacterial or viral infection of the airways or by cold air, physical exertion or cigarette smoke. Mixed forms of allergic and non-allergic asthma also occur frequently. Cardiac asthma and chronic obstructive pulmonary disease (COPD) must be distinguished from bronchial asthma.

Also known as angioplasty. A catheter is inserted into the coronary arteries via an artery in the groin. A balloon is deployed there to widen the vessel. A stent (vascular support) is often inserted to keep the site permanently open.

Inflatable instrument for dilating blood vessels.

Beta-blocker is the abbreviation for beta-receptor blocker. As the name suggests, these are drugs that block beta receptors (β-adrenoceptors). These receptors bind the body's own stress hormone adrenaline - beta blockers prevent the binding of adrenaline and thus ensure that the adrenaline can no longer work. Beta-blockers thus reduce the pumping power of the heart, reduce its excitability, slow down the heartbeat and lower blood pressure. They are therefore used to treat many cardiovascular diseases such as high blood pressure (hypertension), chest tightness (angina pectoris), heart failure (cardiac insufficiency) and cardiac arrhythmia. Examples of beta-blockers that have a selective effect on the heart are bisoprolol, carvedilol, metoprolol and nebivolol.

Concerning the right and left ventricle.

Also known as arterial blood pressure; the pressure in the blood vessels generated by the pumping action of the heart muscle. Two values are determined when measuring blood pressure: systolic and diastolic blood pressure, which correspond to the highest and lowest pressures that occur during a heartbeat and are each expressed in mmHg.

BNP (brain natriuretic peptide) is a hormone from the group of natriuretic peptides (natriuresis = the excretion of sodium in the urine). It is mainly produced in the heart muscle cells and stimulates the kidneys, among other things, to excrete fluid. As BNP was first discovered in the brain of pigs, it is still called the ‘brain’ hormone today.

When the pressure in the heart rises, for example due to high blood pressure or a backlog of blood in acute heart failure, the heart muscle cells release BNP. On the one hand, this causes the kidneys to excrete more water; as a result, the blood volume decreases again and the blood pressure falls. BNP also causes the blood vessels to dilate, which also helps to normalise the pressure in the heart.

An increased BNP value can therefore be an indicator of heart failure - the higher the values, the more pronounced the heart failure.

According to the German Society of Cardiology, a BNP value of more than 100 nanograms per litre of blood is considered elevated if severe symptoms (acute heart failure) suddenly occur. If the onset of chronic heart failure is suspected, however, the BNP threshold value is already at least 35 nanograms per litre of blood.

A slowed heartbeat of less than 60 beats per minute. Bradycardia can be caused by diseases of the sinus node or conduction disorders.

Bypassing a constricted or blocked area of a coronary vessel using a piece of the body's own vein and artery.

Asthma cardiale or ‘cardiac asthma’ refers to a symptom complex of difficult breathing (dyspnoea), which can range from shortness of breath to breathlessness, and nocturnal coughing. The cause is usually left heart failure (left heart failure): The weak pumping capacity of the heart leads to a backlog of blood in the lungs, resulting in congestive bronchitis with shortness of breath, which then manifests itself in what is known as a ‘cardiac cough’. Those affected feel a strong urge to cough, especially at night and when lying down. Mitral valve stenosis, i.e. a narrowing of the mitral valve in the left side of the heart, can also lead to cardiac asthma.

In the worst case, the backed-up blood can lead to life-threatening pulmonary oedema. Bronchial asthma and chronic obstructive pulmonary disease (COPD) must be distinguished from cardiac asthma.

Cholesterol is one of the blood lipids. We ingest it with our food, a smaller amount is produced by the liver. Cholesterol is an important component of cell walls. The body also produces bile acids, vitamin D and hormones (steroid hormones) from cholesterol. The cholesterol level in the blood is made up of LDL cholesterol (low-density lipoprotein; considered ‘bad’ cholesterol), HDL cholesterol (high-density lipoprotein; considered ‘good’ cholesterol) and VLDL cholesterol (very low-density lipoprotein; contains very little cholesterol). Blood lipid levels that are too high - especially an elevated LDL cholesterol level - harbour an increased risk of vascular damage and cardiovascular disease. If your cholesterol level is too high, your doctor may prescribe a cholesterol-lowering drug (statin).

Clipping involves connecting the two halves of the mitral valve with a clip, the MitraClip™, in order to reduce or completely eliminate an existing leak in the mitral valve (mitral regurgitation). The advantage of this method is that the chest does not have to be opened and a heart-lung machine is not required. Instead, the MitraClip™ is inserted via a small incision in the groin into the vein located there using a catheter and advanced to the heart. This minimally invasive, percutaneous procedure is gentler than conventional surgical mitral valve operations and is therefore particularly suitable for people with an increased surgical risk, for example due to concomitant illnesses or advanced age.

COPD stands for ‘chronic obstructive pulmonary disease’ - a disease in which the lungs are damaged and the airways are permanently narrowed. The abbreviation COPD comes from the English term ‘chronic obstructive pulmonary disease’. COPD is characterised by coughing, sputum production and shortness of breath (dyspnoea) on exertion - similar symptoms to asthma, but they are two different lung diseases. It is therefore possible to have both diseases at the same time.

One of the main causes of COPD is smoking, which is why it is also commonly known as smoker's lung. Pollutants inhaled at the workplace also contribute to the development of COPD. In order to slow down the progression of COPD and avoid comorbidities, patients should generally refrain from smoking. Patients with COPD have a 2.5-fold increased risk1 of developing cardiovascular diseases such as chronic heart failure (cardiac insufficiency). Conversely, around one in five patients with heart failure also suffers from COPD2. If you already have heart failure, it is particularly important to stop smoking, as any accompanying illness can have a negative effect on heart failure. Passive smoking should also be avoided.

Source:

1. https://www.awmf.org/uploads/tx_szleitlinien/020-006l_S2k_COPD_chronisch-obstruktive-Lungenerkrankung_2018-01.pdf
2. www.ncbi.nlm.nih.gov/pmc/articles/PMC2639415/

Implantable pacemaker or defibrillator for patients with heart failure. Resynchronisation of the two chambers of the heart (left and right ventricle) improves the symptoms of heart failure and the resilience of the heart.

