What tests are done for heart disease? How to check the heart in different ways? How to check heart function with tests

26.01.2017 10:11:01

Diseases of the cardiovascular system in medical practice are the most complex and dangerous, which most often lead to death, regardless of the patient’s age.

Over the past quarter century in Ukraine, mortality as a result of these diseases has doubled, which cannot but cause serious concern.

That is why it is necessary to constantly monitor the condition of your cardiovascular system and undergo preventive examinations with a cardiologist, especially if there are certain prerequisites for the occurrence of pathologies, for example, heredity, overwork, heavy physical activity, etc.

One of the main symptoms of heart disease is the appearance of pain in the heart area, which can have different strengths and directions depending on the heart disease and its severity.

The second characteristic sign of heart disease is shortness of breath, which occurs from circulatory failure.

The third sign of problems with the heart is a rapid heartbeat, as well as interruptions in the functioning of the heart.

All of the above symptoms are signals to contact a cardiologist, who, in order to make an accurate diagnosis, will necessarily send the patient for additional examination, which includes certain tests.

What tests are done for heart disease?

It is also worth considering that many pathological processes in the cardiovascular system are asymptomatic. Therefore, even if you are not bothered by pain in the heart, shortness of breath, rapid heartbeat or arrhythmia, periodic visits to a cardiologist should be included in the list of mandatory preventive measures that will help maintain your health for many years.

As with any diseases of various organs and systems, timely diagnosis and competently prescribed effective treatment of heart disease will help not only cure certain diseases, but also prevent serious complications, improve the quality of life, prolong it and even save it.

For diseases of the heart and blood vessels, a comprehensive analysis is prescribed - a cardiac profile.

Cardiological profile: why is it needed?

Cardiological profile is a set of special blood tests that allows you to:

Assess risk factors for the development of heart and vascular diseases;

Identify early and hidden lesions of the cardiovascular system;

Identify the risk of developing atherosclerosis, coronary heart disease and heart failure;

Assess the likelihood of myocardial infarction.

Cardiological profile: indications

Indications for prescribing a set of cardiological tests are:

Vascular atherosclerosis;

Cardiac ischemia;

High blood pressure;

Heart rhythm disturbances, including:

Stroke;

Arrhythmia;

Heart attack;

Tachycardia.

What tests are included in the cardiac profile?

- Troponin quantitative;

Potassium (K);

Lipidogram;

Coagulogram;

AST (AST, aspartate aminotransferase);

Creatine kinase (creatine phosphokinase, CK, CPK);

Lactate dehydrogenase (LDH).

What do cardiac profile indicators mean?

Troponin can diagnose myocardial infarction. Troponin is a special protein found only inside cardiac muscle cells (cardiomyocytes); it is practically undetectable in the blood under normal conditions. However, if cardiomyocytes begin to die and collapse, and most often this happens due to the development of myocardial infarction, then troponin begins to penetrate into the general bloodstream, as a result of which its concentration in the blood increases hundreds and sometimes thousands of times. This feature has become a key factor allowing early or late diagnosis of myocardial infarction.

NT-proBNP- brain natriuretic hormone is a protein produced in the left ventricle of the heart. Plays an important role in the diagnosis of heart failure. Blood analysis to D-dimer indispensable when examining patients for various thrombotic disorders. D-dimer is a small protein fragment that is formed as a result of the breakdown of fibrin (fibrin is a blood plasma protein. Fibrin serves as the structural basis of a blood clot - ed.). Elevated levels of D-dimer in the blood indicate the human body's tendency to form blood clots or other clotting problems.

Potassium(K) is an important trace element in the human body. It takes part in the act of muscle contraction, normal heart activity, conduction of impulses along nerve fibers, metabolism and enzyme activity. Potassium deficiency leads to disruption of the cardiovascular system and can cause muscle weakness. Long-term potassium deficiency can cause cardiac arrest. Large doses of potassium cause cardiac paralysis.

INR- this is an indicator purely for assessing the effectiveness and correctness of treatment with anticoagulants ( medications that reduce the activity of the blood coagulation system and prevent excessive formation of blood clots - ed.). Patients who are forced to constantly take blood thinners are required to monitor their blood clotting abilities. This is necessary not only to assess the effectiveness of treatment, but also allows you to select an adequate dose of funds. In the same way, a person can be protected from an overdose of anticoagulants, preventing the development of corresponding complications against this background. One of the modern methods of such control is INR (international normalized ratio).

