Heart Failure

BMI

Body Mass Index (BMI)

The BMI is a simple ratio measure used to classify body weight. It is calculated by dividing body weight in kilograms by the square of height in meters. Clinically the value is used to estimate underweight, normal weight, overweight and obesity; a BMI of about 30 or higher is classified as obesity.

Dyspnoea

Shortness of breath in heart failure arises mainly from pulmonary congestion due to increased left-sided filling pressures and can occur with both reduced and preserved ejection fraction.

thoracic tightness or pressure sensation

A thoracic tightness or pressure sensation, especially retrosternal, can indicate angina pectoris.

up to the first floor

Shortness of breath when climbing stairs up to the first floor can correspond to heart failure NYHA II to III.

two to three minutes

When climbing to the first floor, shortness of breath occurs so that the patient needs a two- to three-minute rest. With absence of symptoms at rest, this more likely corresponds to NYHA III.

The usual distance between two bus stops

Usual distance between two bus stops

The phrase refers to a common everyday distance used as a reference measure (in this context about 400 m). The patient states she can only walk about half of this distance (approx. 200 m) without interruption. This information is commonly used in clinical practice to roughly assess a patient’s walking distance and mobility.

retrosternal, stabbing as well as pressing pains

Retrosternal, pressing pains can indicate myocardial ischemia, for example in angina pectoris or an acute coronary syndrome.

Orthopnea

Orthopnea

Orthopnea denotes the occurrence of shortness of breath when lying flat, causing affected individuals to often sleep with an elevated head and upper body (here: two pillows). Pathophysiologically, lying down promotes redistribution of blood into the thorax and can increase pulmonary venous pressure, leading to exertional or position-induced dyspnea. The simultaneous presence of bilateral leg edema supports the clinical interpretation as a sign of fluid retention or cardiac congestion.

Leg edema

Evening-increasing leg edema can be explained in heart failure by venous congestion and fluid accumulation. When lying down, fluid is redistributed at night, so the legs are less swollen in the morning.

Fatigue

Fatigue in heart failure can be explained by a reduced cardiac output and decreased perfusion of the muscles; it can also occur with preserved ejection fraction.

Lack of drive

Lack of drive in heart failure may be related to reduced cardiac output and limited physical capacity.

Tachypnea

Tachypnea
Definition and recognition:
Tachypnea denotes an accelerated breathing rate; in clinical practice it is often classified as present at a respiratory rate above about 20 breaths per minute.
Significance:
An increased respiratory rate may indicate respiratory or cardiac strain, pain, fever, or a metabolic disturbance and requires clinical evaluation in the overall context.

Dry cough

Dry cough

Brief description: A dry cough is predominantly a non-productive, spasmodic cough with little or no sputum.

Relevance in context: In a backward-congested lung, for example due to heart failure with venous congestion, such a dry cough can occur, especially at rest or at night. It may indicate a cardiac cause and should be assessed together with other symptoms.

Dizziness

Orthostatic dizziness

Brief description: Orthostatic dizziness refers to feelings of dizziness or visual disturbances that occur shortly after standing up or with rapid positional changes.

Likely explanation: Such complaints are consistent with orthostatic blood pressure drop, where standing leads to a transient fall in blood pressure and thus reduced cerebral perfusion.

Hyperhidrosis

Hyperhidrosis

Brief description: Hyperhidrosis denotes excessive sweating beyond what is required for temperature regulation or physical exertion.

Clinical notes: It can be generalized or localized and occur with various underlying diseases or as a side effect of medications.

Nocturia

Nocturia

Brief description: Nocturia means repeated nighttime urination that interrupts the sleep cycle.

Possible mechanism: Increased nocturnal urinary frequency can be promoted by redistribution of fluid when lying down with increased renal perfusion and enhanced diuresis; this is one of several possible explanations and occurs particularly with certain cardiac or fluid-regulation disorders.

Nausea

Nausea (nausea)
Subjective sensation of urge to vomit, not necessarily accompanied by vomiting. In the history, nausea was specifically asked and denied.

Emesis

Vomiting (emesis)
Active expulsion of gastric contents through the mouth. In the screening, vomiting was asked about and denied by the patient.

Loss of consciousness

Loss of consciousness
Temporary or persistent loss of consciousness; syncope is a common cause of transient loss of consciousness. No loss of consciousness was reported in the obtained history.