A procedure in which catheters are inserted into the heart through the arteries and veins. It is used to measure pressure, take echocardiographic and X-ray images and take blood samples from inside the heart and its main blood vessels.

Sterile X-ray room in which cardiac catheters are inserted and corresponding examinations are carried out.

Cardiac sport, also known as coronary sport, is a special rehabilitation programme for people with heart disease. Cardiac sports groups are supervised by a doctor and led by a qualified trainer. In addition to exercise, the programme also includes stress management, healthy eating and weight reduction. In this way, those affected can actively help to slow down the progression of the disease, alleviate disease-related symptoms and limitations and become more efficient in everyday life again.

The doctor can prescribe participation in a cardiac sports group, the costs of which are covered by health or pension insurance. The prerequisite is that you submit an application for funding for rehabilitation sport (sample 56, ‘pink form’), completed and signed by your doctor, to your health or pension insurance company for authorisation.

Many sports clubs, rehabilitation clinics or adult education centres offer such cardiac sports groups. You can ask your health insurance provider whether there is a group in your area. You can also contact the regional organisation of the German Society for Prevention and Rehabilitation of Cardiovascular Diseases (DGPR) in your federal state. On the DGPR homepage, for example, you will find a directory of heart groups by federal state.

If the heart only has a significantly reduced pumping capacity (heart failure), a ventricular assist device (VAD) can be used. A VAD is a mechanical pump that supports the heart. In the short term, it can be used to bridge the waiting time for a heart transplant, for example. In the long term, a VAD is used for patients who are not eligible for a heart transplant.

Depending on which ventricle is affected, either a left ventricular assist device (LVAD) or a right ventricular assist device (RVAD) is surgically implanted in the corresponding ventricle. If both ventricular assist devices are implanted at the same time, this is referred to as a biventricular assist device (BVAD). As in most cases it is sufficient to improve the pumping capacity of the left ventricle, the LVAD is most commonly used.

The blood pump and power supply are controlled from outside the body, and all the necessary elements can be transported in a small bag. This allows patients to maintain their mobility outside of hospital.

A ventricular assist device is also known colloquially as an artificial heart. However, a VAD is only a small pump that is inserted into the affected ventricle. A so-called total artificial heart (TAH), on the other hand, completely replaces the human heart - but the technology is still at the trial stage and has only rarely been used to date.

Cardiac output (cardiac output) refers to the amount of blood (blood volume) that the heart pumps into the circulation in a certain period of time. It is therefore a measure of cardiac output. It is usually measured in litres per minute, so a similarly frequently used term for cardiac output is cardiac output per minute (HMV).

At rest, the heart of a healthy adult pumps an average of around 5 litres per minute through the body. Under stress, it pumps significantly more, up to 30 litres per minute.

In some diseases, cardiac output can be reduced (e.g. cardiac insufficiency or mitral valve insufficiency), while in other diseases cardiac output is increased (e.g. fever or hyperthyroidism).

Vessels that supply the heart muscle with blood and oxygen.

A flexible, tube-like medical device that shows on a screen what it looks like inside the body.

Cardiac resynchronisation therapy (CRT) is used to treat heart failure if it continues to cause symptoms despite optimal drug therapy and is accompanied by typical changes in the ECG (widened QRS complex). A CRT device ensures that the left and right ventricles beat simultaneously, i.e. synchronised. This improves the heart's pumping capacity, which in turn has a positive effect on physical resilience and quality of life. CRT devices are also known as three-chamber pacemakers because they have three electrodes: One is located in each ventricle and a third electrode is located in the right atrium. As both heart chambers (ventricles) can be controlled with the help of the CRT device, the devices are also known as biventricular pacemakers. A CRT device that can also serve as a defibrillator and is therefore a combination of CRT and implantable cardioverter defibrillator (ICD) is called a CRT-ICD or CRT-D for short.

Science and teaching of the heart and heart disease.

Disease of the heart muscle with an impairment of heart function.

The cardiovascular system, consisting of the heart and all the arteries and veins.

Restoration of normal sinus rhythm in patients with cardiac arrhythmia by means of an electric shock (electrical cardioversion) or medication (drug-induced cardioversion).

Two main arteries - one on each side of the neck - that transport blood from the heart to the head.

Narrowing of the carotid artery.

In medicine, a catheter is a thin tube that is inserted into the body. The term catheter is derived from the Greek word ‘καθετήρ’, which means ‘probe’. A catheter can be rigid or flexible and made of different materials such as plastic, silicone or metal. The functions of a catheter can also be very different; for example, it can be used to probe, drain, fill or flush organs. Known catheter types are

• Bladder catheter: used to drain urine from the bladder
• Balloon catheter: contains a small balloon that can expand a constriction in a vessel
• Cardiac catheter: refers to a catheter that is inserted into the heart or coronary arteries to measure various parameters such as blood flow, pressure, oxygen saturation, temperature or electrical activity

Method for the treatment of cardiac arrhythmia. A cardiac catheter is used to sclerose specific structures in the heart in order to treat the cause of the arrhythmia.

A treatment in which a catheter is used.

X-ray examination to visualise the coronary arteries using injected contrast agents.

Collective term for the various types of narrowing of the coronary arteries (e.g. angina pectoris, heart attack). The constrictions impede the flow of blood and the supply of oxygen to the heart muscle.

Termination of ventricular fibrillation by a strong electric shock.

Implantable device that recognises life-threatening cardiac arrhythmia and delivers a life-saving electric shock.

Heart failure can develop over months or even years without the affected person realising it. This is because over a certain period of time, the body can compensate for the poor pumping performance of the heart using various strategies, such as a faster heartbeat, a thickened heart muscle, increased blood volume or increased blood pressure (compensation). Symptoms initially only appear under stress. Decompensation or decompensated heart failure is when symptoms such as shortness of breath (dyspnoea) are clearly evident even at rest and water retention (oedema) leads to weight gain and swollen legs, for example. If the symptoms worsen suddenly, immediate hospitalisation is usually necessary (acute decompensation).

Severing of the nerve connection between individual organs. In renal denervation, the transmission of nerve signals between the kidney and brain is interrupted.