Lipidogram(lipid profile) helps diagnose atherosclerosis and coronary heart disease.

With help coagulograms the level of blood viscosity is determined. An increased blood viscosity level indicates an increased risk of developing complications of hypertension, coronary heart disease, heart attack or stroke.

Increase AST values, an intracellular enzyme involved in the metabolism of amino acids in liver tissue, heart muscle and other organs, shows an increased risk of heart attack.

This is also indicated by the enzyme creatine kinase, which is a catalyst for the rate of ATP conversion. An increase in the activity of CPK-MB, an enzyme found in heart muscle cells, indicates an increased risk of myocardial infarction.

Most active LDH(lactate dehydrogenase), a zinc-containing enzyme, is observed in the cells of the heart muscle, liver, and kidneys. LDH activity also increases sharply during acute myocardial infarction.

How should you prepare for a cardiac profile?

A cardiac profile is a comprehensive blood test for the content of certain enzymes. Blood for a cardiac profile is taken in the morning, on an empty stomach.

The day before taking blood, it is necessary to avoid alcohol consumption, as well as psycho-emotional and physical stress.

The cardiovascular system, by ensuring a constant flow of blood, supplies all internal organs of a person with oxygen and nutrients every second, and therefore its importance is undeniably high. And that is why, when the slightest disturbance occurs in it, cascade reactions of failures are caused in all other systems, and therefore symptoms always appear. But how is the heart and blood vessels examined? There are many methods for this.

Inspection

When a patient first turns to a therapist either for preventive purposes (physical examination) or with specific complaints, the specialist must necessarily examine the heart area and conduct simple studies of this organ and its branches. So, first of all, the doctor conducts a general examination of the patient, paying attention to his skin (with diseases of this system, pallor and even cyanosis, dense cold swelling, small hemorrhages are possible), the condition of the visible mucous membranes (injection of the sclera, white coating at the root of the tongue) , development of the musculoskeletal system (hypotonia, weakness, dystrophy or, on the contrary, obesity), the nature of the pulse (its presence and synchronicity in both arms, conduction of the pulse into the neck veins). Next, the doctor must conduct an examination of the heart, such as percussion of its borders, which can reveal hypertrophy of individual chambers. It is imperative to auscultate it, counting the number of heartbeats, detailing its tones, rhythm, and possible pathological noises.

Anamnesis

Finally, blood pressure is measured because it is an important indicator of cardiovascular health. Next, the doctor must detail the complaints, because a complete examination of the heart includes a detailed medical history. Thus, diseases of the cardiovascular system are characterized by pain in the chest (often of a pressing, squeezing nature) or, more precisely, behind the sternum, shortness of breath (appears with increased physical activity normally, and in pathology - with a slight load or even at rest), and a feeling of what - “interruptions” in the functioning of the heart, manifestations of high blood pressure (headaches, dizziness, heaviness in the body). Be sure to find out the time of their appearance, the factors that provoke and eliminate them, and their intensity.

Other Important Aspects

The heart examination also includes asking the patient what he associates with the development of his disease, thereby identifying risk factors. So, this could be a strong emotional shock the day before (the death of a loved one, stress at work), lifting heavy objects or performing difficult physical work. Symptoms also appear when weather conditions change. Heredity is also an important criterion, because most diseases (diabetes mellitus, arterial hypertension) tend to be transmitted to the next generation. As a rule, a correctly collected anamnesis provides 50% of the patient’s clinical diagnosis. After talking with the patient and examining him, the doctor must refer his ward for a heart examination.We should remember the anatomy and physiology of this organ.

A little about a normal heart

So, it is, roughly speaking, a pump consisting mainly of muscles and a complex system of blood vessels. Inside it there are four chambers that communicate with each other in a strictly defined way and ensure constant movement of blood. And in order for the heart itself to continuously contract and relax, its tissues contain conductive structures through which a nerve impulse passes, thereby causing alternating tension in the muscles of each chamber and the opening and closing of the valves between them. Therefore, all methods of examining the heart can be aimed either at visualizing the anatomy of this organ (ultrasound, Doppler mapping, computed tomography, chest radiography, radioisotope methods) and directly at the arteries and veins (probing of the great vessels, angiography, coronary angiography), or at examining the condition its conduction system (electrocardiography, bicycle ergometry), or to auditory its tones and noises (phonocardiography).