Leg pain

Leg pain
Differential diagnoses include deep vein thrombosis, chronic venous insufficiency and peripheral arterial occlusive disease as important causes of leg pain. In the current inquiry, leg pain was denied, so there are no confirmed indications of these conditions.

Loss of appetite

Loss of appetite
The patient reports a markedly reduced appetite for about two months. Notably, this loss of appetite exists despite reporting an unintentional weight gain of about 3 kg within the last week.

Weight gain

Weight gain in heart failure often arises from increased sodium and water retention leading to fluid accumulation.

Insomnia

Insomnia
The patient complains of difficulty falling asleep and repeated awakenings. She attributes the sleep disturbances primarily to occupational stress; nocturnal nocturia and orthopnea are also mentioned as contributing factors.

Constipation

Constipation
There has been a long-standing disorder of bowel evacuation with constipation complaints.

Type 2 diabetes

Definition: Type 2 diabetes is a chronic metabolic disease in which glucose metabolism is impaired.
Pathophysiology: The disease is mainly due to reduced tissue sensitivity to insulin (insulin resistance) combined with insufficient insulin secretion by beta cells. In contrast, type 1 diabetes arises from an autoimmune reaction with near-complete destruction of insulin-producing beta cells and thus an absolute insulin deficiency.
Clinical course and significance: With inadequate control, large blood glucose fluctuations and occasionally severe acute hyperglycemias can occur that may require inpatient treatment. Long-term uncontrolled type 2 diabetes increases the risk of vascular and nerve damage as well as other complications.

Hypercholesterolemia

Definition: Hypercholesterolemia denotes an elevated cholesterol level in the blood, with particularly increased LDL cholesterol being clinically relevant.
Clinical significance: Persistently elevated cholesterol promotes the development of atherosclerotic changes in the arteries and thereby increases the risk of cardiovascular events.
Practical consequence: With known hypercholesterolemia, blood lipid values are usually monitored and measures for risk reduction are considered.

Atrial fibrillation

Definition: Atrial fibrillation is a common cardiac arrhythmia in which electrical activity in the atria is disorganized, leading to an irregular heart action.
Causes and symptoms: Common triggers are hypertension, coronary artery disease, heart failure, hyperthyroidism or excessive alcohol consumption. Affected individuals often report palpitations, an irregular pulse, dizziness, shortness of breath or fatigue; some patients, however, have no symptoms.
Treatment focus: Therapy aims to control heart rate or restore sinus rhythm and to provide stroke prophylaxis through anticoagulation. Electrical cardioversion and catheter-based ablation are possible interventional options.
Laboratory: The INR value is used to monitor therapy with vitamin K antagonists, as it reflects anticoagulation.

Playing volleyball

Volleyball: brief description
Volleyball is a team sport in which two teams compete against each other over a centrally hung net. The aim is to play the ball onto the opposing court so that the opposing team cannot legally return it. Usually played in sets; the rules distinguish serve, attack, block and defense.

Total endoprosthesis

In a total endoprosthesis (TEP), the damaged joint surfaces are replaced by artificial components made of metal, plastic and/or ceramic. The procedure is considered for severe pain and significant functional limitations when conservative treatments are insufficient. It is performed under general or regional anesthesia. Usually, at least six hours without solid food and two hours without clear fluids are required before anesthesia; the anesthesiology team’s instructions are decisive. Possible complications include infections, bleeding, thromboses, pulmonary embolism and prosthesis loosening as well as dislocation in hip prostheses.

Bisoprolol

Bisoprolol: overview
Group
Selective beta-1 blocker from the class of beta blockers.
Mechanism of action
Primarily blocks beta-1 adrenoceptors in the heart, thereby reducing heart rate and contractility, which lowers myocardial oxygen demand.
Indications
Used, among other things, for hypertension, certain cardiac arrhythmias and for symptomatic treatment of angina pectoris.
Important risks/side effects
Common adverse effects are fatigue and dizziness; it can also cause a slowed heart rate (bradycardia). Special caution is required in decompensated heart failure, severe bradycardia and certain circulatory disorders.