Type 2 diabetes mellitus is also known colloquially as ‘adult-onset diabetes’; it is the most common form of diabetes mellitus (‘diabetes’). This disease is caused by an acquired disorder of sugar metabolism (insulin resistance), in which sugars absorbed through food are no longer processed properly. This leads to increased blood sugar levels, which can cause irreversible damage to blood vessels and nerves over a long period of time. Untreated diabetes can lead to serious secondary diseases, ranging from numbness and poorly healing wounds to blindness or amputations. Good self-management is important to avoid these consequences. This includes changing your lifestyle and diet, as well as regular check-ups with your doctor.

People who suffer from diabetes mellitus also have an increased risk of developing heart failure. On the one hand, this is due to the fact that diabetics are statistically more likely to have other risk factors for heart failure, such as high blood pressure or lipometabolic disorders. On the other hand, an elevated blood glucose level also directly influences the risk of developing heart failure and the severity of its progression. Regular visits to the doctor are therefore recommended both for patients with diabetes mellitus and for people with heart failure to ensure that an elevated blood glucose level does not go unrecognised and untreated.

The relaxation and filling phase of the heart, in contrast to the systole, the contraction and ejection phase.

Digoxin belongs to the group of so-called cardiac glycosides, or cardiac glycosides for short. These active ingredients increase the heart's pumping power while simultaneously reducing the heart rate - the heart can thus work more economically because it can transport more blood with fewer beats. For this reason, digoxin is used for heart diseases such as heart failure and cardiac arrhythmias such as atrial fibrillation or atrial flutter. While digoxin is found in the foxglove Digitalis lanata, the closely related digitoxin comes from the red foxglove (Digitalis purpurea).

Diuretics are active substances that increase the excretion of urine. Such diuretics are used, for example, when the body retains too much water as a result of heart failure (cardiac insufficiency) or mitral insufficiency, leading to fluid retention (oedema). Diuretics can be used to flush out this excess water. Diuretics can be categorised into different groups depending on their mode of action, e.g:

• Loop diuretics such as furosemide and torasemide
• Thiazide diuretics such as hydrochlorothiazide and chlorthalidone
• Potassium-sparing diuretics such as amiloride, spironolactone and eplerenone

Disease management programmes (DMPs for short) are supportive treatment programmes for people with a chronic illness. The statutory health insurance funds offer such ‘chronic disease programmes’ together with doctors, for example for diabetes or asthma, but also for heart failure. Anyone who has several illnesses for which there is a DMP can take part in one for each illness.

The aim of these programmes is to alleviate the symptoms associated with a chronic illness, to halt its progression and to prevent complications, secondary damage or concomitant illnesses as far as possible. In addition, patients learn to cope better with their illness. DMPs therefore not only include regular doctor's appointments with consultations and examinations, but also provide relevant background information in training sessions, for example, so that patients can actively shape their treatment. All of this is intended to improve and maintain the quality of life of DMP participants.

DMPs also improve cooperation between various specialists and facilities involved in patient care, such as general practitioners and specialists, clinics and rehabilitation centres. This means that the individual treatment steps can be better coordinated and, for example, duplicate examinations can be avoided.

If you would like to take part in a DMP, talk to your doctor about it.

A small blood vessel that connects the pulmonary artery with the aorta.

Biological valve prostheses are made of tissue from either pigs or cattle.

ECG written under dosed workload (e.g. cycling), which can provide indications of exercise-related circulatory disorders of the heart.

Echocardiography is an examination method of the heart based on ultrasound. The ultrasound probe is either placed on the chest (transthoracic echocardiography) or inserted into the esophagus (swallowing echocardiography, also known as transesophageal echocardiography). Using echocardiography, the doctor can see whether the heart is pumping normally or whether there are diseases of the heart and/or the heart valves.

The ejection fraction (EF), also known as the ejection fraction, describes the proportion of blood that is pumped from the ventricle into the bloodstream during a heartbeat (in relation to the total volume of the ventricle). In healthy people, the ejection fraction is approx. 55-70%; in certain heart diseases such as heart failure and mitral insufficiency, the ejection fraction is often reduced. Common methods used to determine the ejection fraction are echocardiography, cardiac catheterisation and examination of the heart using computer tomography (CT angiography). The term ejection fraction is derived from the Latin ‘eicere’ for ‘to eject’ and ‘fractio’ for ‘fracture, fragment’.

Thin, flexible insulated wire that is anchored in the ventricles and connected to the heart. The electrode transmits information about the heart rhythm to the pacemaker or defibrillator, which delivers electrical impulses or shocks if necessary.

Change in position of the electrode.

External recording of the electrical activity of the heart.

Cardiac catheterisation for cardiac arrhythmia. Catheters are inserted into the heart via the inguinal artery for diagnostic or therapeutic purposes.

The term embolism is used by doctors to describe the blockage of a blood vessel by material that has been washed into it. Depending on what is blocking the blood vessel, a distinction is made between, for example

• Thromboembolism: blockage caused by a blood clot (thrombus)
• Fat embolism: blockage caused by fat droplets, e.g. after bone fractures
• Amniotic fluid embolism: blockage caused by components of the amniotic fluid
• Gas embolism: occlusion caused by gas bubbles (usually air bubbles), e.g. in the case of diver's disease

The innermost layer of the heart wall. It lines the inside of the heart, including the valves, like wallpaper.

Endocarditis is an inflammation of the inner lining of the heart (endocardium). Endocarditis can be caused either by infection with a pathogen (infectious endocarditis) or by other diseases such as rheumatic fever (non-infectious endocarditis). In this country, the infectious form predominates, as the number of operations and therefore the risk of becoming infected with pathogens (mostly bacteria) has increased, while rheumatic fever has become rare. The insertion of artificial heart valves, vascular connections and pacemakers in particular is associated with an increased risk of endocarditis - which is why doctors can prescribe antibiotics as a preventative measure before such procedures (endocarditis prophylaxis). Congenital or acquired heart defects can also favour the occurrence of endocarditis. Endocarditis is often accompanied by fever and non-specific symptoms such as loss of appetite, weight loss and joint pain. If the inflammation is caused by bacteria, endocarditis can be treated with antibiotics.

Medication to prevent endocarditis.

Fat and vascular layer in the inner part of the pericardium (between the pericardium and the heart).