Echocardiography

As you can see, the examination of the heart must certainly be detailed, detailed, and not lose sight of anything. Because damage to the cardiovascular system can be either a manifestation of an independent disease or a consequence of the pathology of another system. If we talk about visual ones, the first thing that comes to mind is Echo-CG or, as it is also called. What the device shows during this important study can be guessed logically. By penetrating the ultrasound deep into the tissues and returning them back, an image appears on the screen that allows you to evaluate the structure of the heart, the size of its cavities, the condition of the valves and great vessels. Plus, this method is non-invasive and does not involve radiation, and therefore can be used even by pregnant, lactating and children. Although more effective, it still cannot replace ultrasound as a diagnostic tool.

Benefits of Ultrasound

At different stages of gestation, a woman periodically undergoes an ultrasound of the heart for the fetus, which shows a patent ductus arteriosus, stenosis of the ostia of vessels, prolapses or valve insufficiency, the condition of the interventricular and interatrial septum and other congenital malformations. Another important advantage of this method for the patient and the medical institution is its relative cheapness, the possibility of it being carried out on an outpatient basis, the short duration of the study, as well as the instantaneous acquisition of images and interpretation of all data. That is why ultrasound of the heart is so popular for diagnostic purposes.

What does vascular examination show?

In obese people, as well as patients with diabetes, the most common lesions of the cardiovascular system are atherosclerotic lesions of blood vessels, as well as hyalinosis of their walls. Therefore, it is so necessary to examine the vessels of the heart, because only they nourish this important organ, and its work requires a colossal amount of energy and nutrient substrates. So, first, a catheter is inserted into the femoral catheter, through which the vessels are filled with a contrast agent, clearly visible on the X-ray screen. The most important method for atherosclerosis and ischemic myocardial disease is a coronary examination of the heart vessels. It reveals their passability, the correctness of their progress. Also, many operations on this important organ are carried out under his supervision.

Results

Thus, there are currently a lot of methods for studying cardiac and vascular pathology, but each of them has strict indications and contraindications, and therefore it is economically unrealistic and diagnostically pointless to carry them out to everyone. Therefore, the key link is a competent doctor who will carefully supervise the patient and prescribe him the necessary treatment or send him to a more competent institution.

Ignoring signs of heart dysfunction leads to exacerbation of chronic diseases, heart attack or stroke.

But along with this, modern cardiology offers a variety of methods for studying the heart and blood vessels. Diagnostics are very diverse, which allows examination for any course of diseases and individual nuances of a person.

This article describes the most popular methods of studying the cardiovascular system, their features, to whom and when they are prescribed, as well as how they are carried out. Additionally, the issue of examining the organ through the esophagus will be covered. As you read, the reader may have additional questions.

Competent specialists of the portal are ready to give a detailed answer on a topic that interests you free of charge online.

With us you won’t find complicated terminology – we talk about complex things in an accessible way!

Examination of the heart and blood vessels

Disorders in the cardiovascular system occupy first place in terms of incidence. This is due to the fact that treatment proceeds slowly and can sometimes last throughout life. That is why cardiology specialists strongly recommend that a healthy person undergo heart tests at least once a year. Those patients who are diagnosed with the disease need to be examined according to the plan drawn up by the attending physician.

A disease detected early means a high probability of rapid healing. Timely diagnosis has already saved many lives.

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The table below shows the groups of people who are most often prescribed a heart test.

The study of the cardiovascular system is divided into two categories - objective and instrumental. Let's take a closer look at both categories.

Objective diagnostic methods are used during the initial examination of the patient. The history provided by the person allows the doctor to make a preliminary diagnosis and determine the problem. These methods include:

Palpation. It happens as follows: the doctor places his hand on the patient’s chest so that the hand touches the ribs, and the area of the heart is felt with his fingers. This approach allows you to listen to the strength, height and localization of shocks in the heart. In this way, a number of diseases are identified. For example, valvular and aortic stenosis, tachycardia, cardiac dysfunction and others.
Percussion. Determines the approximate size and position of the organ, as well as the vascular “bush”.
Auscultation of the organ. This is done using a stethoscope. Allows you to determine the properties of heart tone, murmurs and possible abnormalities. Heart examinations are carried out in absolute silence.
Measurement of pressure in arteries. Tonometers of any kind are used. In this way, you can find out the development of hypertension and hypotension.