Lisinopril

Lisinopril: brief profile
Group
ACE inhibitor (angiotensin‑converting enzyme inhibitor).
Mechanism of action
Inhibits the angiotensin‑converting enzyme, reducing formation of angiotensin II; this leads to vasodilation and reduced aldosterone effect.
Indications
Used for arterial hypertension and as part of therapy for heart failure as well as in follow‑up after myocardial infarction in suitable cases.
Important risks/side effects
Known side effects include dizziness and occasionally headache. Typical for this drug class are a dry irritating cough and the risk of elevated potassium levels; in rare cases angioedema can occur. In certain comorbidities and pregnancy use is contraindicated or requires caution.

Metformin

Metformin
Group: biguanide antidiabetic.
Effect: Reduces glucose production in the liver and improves glucose uptake in peripheral tissues by increasing insulin sensitivity.
Use: Employed in the treatment of type 2 diabetes as part of non‑insulin therapy; dosing instructions must be followed individually.
Important risks: Common adverse effects affect the gastrointestinal tract (e.g., nausea, vomiting, diarrhea). Occasionally headache or dizziness may occur. Very rarely there is a risk of lactic acidosis, particularly with renal impairment or other risk situations.

Atorvastatin

Atorvastatin
Group: HMG‑CoA reductase inhibitor (statin).
Effect: Lowers endogenous cholesterol production in the liver and thereby particularly reduces LDL cholesterol in the blood.
Use: To lower elevated cholesterol levels and reduce cardiovascular risk; timing of intake is according to medical advice. Atorvastatin has a longer duration of action than some other statins, so timing of intake is less strictly tied to the evening.
Important risks: Possible side effects include gastrointestinal complaints, headache and muscle symptoms up to severe muscle damage in rare cases. Elevations in liver enzymes can also occur. Interactions, especially with CYP3A4 inhibitors, can increase the risk of adverse effects.

Marcumar

Marcumar (phenprocoumon)
Group: oral vitamin K antagonist (coumarin derivative).
Effect: Inhibits vitamin K‑dependent activation of clotting factors, thereby reducing the synthesis of functional factors II, VII, IX and X as well as the anticoagulant proteins C and S.
Use/monitoring: Used for oral anticoagulation; regular monitoring of coagulation inhibition by INR is required. Dose adjustments are made individually according to INR values.
Important risks: Increased bleeding risk; numerous drug and food interactions influence the effect. When switching to direct oral anticoagulants, clinical considerations and monitoring measures are necessary. In the event of bleeding there are specific countermeasures available that must be managed by the treating physicians.

Laxoberal

Laxoberal
Group: stimulants (laxatives) with the active ingredient sodium picosulfate.
Effect: Converted by bacteria in the gut into an active metabolite that stimulates intestinal motility and thus promotes bowel evacuation.
Use: Short‑term treatment for constipation or for bowel evacuation after medical indication; use as needed as prescribed.
Important risks: Common effects are abdominal cramps and increased bowel movements. Prolonged or improper use can lead to electrolyte disturbances and habituation effects; persistent symptoms require medical evaluation.

Atrial septal defect

Atrial septal defect (ASD)

Definition: An ASD is a congenital malformation of the atrial septum with an open communication between the left and right atrium.

Clinical features: Small defects often remain asymptomatic for a long time. Larger defects can cause exertional dyspnea and reduced exercise tolerance; in the long term, cardiac arrhythmias (e.g., atrial fibrillation) are also possible. In childhood additional clinical problems may occur depending on the defect.

Pancreatic carcinoma

Pancreatic carcinoma

General: Pancreatic carcinoma is a malignant tumor of the pancreas, more frequently located in the head of the pancreas.

Clinical presentation and prognosis: Early symptoms are often nonspecific, e.g., upper abdominal pain, loss of appetite and weight loss; involvement of the pancreatic head may also cause jaundice. The disease is often only recognized at advanced stages, which is why overall prognosis is poor.

Abdominal malignancies

“Abdominal cancer” is a nonspecific collective term for malignant tumors of the female reproductive organs. These include endometrial carcinoma (uterine lining cancer), cervical carcinoma (cervical cancer), vaginal carcinoma, vulvar carcinoma and ovarian carcinoma (ovarian cancer).

exertion‑related dyspnea, chest pain, fatigue, orthopnea

Symptom combination: exertion‑related dyspnea, chest pain, fatigue, orthopnea

Meaning: This symptom complex indicates cardiac dysfunction and can specifically point to left‑sided heart failure. Orthopnea and exertional dyspnea are typical symptoms of impaired left ventricular function. Present risk factors such as obesity, physical inactivity, arterial hypertension, diabetes mellitus and dyslipidemia increase the likelihood of a cardiogenic origin.