Chronically elevated blood pressure that cannot be attributed to organic causes or the intake of medication with a known blood pressure-increasing effect.

Heartbeat that occurs outside the normal sinus rhythm. It can be recognised as a kind of ‘heart stumble’.

Measured value that describes the maximum blood flow capacity of an artery and provides information on the extent of vasoconstriction.

A large artery in the groin area that provides access to the most important organs via the network of arterial blood vessels. The femoral artery is often used as an insertion site for catheters and wires during interventional and diagnostic procedures.

Tube-shaped instrument as a transport aid for invasive procedures, e.g. pressure measurement or angioplasty.

A guideline serves as a practical aid for doctors, as it contains comprehensive recommendations for the diagnosis and treatment of a disease. There are therefore a large number of guidelines on a wide variety of diseases. Guidelines are drawn up by institutions and/or professional associations. They either write a guideline on their own or it is produced in co-operation with several representatives. These institutions include, for example, the German Medical Association (BÄK) and the National Association of Statutory Health Insurance Physicians (KBV). Associations of scientifically active specialist groups, such as cardiologists, are referred to as specialist societies. Guidelines are available free of charge and are regularly updated to reflect the latest research in diagnosis and treatment. There are also so-called patient guidelines for laypeople. They convey the content of the guidelines in a more understandable language.

See hypertension.

Blood flow.

HDL cholesterol (high-density lipoprotein) is a component of blood lipids. Together with LDL cholesterol (low-density lipoprotein) and VLDL cholesterol (very low-density lipoprotein), it forms ‘cholesterol’. Cholesterol is fundamentally important for many bodily functions, for example for stabilising cell walls or as a building block for some vital hormones such as testosterone, oestrogen, cortisone and progesterone as well as the insulating layer of nerve fibres.

HDL cholesterol transports excess cholesterol from the blood and tissue to the liver, where it is broken down. As the risk of cardiovascular disease is lower with a high HDL level, HDL is also known as ‘good’ cholesterol - in contrast to LDL cholesterol, which is associated with an increased risk of cardiovascular disease.

A balanced ratio between LDL and HDL cholesterol is important: according to the German Society for Combating Lipid Metabolic Disorders and their Consequential Diseases DGFF (Lipid League) e. V., a LDL value of less than 115 milligrams per decilitre and an HDL value of more than 40 milligrams per decilitre for men and more than 45 milligrams per decilitre for women are considered favourable values for healthy people - the more HDL cholesterol the better.

Machine that takes over the function of the heart and lungs during open heart surgery and supplies the body with blood and oxygen.

Defect or malformation of the heart, usually present at birth.

Frequency of the heartbeat per time unit.

Pathological murmurs of the heart caused by hereditary defects or damaged heart valves that do not close properly.

Heart failure is a disease of the heart characterised by the fact that the heart's pumping capacity is not sufficient to supply the body with enough oxygen-rich blood. If the left side of the heart is mainly affected, the doctor speaks of left heart failure - this is the most common form of cardiac insufficiency. However, the pumping capacity of the right side of the heart may also be restricted (right heart failure) or both sides of the heart may be equally affected (global insufficiency). The term insufficiency is the opposite of sufficiency and is derived from the Latin adjective sufficiens, which means ‘sufficient’ or ‘enough’.

Biological valve prostheses are made of tissue from either pigs or cattle.

Mechanical heart valves are made of so-called pyrolytic carbon.

Biological heart valve that is inserted into the heart with a catheter either via the groin or via a small incision in the chest. Once the catheter is in the right place, the heart valve is deployed.

Four valve-shaped parts of the heart that function as one-way valve systems. They serve to regularly fill and empty the heart chambers with blood.

Heart valve diseases include valvular insufficiency, in which one of the four heart valves does not close properly, and valvular stenosis, in which a heart valve does not open wide enough. These changes to the heart valves can be congenital, occur after rheumatic diseases or bacterial endocarditis, but can also be age-related. In the long term, these conditions can lead to heart failure.

If a heart valve cannot be repaired (valve reconstruction), the surgeon must remove the diseased valve and replace it with a prosthetic valve. Either a mechanical heart valve made of metal or plastic or a biological heart valve replacement can be used. Surgical heart valve replacement is performed with the chest open and using a heart-lung machine, as the heart must be immobilised for the duration of the operation.

Leaking heart valve that does not close properly and allows reflux.

Stiff heart valve that restricts the outflow of blood.

Cardiac arrhythmias are a collective term for conditions in which the normal heartbeat sequence is disturbed. Cardiac arrhythmias can be divided into different groups, for example according to the speed of the heartbeat: if the heart beats too fast, this is called tachycardia, whereas if it beats too slowly, this is called bradycardia. Another way to differentiate is to describe where the cardiac arrhythmia originates: in the atrium (supraventricular arrhythmia, e.g. atrial fibrillation), in the ventricle (ventricular arrhythmia, e.g. ventricular fibrillation) or in the excitation and conduction system (e.g. AV block, sick sinus syndrome, etc.). Cardiac arrhythmias can be treated with medication such as beta-blockers and digoxin, the insertion of a pacemaker or an implantable cardioverter defibrillator (ICD) or by targeted obliteration of the affected region (catheter ablation).

The heart is one of the body's central organs and is at the centre of the circulatory system. One of its main tasks is to transport oxygen-rich blood from the lungs through the vessels to the organs and tissues. It transports deoxygenated blood via the veins back to the lungs, where it is enriched with oxygen. Its continuous pumping maintains the blood pressure. Diseases of the heart muscles (cardiomyopathy), heart disease due to circulatory disorders of the coronary arteries (coronary heart disease), congenital malformations of the heart and heart failure (cardiac insufficiency) can result in terminal heart failure. If all medical treatment approaches fail to improve the patient's state of health, heart transplantation is the last therapeutic option. In this surgical procedure, the original heart is removed and replaced with the heart of an organ donor.

Hyperlipidaemia (also hyperlipoproteinaemia, HLP) is a collective term for various lipometabolic disorders that are associated with an increase in blood lipid levels. The term is made up of ‘hyper’ (too much, excessive), ‘lipid’ (fat) and ‘-aemia’ (in the blood). Elevated blood lipids, as in hyperlipidaemia, are generally a risk factor for atherosclerosis, including of the coronary vessels, and promote coronary heart disease and ultimately heart failure.