These methods are used by the doctor during a face-to-face examination of the patient. If there are deviations, it is necessary to undergo further examination of the cardiovascular system.

Instrumental diagnostics studies of heart function

The table below provides information about normal parameters of the heart and blood vessels.

In addition to objective methods, there are also instrumental diagnostics that identify the disease with high accuracy. Of course, the most common is an electrophysiological study of the heart (ECG), but there are other ways to examine the organ and vascular system:

ECG is a method of recording electrical impulses that are emitted by the surface of the body. These impulses are identical to the cyclic activity of the organ. The examination allows you to identify myocardial infarction, ischemia, arrhythmia, and conduction dysfunction. Today, there is an innovative approach to this method - the examination is carried out remotely using a PC or mobile device, and information is collected during the patient’s daily activities.

The figure below shows how the procedure is carried out.

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Ultrasound diagnostics. Identifies pathological processes in organ parts. The task of ultrasound is to study the system. The latest update of the equipment allows you to monitor the activity of blood vessels, blood clots, and detect the presence of plaques.
EchoCG. Monitors the activity of the valve apparatus, the dimensions of the walls of the heart, and also assesses blood flow. EchoCG is an advanced method in diagnosing blood clots, defects, oncology, ventricular and aortic aneurysms. This examination is recommended for patients who have had a heart attack.
Myocardial scintigraphy. It is carried out using a special pharmaceutical preparation. Once in the blood, it fixes the blood flow, thereby making it possible to assess the condition of the vascular system.
MRI. Tomography reveals murmurs, localization of ischemia and vascular dysfunction.

Methods for studying the functioning of the heart can be carried out as independent procedures or in combination. Preventive methods based on research are a guarantee of high results. Of course, this is not the entire range of instrumental methods. There are also Holter diagnostics and through the esophagus; they will be discussed in the following sections.

It should be noted such diagnostics as functional tests of the cardiovascular system. These samples are used for physical education research. The results obtained from the indicators are in addition to the physical fitness of the subjects.

You can find out how diagnostics are carried out by downloading the free file “Functional tests of the cardiovascular system,” which presents the examination technique and standards.

Holter study

The Holter technique is named after the American scientist Norman Holter. Diagnosis consists of monitoring the heart's function over a 24-hour period. The examination is indispensable when analyzing data on the functioning of the heart and blood vessels.

Holter cardiac monitoring is carried out using a mobile device that the patient wears during the day on a belt or over the shoulder.

The weight of the device is 0.45 kg, so a person does not feel any discomfort caused by wearing it. From this device there are wires that end in electrodes. The latter are attached to the body and transmit information to a disk in the device.

There are two Holter diagnostics - fragmentary and full-scale.

A full-scale examination can take up to three days and is used very often today. Due to the fact that data recording occurs throughout the day, the survey result is highly informative. Thus, the doctor can analyze the activity of the organ and identify the cause of the failure. A classic ECG is capable of recording no more than 50 heart beats, and the Holter method is capable of recording beats.
A fragmented Holter examination is used if the patient has a heart failure that occurs in rare cases. The monitoring time range may be longer, because It is necessary to understand the cause of periodic failures. Data can be recorded continuously or only during moments of discomfort and pain.

Holter diagnostics are of particular value in cases of heart rhythm disturbances. After all, using a traditional ECG it is quite difficult to identify symptoms. And the Holter method allows you to track the onset of arrhythmia and, accordingly, understand the cause. This monitoring is useful for unexpected loss of consciousness, frequent dizziness and unknown chest pain. These signs indicate diseases of the organ, and such diagnostics can confirm or refute suspicions.

Holter monitoring is most often prescribed to the following categories of people:

have had a heart attack;
when diagnosed with angina or suspected;
if the myocardium is enlarged;
with prolonged QT (author's note - disruption of the ventricles with a high probability of death).

Thanks to the scientist’s developments, diagnosing a disease such as ischemia at an early stage has become accessible to any patient. If a person experiences discomfort, they should contact a medical facility. And then there is a high probability of being cured of the disease and continuing to enjoy life for many years to come.

Transesophageal heart diagnosis

Transesophageal examination is primarily used to evaluate patients for ischemia. The main aspect is the assessment of the state of the coronary reserve. A distinctive advantage of diagnostics is non-invasiveness. For example, an electrophysiological study of the cardiac activity of the sinus node is carried out using tactile contact with the surface of the body.