Leg edema and nocturia

Leg edema and nocturia

Findings: Recurrent swelling of the lower legs combined with increased nighttime urination can indicate volume overload. Pathophysiology: In right heart failure there is venous congestion and fluid retention with peripheral edema; in the supine position nocturnal diuresis can increase, leading to nocturia.

chronic obstructive pulmonary disease

chronic obstructive pulmonary disease

Core aspect: Chronic obstructive pulmonary disease (COPD) is a progressive disease of the airways with persistent airflow limitation that is typically not fully reversible.

Clinical features and causes: Leading symptoms are exertional dyspnea and often a chronic productive cough with sputum; acute exacerbations occur regularly. Important risk factors are primarily smoking as well as long‑term exposure to air pollutants, fine particulates or occupational hazards.

Diagnosis: Definitive diagnosis is made by pulmonary function testing (spirometry) to objectify a persistent obstructive ventilatory disorder.

Pulmonary embolism

Pulmonary embolism

Core information: A pulmonary embolism results from embolization of thrombotic material into the pulmonary circulation and usually presents acutely with shortness of breath, pleuritic chest pain and occasionally syncope.

Risk factors and effect of anticoagulation: Typical risk factors are malignancy‑associated coagulopathies, prolonged immobility and vascular injury. Ongoing oral anticoagulation reduces the risk of thromboembolic events but does not exclude pulmonary embolism — especially if the anticoagulation is not therapeutic.

Diagnostics: Imaging to confirm the diagnosis is CT angiography of the chest; a concurrent deep vein thrombosis in the legs is often found.

decompensated

decompensated

Definition: “Decompensated” in heart failure describes the state in which cardiac output is so impaired that symptoms occur at rest or with minimal exertion (e.g., pronounced dyspnea, peripheral edema, severe fatigue, orthopnea).

Acute management: A decompensated state requires prompt clinical assessment and often hospital admission. Immediate measures include measurement of vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation, temperature) and a focused physical examination; laboratory and imaging investigations follow to determine the cause and extent.

Blood pressure

Blood pressure

Definition and significance:
Blood pressure denotes the force with which circulating blood acts on the vessel walls. It is divided into systolic and diastolic components and is a central circulatory parameter for assessing hemodynamic status.

Measurement and device:
Blood pressure is measured using either manual systems or automatic oscillometric devices. A classic manual set consists of an appropriately sized upper arm cuff, a device for inflation and a pressure gauge; auscultation is performed with a stethoscope. Choice of method and cuff size affect measurement accuracy.

Clinical relevance:
Regular blood pressure checks are important for detecting and monitoring treatment of hypotension and hypertension and for assessing volume and circulatory status, for example in heart failure.

Respiratory rate

Respiratory rate

Definition:
The respiratory rate is the number of breaths per minute and represents a fundamental vital parameter for assessing respiratory function.

Normal range and deviations:
In adults, the respiratory rate is typically in the range of about 12–20 breaths per minute. An increase above this range is called tachypnea; a decreased respiratory rate is called bradypnea.

Oxygen saturation

Oxygen saturation

Term and measurement:
Oxygen saturation (SpO2) describes the proportion of hemoglobin bound with oxygen relative to total hemoglobin and is measured noninvasively with a pulse oximeter.

Interpretation and limitations:
The measurement provides rapid clues about the blood’s oxygenating function but can be distorted by poor peripheral perfusion, movement, nail polish, or certain poisons/anomalies (e.g., carbon monoxide binding). Clinical assessment and, if necessary, arterial blood gas analysis are required in unclear or critical findings.

Body temperature

Body temperature

Definition and clinical significance:
Body temperature is a parameter for assessing thermoregulatory status. Deviations can indicate infections, inflammatory processes, or disturbances of heat regulation.

Measurement methods and sites:
Temperature measurements are taken at different sites (oral, axillary, rectal, tympanic) and with various devices (digital thermometers, infrared or tympanic devices). The measurement site influences the measured values and must be considered during interpretation.