Hyperlipidaemia is a symptom, not a disease. It can have various causes: If it is genetic, it is referred to as primary hyperlipidaemia. However, it can also occur as a result of another disease such as diabetes mellitus or its precursors, hypothyroidism or chronic liver or kidney disease. This is referred to as secondary hyperlipidaemia. However, the most common cause is an unhealthy lifestyle: A poor diet, obesity, lack of physical activity or stress favour a lipid metabolism disorder. Various medications can also cause hyperlipidaemia. These include cortisone preparations, beta-blockers or, in women, the contraceptive pill and hormone replacement preparations after the menopause. In order to bring elevated blood lipids back into balance for the sake of your heart, you should have the underlying disease treated and also adjust your lifestyle. Your doctor may also prescribe a lipid-lowering drug, such as a statin.

Unusually low blood pressure.

An implantable cardioverter-defibrillator (ICD) is a device that is used to treat serious forms of cardiac arrhythmia. In this case, the ventricles contract too quickly - in extreme cases, ventricular fibrillation occurs, in which the heart can no longer pump blood. An ICD continuously monitors cardiac activity and automatically recognises when cardiac arrhythmia occurs. The device can interrupt these with electrical impulses so that the activity of the heart muscle returns to normal. The ICD device is implanted in the same way as a pacemaker - unlike an ICD, however, a pacemaker is normally used in patients whose heart beats too slowly, while the ICD is used when the heart beats too quickly. However, if the heart of a patient with an ICD beats too slowly, the ICD device can also stimulate the heart muscle with electrical impulses like a pacemaker. A special type of ICD, the so-called three-chamber ICD, has three electrodes: one electrode is located in each ventricle and one in the right atrium of the heart. These ICDs are used for cardiac resynchronisation therapy (CRT), in which the activity of the atrium and the two ventricles are coordinated (i.e. synchronised) with each other - they are therefore classed as CRT devices.

Installation of the pacemaker or defibrillator under the skin.

Prevent pulse emission.

Intervention. Any therapeutic measure.

Abnormal condition of the heart in which the two ventricles no longer contract together. Interventricular asynchrony is usually caused by cardiac insufficiency-related conduction disturbances within the heart and is corrected by cardiac resynchronisation therapy.

Inside the heart.

An ultrasound test for imaging the heart in which a camera probe is inserted into a blood vessel and placed next to the heart.

Invasive procedure to determine the severity of constrictions in the coronary arteries.

Penetrating into the body.

Number of cases of a particular disease that occur per year.

Restricted supply of blood and oxygen to the heart muscle due to constrictions in the coronary arteries.

Invasive imaging procedure to assess the shape and structure of the interior of the vessels.

An organ located in the abdominal cavity that acts as a blood filter and produces urine. Healthy kidneys help to maintain the potassium (salt) and water balance and are involved in the regulation of blood pressure. Normally, humans have two kidneys.

The atrial appendages or cardiac appendages are muscle pockets that are connected to the atria on the right and left side of the heart. They are a normal part of the heart's anatomy and do not usually cause any problems. In people with atrial fibrillation, however, blood clots can form in the left atrial appendage due to the reduced pumping capacity; these can then be flushed out, block the blood flow to the brain and thus trigger a stroke.

Doctors also call the left atrial appendage the ‘left atrial auricle’, or LAA for short.

Damage, injury, disturbance.

LDL cholesterol (low-density lipoprotein) is the so-called ‘bad’ component of blood lipids (cholesterol). LDL cholesterol transports fats from the liver to body tissues. There, the cholesterol is used to produce various hormones and also vitamin D. However, LDL cholesterol can also release cholesterol into the blood. If too much LDL cholesterol accumulates there, it is deposited on the vessel walls in the form of plaques. The arteries constrict and less blood can flow through them. If the vessels that supply the heart with blood are affected, it no longer receives enough oxygen. The heart has to pump harder and there is a risk of overload. If a vessel becomes completely blocked, this can lead to a heart attack. LDL cholesterol is therefore one of the triggers for arteriosclerosis, cardiovascular disease and stroke.

Other components of blood lipids are HDL cholesterol (high-density lipoprotein, considered ‘good’ cholesterol) and VLDL cholesterol (very low-density lipoprotein). HDL cholesterol in particular protects the blood vessels as it transports cholesterol to the liver where it is broken down.

According to the German Society for Combating Lipid Metabolic Disorders and their Consequential Diseases DGFF (Lipid League) e. V., favourable values for healthy people are an LDL value of less than 115 milligrams per decilitre and an HDL value of more than 40 milligrams per decilitre for men and more than 45 milligrams per decilitre for women.

Whether a certain cholesterol level requires treatment varies greatly from person to person and also depends on other risk factors. According to the Lipid League, a fixed limit value alone is therefore not suitable for deciding whether treatment is necessary.

In left heart failure, the pumping power of the left side of the heart, which is responsible for pumping oxygen-rich blood into the body's circulation, is restricted. The undersupply leads to typical symptoms such as rapid fatigue and reduced physical resilience. At the same time, the blood cannot be transported quickly enough due to the reduced pumping capacity and backs up into the blood vessels. In the case of left ventricular failure, the backlog builds up primarily in the lungs. This increases the pressure in the blood vessels of the lungs and the liquid components of the blood are pressed into the lung tissue (congested lungs). The consequences are water retention (pulmonary oedema), reduced absorption of oxygen into the blood, rattling breathing noises and shortness of breath. Coughing fits can also occur, particularly at night. This form of breathlessness is known as cardiac cough (cardiac asthma).

Fluid accumulation in the lungs, usually due to heart failure.

A diagnostic procedure that uses a magnetic field to image body tissue.

The four most important risk factors for coronary heart disease: high blood pressure, obesity, altered blood lipid levels and a sugar utilisation disorder.

Term used to describe procedures that only require a very small incision in the skin. Minimally invasive procedures have been made possible by advances in medical technology, thanks to which surgical interventions can be performed without having to open the body cavity wide.