To a certain extent, transesophageal examination is the safest, because no physical activity is required, which cannot be said during tests with physical activity.

Most often, monitoring through the esophagus is prescribed to those people who cannot be physically overloaded. Such patients include:

musculoskeletal disorder;
for diseases of the respiratory system;
with affected veins and arteries;
high hypertension;
lack of physical preparation.

This method is strictly contraindicated for diseases of the esophagus.

For diagnostics through the esophagus, each treatment center has a separate room containing cardiac equipment, resuscitation and registration equipment. The patient takes a horizontal position, and without the use of anesthetics, a wire from 25 cm to 45 cm is inserted into the esophagus through the nasopharynx, with an electrode at the end. Movement control is carried out using an electrogram coming from the esophagus.

To assess arrhythmia, a multipolar electrode is mainly used, which allows stimulation and data recording. Thanks to the use of innovative equipment, in some cases the His bundles are examined using this method. For diagnostics through the esophagus, pacemakers are used, which create pulses up to 20 mm with the ability to adjust up to 50 V.

The figure below shows a diagram of heart diagnostics through the esophagus.

To summarize the article, it should be noted that there is a wide range of diagnostic methods for the heart and vascular system. Thus, medicine gives every person the opportunity to monitor the state of the main organ of the human body, respond in a timely manner to changes in its work and, accordingly, maintain health. Don’t ignore the signs of illness, sign up for a consultation with a cardiologist and your heart will give you long healthy years of life in gratitude!

Do you often experience discomfort in the heart area (stabbing or squeezing pain, burning sensation)?
You may suddenly feel weak and tired.
The pressure is constantly fluctuating.
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What tests should be taken for cardiovascular diseases?

Diseases of the cardiovascular system are by far the most global problem in medicine, because they are the reason why the largest number of people die every year. Heart attack, heart failure, hypertension and stroke affect people of all ages. Even children nowadays suffer from such ailments from a very early age and learn what shortness of breath or pain in the heart area is. The reasons may be hereditary predisposition, unhealthy lifestyle, and even poor ecology. The most important point in treatment, on which the further prognosis of the outcome of the disease and the possibility of recovery depends, is timely tests.

What tests can detect problems with the heart and blood vessels?

It is worth noting that some stages of various diseases of the cardiovascular system can be completely asymptomatic. And only preventive visits to the doctor and his appointments for tests can identify the problem in time and take measures to eliminate it. Let's consider what tests need to be done first.

Lipidogram. This is a blood test taken from a vein in the morning on an empty stomach to check for high cholesterol levels.
Coagulogram. Needed to determine blood clotting time and identify problems such as blood clots.
Aspartate aminotransferase (AST). Such an analysis is required to detect changes in the activity of the AST enzyme involved in amino acid metabolism. An increase in activity several times is a sign of a pre-infarction state.
Creatine kinase. This is the establishment in the blood of indicators of the intracellular enzyme crest kinase, which acts as an indicator of myocardial damage.
Lactate dehydrogenase. This is also an enzyme that is present in the muscles of the heart, and enters the blood only when they are destroyed.

Thus, identifying and identifying some catalysts and anomalies in hematopoietic processes is very important and can save a person’s life.

How is the heart checked and examined if pathology is suspected?

Modern people often develop heart and vascular diseases due to stress, fast pace of life, environment and other factors. They may not know about the pathology until a critical situation arises. In this case, it will be difficult for doctors to help and cure the patient, so to maintain heart health, it is important to carry out preventive diagnostics, and we will tell you how to check the heart in this article.

Symptoms of heart failure

Many people do not go to the doctor when heart problems appear, since the symptoms are often vague and can be confused with other diseases, for example, the lungs or stomach. Even if the problem is obvious, and the patient understands that something is wrong with the heart, he often goes to the pharmacy to buy drugs that can relieve the symptoms, but the disease itself is not treated and progresses.

The main symptoms of heart disease, which require medical help and a thorough examination, are as follows:

Shortness of breath and lack of air. We are talking about shortness of breath without physical exertion.
Lack of air at night. In a lying position, the symptom intensifies, and when the body is in an upright position, it disappears, which indicates heart failure.
Edema. This symptom occurs for various reasons, but if there is a pathology of the heart, then initially the legs swell in the evening, gradually the swelling spreads higher, right up to the abdominal area.