Edema

Edema – classification and clinical examination
Definition and test: Edema are fluid accumulations in the interstitium. To differentiate, one presses a thumb pad on the swelling for several seconds; if a pit remains, it is called pitting edema.
Causes of pitting edema: Common causes include heart failure, renal insufficiency, liver diseases, venous insufficiency, or hypoalbuminemia. The distribution (bilateral, bilateral on exertion, generalized) helps with classification.
Causes of non‑pitting edema: Non‑pitting swelling is more typical for lymphedema or myxedematous changes (e.g., in hypothyroidism).
Important clinical note: The distinction pitting vs. non‑pitting is an orientation feature and leads to targeted further evaluation of the underlying cause.

Pallor

Pallor – significance and clinical clues
What is pallor: Pallor describes a visible lightening of the skin or mucous membranes and is a clinical clue, not a diagnosis.
Important causes: The most common cause is anemia due to reduced hemoglobin content. Other causes are acute blood loss, chronic diseases with anemia, as well as peripheral vasoconstriction in shock or cold environment.
Examination: For assessment, inspection of the conjunctivae, oral mucosa, and nail beds is recommended. Pallor alone does not allow a reliable attribution to cardiac performance; reduced cardiac function can secondarily contribute to poor perfusion but is not the primary explanation in all cases.

Jugular venous distension

Jugular venous distension (JVD) – significance and causes
Definition and examination: A noticeable enlargement of the neck veins (jugular venous distension) indicates elevated central venous pressure. Assessment is often done with the patient reclined (30–45°) and evaluation of the prominent venous wave height.
Typical causes: Increased central venous pressure can result from right heart failure, pericardial diseases (cardiac tamponade, constrictive pericarditis), volume overload, or obstructive processes in the major venous system.
Clinical significance: Jugular venous distension is an important clue to systemic volume/pressure elevation but should always be evaluated in the overall clinical context.

Tenderness to palpation

Tenderness to palpation – significance and differential diagnoses
What tenderness to palpation means: Localized pain provoked by palpation is referred to as tenderness to palpation and is a clue to a peripheral, often musculoskeletal problem.
Important differential diagnoses: Common causes are costochondritis or other inflammatory changes of the chest wall, muscle or tendon injuries, and rib fractures. Subcutaneous infections or early manifestations of herpes zoster can also be tender to palpation. Pleuritic or cardiac diseases typically do not cause isolated chest wall tenderness.
Clinical relevance: Location, triggering mechanism, and accompanying symptoms are crucial for further evaluation; tenderness to palpation alone is not specific for a single diagnosis.

percussed

Percussion

Procedure: The examiner places the distal finger of one hand on the area to be examined and strikes this support finger briefly with the middle finger of the other hand. This produces sound events that give information through different acoustic qualities.

Purpose and interpretation: The sounds produced by tapping help assess the nature of the underlying tissue. A relatively dull sound can indicate increased tissue density, as seen with fluid collections or consolidations; a loud, tympanic note, by contrast, indicates air-filled spaces. Percussion is often used to assess the lungs and upper abdominal organs.

Signs of jugular venous distension

Examination of the neck veins (assessment of the jugular venous distension sign)

Positioning and inspection: The patient should be positioned semi-recumbent (about 30–45°). Observation is primarily of the right side of the neck, as the visible veins and their pulsations can be assessed most reliably here.

Measurement method and classification: One determines the highest point of visible venous pulsation and then measures vertically the distance to a reference, usually the sternal angle (Angle of Louis). A markedly increased filling of the neck veins compared with normal indicates elevated central venous pressure and suggests possible right heart strain.

hepatojugular

Hepatojugular reflux (abdominojugular test)

Procedure: With constant, moderate pressure, the right upper abdominal area (liver region) is pressed for several seconds while the neck veins are simultaneously inspected.

Assessment: A sustained rise in venous filling or jugular pressure during and after the pressure is considered positive. A persistent increase indicates impaired right ventricular pumping function or increased right heart strain.

complete blood count

Complete blood count

Purpose: The complete blood count serves basic hematological assessment, particularly for detecting or excluding anemia.

Contents: Typically parameters such as hemoglobin, hematocrit, and red blood cells are used to identify anemia and provide clues about its mechanisms.

