Heart failure cells are defined as the presence of pulmonary macrophages containing hemosiderin in the sputum (Herold 2020). These are also referred to as "siderophages". Siderophages always indicate that there has been bleeding into tissue or body cavities (Klauschen 2023).
The term "heart defect cells" comes from the fact that the most common cause for the appearance of such cells is caused by congestion in the small circulation (triggered by left heart failure) (Glatz- Krieger 2024).
Siderophages can occur throughout the body as a result of bleeding (Klauschen 2023).
They are particularly common in:
- Left heart failure in the sputum as so-called "heart defect cells" (Herold 2020)
- Bleeding in the cerebrospinal fluid as "siderophages" (Berlit 2006).
The cells that appear in the cerebrospinal fluid during a hemorrhage have a long lifespan of up to 6 months (Berlit 2006).
Heart defect cells can occur in the sputum (Herold 2020) after alveolar bleeding (Glatz-Krieger 2024) and in the cerebrospinal fluid as so-called siderophages after bleeding in the entire cerebrospinal fluid space (Schwab 2015).
Numerous macrophages can be found in the iron staining of the sputum smear. These contain varying amounts of iron-containing, blue-colored hemosiderin in the cytoplasm (Glatz-Krieger 2024).