Pain and feeling of tightness in the chest. The symptom appears after and during exercise, but after 5-10 minutes the pain goes away. It disappears if you put nitroglycerin under your tongue. The symptom appears when the patency of the vessels is impaired and they cannot normally cope with the blood supply to the myocardium.
Heartache. If your heart hurts, there is a stabbing, piercing sensation. When turning or bending, true pain in the heart does not intensify.
Headache, nausea, tinnitus. Symptoms appear with arterial hypertension. The problem occurs in people over 50 years of age.
Heart rhythm failure. If your heart begins to beat irregularly and unevenly, it is better to consult a doctor for diagnosis and proper treatment.

Important! In addition to heart rhythm problems, you should consult a doctor if your resting heart rate is more than 90 or less than 60 beats per minute.

Primary diagnosis

The cardiovascular system leads in the number of diseases. A common problem is vascular atherosclerosis. It develops slowly. throughout life. Therefore, doctors advise undergoing diagnostics once a year. If the disease is detected early, treatment will be quick and effective.

Methods for studying the heart in medical practice are divided into two types:

During the initial examination in the hospital, doctors use an objective examination of the cardiovascular system. After the examination, the doctor makes a presumptive diagnosis, then uses instrumental diagnostics.

Objective methods for examining the heart include:

Palpation. The test is carried out by placing the hand on the patient's chest, so that the hand is in contact with the ribs, after which the fingers are felt around the heart area. This method helps to hear the heart rhythm, the force of the beats, the height and their location. Due to this, it is possible to identify some pathologies, for example, stenosis, aorta, tachycardia.

Percussion of the heart. This method of studying the cardiovascular system makes it possible to approximately determine the size of the organ and its position in the chest by tapping. Due to this, a preliminary diagnosis can be made.

Auscultation of the heart. This is done using a stethoscope. This method involves listening and allows you to assess the nature of the heart murmur and the deviation of the sound picture from the norm. The procedure must be carried out in complete silence.

Blood pressure measurement. In this case, any type of tonometer is used that measures pressure to determine hypertension or hypotension.

The described methods of studying the cardiovascular system are carried out only during the initial examination; if the doctor finds certain deviations from the norm, he prescribes additional methods to check the activity of the heart; in this case, a full examination with special equipment is used.

Electrocardiography

This diagnostic method allows you to record and then study the electrical impulses that the heart muscle produces during operation. If the heart is without pathologies, then electrical excitation passes through different parts of the heart with a certain sequence. If the excitability of the heart muscle fails, this indicates pathologies and possible diseases.

When the myocardium contracts and relaxes, all data is recorded and written in the form of teeth, after which the doctor receives a curve or graph.

The data is recorded by a special device called an electrocardiograph. This diagnostic method allows you to evaluate the frequency and uniformity of the heart rhythm, various electrical processes occurring in the organ. An ECG is performed to detect arrhythmia, ischemia, and heart attack.

Important! Shifts in the ECG curve occur not only due to improper functioning of the heart. The reason may be diseases not related to this organ: pneumonia, pleurisy, obesity, etc.

Electrocardiography may be included in a comprehensive examination of the heart along with other methods.

In addition to taking a cardiogram at rest, other ECG techniques are used:

In the first case, the study continues for a day. Equipment and sensors are connected to the patient, after which round-the-clock recording of indicators of changes in excitability begins. Often, this method is used for severe patients, or if the problem appears periodically, for example, with short-term arrhythmia.

In the second case, an ECG is taken before and after stress on the body. This method allows us to identify the patient’s sensitivity to physical activity. Bicycle ergometry is often used for ischemia, namely exertional angina.

Phonocardiography and echocardiography

Phonocardiography allows you to record all sounds and murmurs of the heart. Recording is performed through a phonocardiograph, which is usually an additional device to an electrocardiograph. This method of instrumental diagnosis allows you to evaluate the symptoms of diseases by sound.

Echocardiography is performed using ultrasound. Today there are several methods for conducting echocardiography:

One-dimensional echocardiography allows you to obtain a projection of the organ in the plane. The heart is examined using this method to determine the thickness of the walls and the size of the cavities. Additionally, the functioning of the valves and the condition of the organ during and after contraction are assessed.
Two-dimensional echocardiography provides a three-dimensional image of the organ being examined, so the method is considered more informative.
Doppler echocardiography – diagnostics of blood flow inside the heart, used to assess hemodynamics, identify valve and septal defects, and the presence of shunts.

