Dirk Rabenau
was healthy and athletic. He loved mountain bike tours and
was a passionate glider pilot. Discovering foreign countries with his sailboat
was the greatest thing for him. Freedom, independence, that
's the feeling you get. It's just beautiful
to fly. You clear your head. That's wonderful, but with the current diagnosis
it's no longer feasible. January 2020. Dirk Rabenau returns
from a skiing holiday with his family. You were in Austria. He has strong flu symptoms and can hardly walk
because he feels too weak. In the clinic, he
was one of the first in Germany to receive the devastating diagnosis:
Corona with a severe course. A shock! The infection
has damaged his heart. I now have
a cardiac output of about 50%. I only
have half my cardiac output. Of course, this is noticeable in everyday life
at every point.
There are serious limitations. Over long distances, the
moment I increase my speed, I notice it. That is, when I walk with people who have a high walking
speed, I can usually
no longer keep up. Otherwise, of
course, it's stressful not to be able
to perform as well as you normally should at my age. It's like
someone putting a brake block in your way.
It
takes time to process it all. We meet the cardiologist
Dr. Andreas Rolf in front of the clinic. Corona triggered a violent autoimmune reaction in Dirk Rabenau
and thus
damaged his heart function. Through several MRIs
, the internist was also able to demonstrate the infection in his heart. Unfortunately, SARS-CoV-2
also affected Mr. Rabenau's heart muscle and caused pronounced
myocarditis there , which resulted in
cardiac insufficiency.
During physical exertion, the heart has to pump a lot more blood volume,
i.e. it has to beat faster. It also has to
eject more blood volume per heartbeat. And
as a result of this cardiac insufficiency, that is no longer possible to the extent that
he was used to.
Every day I have
about 15 different pills that I have to take at certain
intervals. Accepting his new life
is a big challenge for Dirk Rabenau, but also for his 9-year-old
daughter. This is also a rehearsal
for the family. This is a rehearsal
for the spouse. I think
this is a rehearsal for everyone. People know you when you were
still very fit and energetic. Suddenly that's not the case anymore.
It a break. It's not great because you ca
n't do as much as you have in the last few months. But you can do it.
The main thing is that he survived.
The support of his family gives the business graduate stability
and strength to accept that even everyday situations
such as climbing stairs are a physical
challenge. Yes, you can feel it in your heart. You notice I'm out of breath,
the whole thing after 2 floors. The physical strain
is reached much earlier than when you have 100% cardiac output. It's not a good feeling to know that after 2 floors you get
out of breath.
But the hardest thing for
the 49-year-old is that he is
no longer allowed to fly gliders with his current cardiac output.
We continue with these restrictions. The good news is I'm alive. That's enough hook to look positively
into the future. However, the doctors cannot tell him whether his heart will ever be
more efficient . Uncertainty and fear remain. dr Andreas Rolf, cardiologist at the
Kerckhoff Clinic in Bad Nauheim, is with us, good evening! Good evening! Why is this
so difficult to predict? It is basically the case
that inflammatory heart diseases have the chance that
the cardiac output will improve again.
But you can't predict it. You can get information from magnetic resonance imaging
that predicts a certain probability
. But you can't say for sure that it will get better
or stay that way. In many cases,
heart muscle inflammation remains undetected. That is often
a hidden illness. But there are some symptoms
that we should pay attention to. Which are they? There is classic chest pain. In the case of heart muscle inflammation
, they are more stinging. But also shortness of breath and
a general lack of performance. Things that you could do without
problems can no longer be done. Or cardiac arrhythmias
and palpitations. What about water in the legs? Exactly, water in the legs.
It's the same cause
as the shortness of breath. The water accumulates in the
lungs and legs. Can this be diagnosed with a
cardiac ultrasound? Yes, the heart ultrasound helps
to detect heart failure. Fortunately, many heart muscle infections do not always
immediately cause cardiac insufficiency. The tissue changes that
are typical for heart muscle inflammation cannot be seen in the cardiac ultrasound
examination. This then
requires a magnetic resonance imaging. Because you can make scars on the
heart muscle tissue visible. Do I have to go
to a special clinic for that? The large clinics
with cardiology departments all have this in their repertoire. Some practices also offer this. But most often this
is found in clinics. Who would you recommend such an investigation to
? And who rather not? In principle,
all patients who have cardiac insufficiency should have this done. There is the so-called
Long Covid Syndrome. The patients do not recover,
despite the healing of the disease.
They cannot find their way back to their
old efficiency. You should have that
MRI done.
Unfortunately, this is not covered by health insurance in the outpatient area. Not yet. This is not
always open to all patients. But you can
ask your cash register if it might
be taken over after all? Not just for private patients. The media has reported a lot about the myocarditis
in Covid.
That definitely got
things moving. If the cardiologist
recommends this examination, it is worth
asking the health insurer. How is heart muscle inflammation
treated? Unfortunately, that's the downside. Even if we have made the
diagnosis, there is no
really established therapy for it. There are
no accepted studies on this and no drug approvals. But you can
try cortisone. During the pandemic
, we learned that cortisone can have a positive effect on the course of the disease
.
This also applies to the
Covid-related myocarditis. If you
do endurance sports with guidance, does it help
if you monitor your heart rate well? In the acute phase you should
rest and not do any sport. But during the recovery phase
, it is important to slowly return to
physical activity. This applies to almost all diseases. Sport always has a positive
effect. But under guidance. You have to watch yourself doing it. thank you dr Rolf from the
Kerkhoff Clinic in Bad Nauheim! Gladly..