The mitral valve is one of the four valves in the heart. It sits between the left atrium and the left ventricle and works like a bicycle valve: blood can only flow through it in one direction. As a result, the mitral valve prevents blood from flowing back into the left atrium when blood is pumped from the ventricle into the systemic circulation. Important diseases of the mitral valve are mitral stenosis, in which the valve opening is so small that blood can no longer flow unhindered, and mitral insufficiency, in which the valve no longer closes properly.

The mitral valve sits between the left atrium and the left ventricle, where it prevents the backflow of blood from the ventricle into the atrium. In the case of mitral valve stenosis, the opening of the mitral valve is severely narrowed, which is why the heart has to exert more force to push the blood into the left ventricle. As a result, the left atrium expands over time, which can lead to atrial fibrillation, a specific type of cardiac arrhythmia. In addition, the blood pressure in the pulmonary circulation rises (pulmonary hypertension). The backlog of blood in the lungs often leads to shortness of breath (dyspnoea), especially during exertion. One of the most common causes of mitral valve stenosis is endocarditis (inflammation of the inner lining of the heart).

A leak in the mitral valve is known as mitral valve insufficiency or mitral regurgitation for short. In this heart valve disease, the mitral valve can no longer close properly, so that oxygen-rich blood from the left ventricle flows in the wrong direction, namely back into the left atrium, instead of being pumped completely through the aorta into the systemic circulation. Typical symptoms of mitral regurgitation are shortness of breath, rapid fatigue, reduced performance and swollen feet/ankles (oedema). If you suspect that you are suffering from mitral regurgitation, be sure to talk to your GP about your symptoms.

Millimetre of mercury column, a unit of pressure used to indicate blood pressure values.

Muscle tissue of the heart.

Also heart attack. Damage or death of heart muscle tissue caused by the interruption of the blood supply to this region of the heart.

Myocarditis is an inflammation of the heart muscle that can be caused by various factors. Infections with pathogens, especially viruses, can lead to myocarditis. However, disorders of the immune system (autoimmune myocarditis) and certain substances such as chemotherapeutic agents or ethanol as well as heat stroke or radiotherapy can also inflame the heart muscle. Myocarditis is usually characterised by a gradual progression; typical symptoms are fatigue, weakness and palpitations. If the heart muscle becomes inflamed, the inflammation can also spread to other heart tissue. In most cases, however, myocarditis heals without consequential damage. However, it is possible for the inflammation to become chronic, resulting in impaired heart function (heart failure).

Natriuretic peptides are a group of hormones that regulate the electrolyte balance and blood pressure (natriuresis = excretion of sodium in the urine). If, for example, the pressure in the heart rises due to high blood pressure or a backlog of blood in acute heart failure, these hormones are increasingly released. This causes the kidneys to excrete more water, which reduces blood volume and lowers blood pressure. At the same time, these hormones dilate the blood vessels, which also helps to normalise the pressure in the heart. A distinction is made between the atrial natriuretic peptide (ANP), which is primarily produced in the heart's right and left atria, the B-type natriuretic peptide (BNP, from brain natriuretic peptide) and the related NT-proBNP, both of which are primarily produced in the heart muscle cells, and the C-type natriuretic peptide (CNP), which is produced in the brain and kidneys, among other places.

Elevated levels of natriuretic peptides in the blood can therefore be indicators of heart failure.

Medical procedure in which the body is not penetrated, e.g. echocardiography.

Like BNP, N-terminal pro-BNP (NT-proBNP) indicates how high the so-called wall tension in the heart is, i.e. ultimately how high the pressure and therefore the strain is. Elevated BNP and NT-proBNP values indicate increased wall tension or overloading of the heart. They are therefore considered biomarkers, i.e. indicators of heart failure. The higher the values, the more pronounced the heart failure.

According to the German Society of Cardiology, the NT-proBNP threshold value for chronic heart failure is 125 nanograms per litre of blood, while for acute heart failure it is 300 nanograms per litre of blood.

The severity of a heart disease such as heart failure or mitral regurgitation can be assessed according to various criteria. Originally developed by the US New York Heart Association (NYHA), the so-called NYHA class describes how severely a patient's physical performance is limited by their heart disease:

• NYHA class I: known heart disease but no symptoms → no limitation of physical performance
• NYHA class II: no symptoms at rest, but symptoms during everyday physical exertion → physical performance slightly impaired
• NYHA class III: symptoms even with little physical exertion, still no symptoms at rest → physical performance severely restricted
• NYHA class IV: symptoms during all physical activities and at rest, bedridden

The term ‘nocturia’ is used by doctors to describe the urge to urinate at night. Anyone who has to urinate more than once or twice during the night suffers from nocturia.

Frequent urination at night can have various causes, such as bladder inflammation, diabetes mellitus or impaired kidney function (renal insufficiency). However, nocturia is very often the result of heart failure. Due to the reduced pumping capacity of the heart, the kidneys are less well supplied with blood and can no longer work sufficiently, and water accumulates in the body. However, at night, when lying down, the kidneys are better supplied with blood and excrete more of the excess water. Hence the frequent urge to urinate at night. In addition, diuretics are often used to combat water retention. They also promote dehydration and thus the urge to urinate.

The word oedema is derived from the Greek ‘οἴδημα’, which can be translated as ‘lump, swelling’. Accordingly, doctors refer to oedema as a non-reddened swelling caused by the accumulation of fluid. This occurs when fluid leaks from a blood vessel into the surrounding tissue and accumulates there. Oedema is usually not the cause but the result of a disease, so it is a symptom. Diseases in which oedema can occur include heart failure, mitral insufficiency, kidney disease, thrombosis and liver cirrhosis. Depending on the location of the fluid accumulation, a distinction is made between pulmonary oedema, lower leg oedema and eyelid oedema. To flush out the excess fluid, the doctor often prescribes diuretics, i.e. diuretics.

Closing or blocking an opening.

Imaging diagnostic procedure with which the lumen (the inner space) and the surface of coronary vessels can be visualised.

A device that uses regular electrical impulses to stimulate the heart muscle. It may be required temporarily after an operation, in which case it is placed outside the body. If it is required in the longer term, an implantable device is transplanted under the skin.

A small clot or deposit that leads to reduced or blocked blood flow in an artery.

Suddenly starting and suddenly ending.

Pericardium. Covering of the heart consisting of connective tissue.

Through the skin.