C-reactive protein

C-reactive protein (CRP)
CRP is an acute-phase protein produced in the liver that rises in the serum during inflammation, infection, or tissue damage. It serves as a nonspecific inflammatory marker; elevated values can occur in pericarditis but are not specific for this disease and do not alone prove the diagnosis.

Lipid profile

Lipid profile
The lipid profile usually includes measurement of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. These measurements are used for cardiovascular risk assessment and therapy planning.

Renal function parameters

Renal function parameters
Important laboratory parameters for assessing renal function are serum creatinine with calculated estimated glomerular filtration rate (eGFR), blood urea (Urea/BUN), and electrolytes. In heart failure, renal function can be impaired by reduced perfusion or venous congestion, so monitoring these parameters is clinically relevant.

Liver values

Liver values
Routine liver parameters include alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma‑glutamyl transferase (GGT). ALT is considered relatively liver-specific, AST is also found in muscle and heart tissue and is therefore less specific; GGT is often elevated in cholestatic conditions.

HbA1c

HbA1c — meaning and clinical significance

The HbA1c value describes the proportion of glycated hemoglobin and thus reflects the average blood glucose concentration over the past approximately eight to twelve weeks. The laboratory result is used for follow-up assessment in known diabetes mellitus and can support the diagnosis of diabetes. Reliability and interpretation can be affected by changes in erythrocyte lifespan (e.g., hemolysis, blood transfusion, hemoglobinopathies).

Coagulation parameters

Coagulation parameters — overview and significance

Routinely determined coagulation parameters include prothrombin time/INR and activated partial thromboplastin time (aPTT). PT/INR primarily assesses the extrinsic and common coagulation pathways, while aPTT assesses the intrinsic and common pathways. These laboratory values are used to evaluate coagulation disorders and to monitor anticoagulant therapies; other coagulation-relevant findings such as platelet count or D-dimer complement the diagnostics depending on the question.

B-type natriuretic peptide

B-type natriuretic peptide (BNP / NT-proBNP)

The precursor molecule proBNP is cleaved under cardiac pressure or volume overload into the active BNP and the inactive fragment NT-proBNP. Both fragments increase in heart failure and are used diagnostically, with NT-proBNP often measured because of its stability. BNP mediates, among other effects, vasodilation as well as sodium and water excretion. Concentrations are influenced by age and renal function and are clinically relevant in the diagnosis and monitoring of heart failure.

Troponin

Troponin — marker for myocardial injury

Cardiac troponins (troponin I and troponin T) are specific laboratory parameters for detecting myocardial injury and are used in the evaluation of an acute coronary syndrome. High-sensitivity troponin assays enable early detection and require serial measurements in acute situations to demonstrate a rise or fall. In chronic renal insufficiency, troponin T in particular can be elevated even without an acute coronary occlusion, so interpretation of the findings is more challenging there.

CK-MB

CK-MB
Brief description:
CK-MB is an isoenzyme of creatine kinase that occurs predominantly in the heart muscle.
Clinical significance:
Determination of CK-MB can provide additional information in suspected reinfarction, as its concentrations change over time and thus can indicate a recurrent myocardial injury event. However, cardiac troponins are preferred in the diagnosis of acute coronary syndrome.

Ejection fraction

Ejection fraction
Definition:
Ejection fraction (EF) indicates the percentage of blood volume that the left ventricle ejects into the circulation with one heartbeat.
Clinical relevance:
EF is an important measure for assessing the systolic pumping function of the left ventricle and is often determined by echocardiography.

Weight reduction

Weight reduction
Goal and approach:
Weight reduction refers to the intentional lowering of body weight. An adapted, calorie-conscious diet is a central measure.
Note:
Dietary changes are often part of weight-reduction measures and are frequently combined with other interventions.

Salt intake

Goal: Reduction of salt intake

Background: A lower intake of salt can help lower blood pressure and reduce cardiovascular risk.

Practical tips: Pay attention to hidden salt additions in processed foods such as bread, cold cuts, cheese and convenience products. Use herbs and acidic ingredients instead of additional salt when cooking, and read food labels to identify high-salt products.

Coronary arteries

Coronary arteries (coronary vessels)

Function: The coronary arteries supply the heart muscle with oxygen-rich blood.

Diagnosis and treatment: Coronary angiography visualizes narrowings or occlusions of the coronary arteries. If significant stenoses are found, interventional procedures are possible to restore blood flow.