Radiography

Methods for studying the heart and blood vessels using X-rays allow us to evaluate the size and shape of the heart, large vessels, and the volume of fluid in the pericardial part. When using this method, a person receives a dose of radiation, so there is no point in using it unnecessarily. It is used when other methods do not provide adequate information about the condition of a person and his organ.

X-rays cannot be used to examine pregnant women. One of the types of radiography is tomography. The latter method is more informative, since the picture is displayed on the monitor screen, simulating the patient’s organ, however, the radiation exposure in this case is higher than with x-rays.

Radionuclide examination and angiocardiography

An isotope study of the heart, namely the radionuclide method, is carried out by introducing radioisotopes into the blood, which make it possible to further evaluate their distribution. This method helps determine the formation of blood clots in blood vessels, as well as myocardial infarction. In this case, the patient also receives radiation.

Angiocardiography involves injecting a radiopaque contrast agent directly into the heart. With its help, doctors can study many parameters of the heart chambers and blood vessels. A procedure is used to determine the feasibility of surgery on an organ. This method is one of the main ones when examining for blood clots. Angiocardiography is performed by catheterization.

Important! Only the doctor chooses how to check the blood vessels of the heart, by Dopplerography or angiography. The choice of method is influenced by many parameters, including the purpose of the study.

For each person and specific case, a certain type of diagnosis can be used, although in some situations more than one method may be used, but several at once. It depends on the state of health, the age of the patient and the reason why the heart hurts, that is, the existing pathology.

Home testing methods

You can check your heart function at home, and people over 40 years of age are recommended to do this more often in order to detect deterioration of the condition in time. For home diagnostics, a tonometer is used, which can measure blood pressure and pulse rate.

A tonometer can be used of any type, for which you have enough money. Measurements are taken only in a sitting or lying position, at rest. You can do them on both arms, but only on the elbow. If during measurements the pressure is more or less than 110/70-140/90 and the indicator persists for a long time, it is recommended to visit a cardiologist.

To measure your pulse at home, you just need to be at rest and record the beating of a vessel on your neck or arm. The pulsation must be counted for a minute. This method will allow you to catch a rhythm failure, if there is one.

Some types of tonometers can independently count the pulse while measuring blood pressure.

Suspicion of atherosclerosis: examinations that must be completed to confirm or refute the diagnosis

With atherosclerosis, fat accumulates and connective tissue grows in the artery wall. The integrity of the inner lining of the vessels is compromised, their lumen narrows, which leads to an obstruction to the blood supply to organs and tissues. Diagnosis requires consultation with a therapist, cardiologist, and other specialists, as well as a study of the lipid spectrum of the blood, ultrasound of blood vessels, heart, and angiography.

Examination by specialists for atherosclerosis

Most often, an assumption about the presence of atherosclerosis in a patient may arise from a local therapist or family doctor. The process of changes in the walls of blood vessels develops in almost all people after 45 years.

But its manifestations and severity are different. After the doctor ascertains the complaints, he gives a referral for biochemical blood tests to confirm elevated cholesterol levels, low-density lipids and an ECG.

Following the initial diagnosis, as a rule, it is recommended to consult such specialists for a more in-depth examination:

cardiologist – examines damage to the heart and large arteries;
vascular surgeon – identifies circulatory disorders in the lower extremities;
neurologist - determines the degree of blood flow in the vessels of the brain;
endocrinologist – examines the thyroid gland, hormones, etc. (and atherosclerosis is often a sign of diabetes);
ophthalmologist - examines changes in vision.

And here is more information about the main signs of aortic atherosclerosis.

What will the doctor reveal during the examination?

To make a diagnosis, the following patient complaints are important:

headache, dizziness, tinnitus;
paroxysmal weakness and numbness in the limbs;
during physical activity there is difficulty breathing, increased heart rate and pain in the chest;
When walking you need to stop because of pain in your legs.

Upon examination, nonspecific signs are revealed:

xanthomas - yellow spots on the lower eyelids;
xanthelasma - cholesterol deposits on the outer surface of the elbow joints and heel tendons;
clouding of the iris in the form of a crescent;
tortuous, dense temporal and brachial arteries;
difference in pulse filling in the extremities.

High blood pressure, systolic murmur at the apex of the heart, accentuated 2nd tone above the aorta are often detected.