The term percutaneous is made up of the Latin preposition ‘per’ for ‘through’ and the noun ‘cutis’ for ‘skin’. A percutaneous procedure is therefore a procedure in which the doctor gains access to the organ or tissue to be treated through the skin. If you suffer from mitral regurgitation, for example, you may be eligible for percutaneous mitral valve repair (PMKR). This involves inserting a long, flexible guide catheter through a vein in the groin and guiding it to the heart. This catheter is then used to attach the MitraClip™ to the mitral valve - the clip connects the two halves of the mitral valve and ensures that the valve closes better again. This therapy, also known as clipping, does not require the chest to be opened and does not require the use of a heart-lung machine.

Describes an arterial opening that connects the pulmonary artery to the aorta.

Describes a small opening or valve in the atrial septum known as the foramen ovale. The PFO is a relatively common congenital heart defect.

The persistent foramen ovale, or PFO for short, is a congenital flap-shaped opening between the two upper chambers of the heart, the atria.

In unborn babies, this opening between the two atria allows the mother's oxygen-rich blood to flow directly from the right side of the heart to the left side, as the embryo's lungs have not yet developed. After birth, the baby can breathe on its own and supply its body with oxygen-rich blood; the blood flow from right to left is no longer necessary. Normally, the opening now grows together and forms a solid wall (septum); the blood then circulates via the lungs to be oxygenated there. In around a quarter of the population, however, the PFO remains like a tunnel or flap between the atria of the heart; it is ‘persistently’, i.e. permanently, open. The problem: the PFO is a risk factor for a stroke. Due to the direct access from the right to the left atrium, blood clots can bypass the lungs and enter the systemic circulation, possibly reaching the brain and triggering a stroke there. However, the risk can be minimised with medication or surgery.

Deposits on the vessel walls.

The number of cases of a particular disease present in a population at a given time.

Pacemaker therapy to prevent atrial fibrillation.

Constricted coronary arteries are dilated using a special catheter that is inserted through the skin and advanced into the vascular system.

Concerning the lungs.

The artery that is connected to the right ventricle and transports deoxygenated blood to the lungs. Often a source of atrial fibrillation.

The pulmonary valve is one of the four heart valves. It is located between the right ventricle and the pulmonary artery and prevents the backflow of blood into the right ventricle during the relaxation phase (diastole) of the heart.

The pulmonary valve consists of three crescent-shaped pockets. As the heart valves on the left side of the heart are exposed to more mechanical stress than those on the right side, the mitral and aortic valves develop hardening or narrowing (stenosis) or leakage (insufficiency) much more frequently than the pulmonary valve, for example.

A needle is used to find and pierce a vein through which an electrode or catheter, for example, can be inserted into the heart.

Just like anticoagulants, platelet aggregation inhibitors are often referred to as blood thinners, but this term is somewhat misleading because, like anticoagulants, these drugs do not thin the blood. Instead, antiplatelet agents prevent the platelets (thrombocytes) in the blood from clumping together, i.e. aggregating. These active substances are therefore used to prevent the formation of blood clots in the arteries (arterial thrombosis). Doctors often prescribe platelet aggregation inhibitors after a stroke or heart attack - it has been shown that taking these drugs can significantly reduce the risk of another stroke or heart attack. The best-known antiplatelet drug is acetylsalicylic acid (known under trade names such as Aspirin, Alka-Seltzer and Acesal), but there are also other active ingredients such as clopidogrel, prasugrel and ticagrelor.

Renal insufficiency, also known as kidney failure, refers to a functional disorder or the complete failure of one or both kidneys. A distinction is made between acute renal insufficiency, which occurs suddenly, and chronic renal insufficiency, which worsens over a longer period of time. Heart patients often develop renal insufficiency: due to the decreasing pumping capacity of the heart, the kidneys are not sufficiently supplied with blood, which restricts their function. As a result, they are unable to dispose of certain metabolic waste products, causing them to accumulate in the blood. If left untreated, this can poison the body in the long term. An accumulation of degradation products can also have a direct effect on the heart: if too much potassium accumulates in the blood, for example, this can trigger cardiac arrhythmia, which in turn further weakens the heart - a vicious circle.

Water retention in the body (oedema) can also worsen as a result of impaired kidney function, which puts additional strain on the heart. To avoid complications, your doctor will always check your kidney function if you have heart failure.

In right heart failure, the pumping power of the right side of the heart, which is responsible for pumping deoxygenated blood to the lungs, is reduced. The reduced pumping capacity causes blood to back up into the body's circulation, which leads to leg oedema, for example, i.e. water retention in the ankles and lower legs. This can lead to a seemingly inexplicable weight gain of more than half a kilogramme in a day or more than two kilogrammes in a week.

In the advanced stages of right heart failure, the hands can also be affected by water retention. Another consequence is a frequent urge to urinate, especially at night. During sleep, the heart can work more easily, so the kidneys are better supplied with blood and the water in the tissue can be removed again. Right heart failure can also lead to a loss of appetite, a feeling of fullness and fluid retention in the abdomen due to the backlog of blood in the digestive tract.

Rehabilitation is an attempt to alleviate the damage to health caused by an illness or accident or to restore health. Rehabilitation often takes place directly after hospitalisation and is then referred to as follow-up rehabilitation or follow-up treatment (AHB).

In the case of heart disease, for example, rehabilitation often includes cardiac gymnastics or ergometer training if the patient's performance is to be improved.

For rehabilitation measures, an application must first be submitted to the service provider, who is responsible for the (partial) financing of the measures and must approve them. There are various service providers in Germany, including, for example, the statutory health insurance funds and the Federal Employment Agency.

Belonging to the kidney, concerning the kidney.

Renewed stenosis of a surgically dilated stenosis. Revascularization: Re-expansion of the vessels in the case of restenosis.

Excitation conduction system of the heart. An autonomous system for the generation and transmission of electrical impulses that lead to the heartbeat.

Sartans are antihypertensive drugs that are also known as AT1 receptor antagonists or angiotensin II blockers. The mechanism of action of sartans is based on the fact that they reduce the effect of the hormone angiotensin II. This hormone normally causes the blood vessels to constrict, which leads to an increase in blood pressure. If the binding site for the hormone is blocked by sartans, the blood vessels widen and the blood pressure drops. This relieves the strain on the heart, so doctors prescribe sartans not only for high blood pressure (hypertension), but also for other conditions such as heart failure. Typical representatives of this class of medication are the active ingredients candesartan, losartan and valsartan.

The sudden loss of brain function caused by a blocked or ruptured blood vessel leading to the brain.

High blood pressure due to an organic cause.

Partition wall, partition.

Electrical pulse generator of the heart. It is located in the right atrium and determines the heart rate. A healthy heartbeat is in sinus rhythm.

Another term for electrode.

A statin is a drug that lowers blood lipid levels and regulates cholesterol levels. This group of active ingredients is therefore also known as cholesterol-lowering drugs or lipid-lowering drugs (lipid = fat). Statins are primarily directed against the so-called “bad” LDL cholesterol, which attacks the blood vessel walls and is therefore partly responsible for vascular and heart disease. Under the influence of the drug, the body produces less cholesterol itself. As a result, there is a cholesterol deficiency in the cells and the cells produce more receptors in order to absorb as much of the remaining cholesterol from the blood as possible - especially LDL cholesterol. This removes LDL cholesterol from the bloodstream, reducing the risk of cardiovascular disease.

In addition, statins can also inhibit existing inflammatory processes in the blood vessel walls. This is why they are used in many people with heart disease, for example after a heart attack, regardless of whether their cholesterol levels are elevated or not.

In Germany, the active substances atorvastatin, fluvastatin, lovastatin, pravastatin and simvastatin from the statin group are approved.

Constriction of a vessel.

Vascular support, small metal grid. In coronary heart disease, a stent is placed in an affected vessel to restore blood flow.

Frequency of a stimulation per unit of time. For example, through a pacemaker.

Under the skin.

The nerve plexus that contributes to the functional control of the body's most important organs, including the kidneys.

Sudden onset of circulatory arrest resulting in brief unconsciousness. The cause may be a temporary circulatory disorder of the brain triggered by a cardiac arrhythmia.

Tension and ejection phase of the heart, in contrast to diastole, the relaxation and filling phase.

The higher of the two blood pressure values, which indicates the highest pressure that can be measured in the arterial walls during a heartbeat.

Cardiac arrhythmia with an increase in heart rate to over 100 beats per minute.

Also known as palpitations. A very fast heart rate of over 100 beats per minute when the body is at rest. Tachycardia can occur with atrial fibrillation or be triggered by stress, hormonal changes or anxiety.

Remote monitoring of implanted ICDs or pacemakers via a transmitter. The attending physician can view complete follow-up data via the Internet.

Interrogation of a pacemaker or AICD through the skin.

Blood pressure that remains too high despite treatment with at least three antihypertensive drugs of different classes, including at least one diuretic.

Blood clots.

A temporary lack of oxygen supply to the brain.

Through a catheter.

Transmitter unit for telemedical remote monitoring of ICDs or pacemakers.

An ultrasound-based examination procedure for imaging the heart in which a camera probe is placed in the esophagus near the heart.

The tricuspid valve is one of the four valves in the heart. It is located on the right side of the heart and ensures that venous blood is pumped from the right ventricle into the pulmonary circulation and does not flow back into the right atrium.

Important diseases of the tricuspid valve are tricuspid valve stenosis, in which the valve opening is reduced and the blood can no longer flow unhindered, and tricuspid valve insufficiency, in which the valve no longer closes properly.

If the opening of the tricuspid valve is narrowed, doctors call this tricuspid valve stenosis. The narrowing causes blood to back up, resulting in typical symptoms such as water retention (edema), loss of appetite, nausea, vomiting and belching. Tricuspid valve stenosis is usually caused by rheumatic fever. As this rarely occurs in countries such as Germany nowadays, tricuspid valve stenosis is a rather rare disease. Other possible causes of tricuspid valve stenosis can be a tumor or a blood clot.

If the tricuspid valve opening leaks and blood flows back into the right atrium, this is known as tricuspid valve insufficiency or tricuspid regurgitation for short. With a slight leak in the tricuspid valve, only a small amount of blood flows back, patients often have no symptoms and usually require no treatment. In the case of severe tricuspid valve insufficiency, it may be necessary to repair the tricuspid valve (valve reconstruction) or replace it with a new valve (valve replacement). Typical symptoms are congestion of the liver and neck veins as well as leg edema (water retention in the legs). In addition, cardiac arrhythmia can occur in the form of heart stumbling or palpitations.

Troponin, also known as cardiac troponin (cTn), is a protein in the muscle cells of the heart that is released into the blood in the event of damage such as cardiac insufficiency or a heart attack. An elevated troponin level can therefore be an indicator of heart damage and therefore of an increased risk of heart attack. On the other hand, an increased troponin value also serves as proof of a previous heart attack: the troponin value rises around three hours after a heart attack, reaches its maximum value after around 24 hours and falls back to the normal value over the next 10 to 14 days.

The cause of a conspicuously high troponin value should always be clarified in detail, as troponin can also be elevated in other diseases such as acute kidney failure, rheumatic diseases or a pulmonary embolism. Troponin values that are too low, on the other hand, have no medical significance.

Uncoordinated twitching of the two lower chambers of the heart. The heart can no longer pump blood into the body and the circulation collapses.

Belonging to the vascular system.

Belonging to the flap.

The two lower chambers of the heart (right and left).

Blood vessels that transport blood to the heart.

Arrhythmia of the ventricle.

A hole in the cardiac septum between the two lower chambers of the heart. There are two types of VSD - muscular and membranous.

VLDL cholesterol (very low-density lipoprotein), together with HDL cholesterol (high-density lipoprotein) and LDL cholesterol (low-density lipoprotein), forms ‘cholesterol’, a component of blood lipids.

VLDL cholesterol is a precursor of LDL cholesterol, both of which are classed as ‘bad’ cholesterol as they attack the blood vessel walls and can trigger arteriosclerosis. The higher the (V)LDL cholesterol level, the higher the risk of developing cardiovascular disease as a result of arteriosclerosis. HDL cholesterol, on the other hand, is considered ‘good’ cholesterol as it protects the blood vessel walls.

For healthy adults, a VLDL cholesterol level of less than 30 milligrams per decilitre is usually considered normal.