What tests to take for atherosclerosis and their interpretation

The diagnosis of atherosclerosis can take place in several stages. First, the lipid composition of the blood is examined, and then instrumental diagnostics of the vascular network is carried out.

Blood tests, including biochemical

A general blood test is not very informative; sugar may be elevated, which requires an in-depth study of carbohydrate metabolism.

The coagulogram reveals symptoms of increased blood coagulation, decreased activity of fibrinolysis and platelet functions. This may be useful in assessing the risk of blood clots.

To further assess cardiac risk, the following indicators are determined:

c-reactive protein, ALT and AST for suspected myocardial infarction;
blood potassium is increased during tissue ischemia.

Determination of lipid metabolism

The main laboratory sign of atherosclerosis is impaired fat metabolism. Its signs:

increased cholesterol, triglycerides and low- and very low-density lipoproteins;
reduction of high density lipoproteins;
apolipoprotein A1 is below normal;
apolipoprotein B is high.

To determine the risk of cardiovascular pathology, an indicator called the atherogenicity index is used. This is the ratio of the concentration of total blood cholesterol to low-density lipoproteins. If it is below 2.9, then the patient’s probability of developing atherosclerosis is low, the average risk is up to 4.9, and higher values indicate 100% atherosclerotic vascular damage.

Ultrasound of blood vessels, including lower extremities

The patency of the arteries is determined, the disturbance of blood flow, the presence of signs of thrombosis or blockage by atherosclerotic plaque are assessed. The method is used for reduced pulsation in the feet, popliteal and femoral arteries, as well as differences in pulse filling in the lower extremities. An indirect symptom is slow healing of wounds at the site of impaired blood supply.

X-ray examination

Allows you to establish signs of atherosclerosis of the heart (coronary arteries), aorta, pulmonary artery:

the size of the heart is increased, mainly due to the left ventricle;
there may be symptoms of a wall aneurysm - a bulging area, most often on the left;
elongation of the aorta, pathological bending, increased shadow contrast, areas of calcification;
when the pulmonary artery is damaged, the pulmonary pattern is enhanced, and there are aneurysmal changes in the branches.

On an x-ray (direct projection): a penetrating atherosclerotic aortic ulcer with a false aneurysm (shown by an arrow).

Cardiogram (ECG)

With coronary heart disease, as the main manifestation of atherosclerosis, the symptoms on the ECG during a routine study are not very specific, especially in the initial stages: left ventricular hypertrophy, arrhythmia, conduction disturbances. Therefore, more complete information can be obtained from load tests.

Stress testing for atherosclerosis

Several options for physical activity are used to determine its tolerance:

climbing onto a step platform (Master's test);
bicycle ergomertry – riding a special bicycle;
treadmill - walking on a treadmill.

Bicycle ergometry

In case of joint diseases or thrombophlebitis, as well as general detraining, they are replaced with pharmacological tests with Isadrin or Ergometrine.

These studies are considered positive (the diagnosis is confirmed) if the patient experiences chest pain of a typical nature for angina pectoris, a greater than normal increase in heart rate, a decrease in pressure by 25% or less, a change in the location of the ST segment in relation to the isoline.

Ankle-brachial index

The pressure on the shoulder is measured in a standard way in the supine position, and then the cuff is installed 5 cm above the ankle. The index is calculated by dividing the systolic pressure indicators - ankle by brachial. The norm at rest is from 1 to 1.3.

When the coefficient changes, the following pathology can be suspected:

less than 0.4 – severe arterial blockage, risk of trophic ulcers and gangrene;
from 0.41 to 0.9 – moderate or mild degree of circulatory impairment, angiographic examination is necessary;
from 0.9 to 1 – the upper limit of normal, pain may occur during physical activity;
more than 1.3 – the vessel wall is dense, rigid, a symptom of diabetes or kidney failure.

Dopplerography

Using Doppler, the speed of blood flow in the vessels of the neck, brain and lower extremities is determined. Most often, a duplex or triplex study is prescribed, in which scanning is performed using ultrasound and visualization on the screen of blood supply disorders and the location of atherosclerotic plaques.

Ultrasound of neck vessels: stenosis of the external carotid artery due to atherosclerosis

Vascular contrast

By filling the vascular network with a contrast agent, narrowing of the lumen, obliteration (blockage), the affected area and the state of regional blood flow, and the development of bypass pathways - collaterals can be detected.

The following types of diagnostics are used:

aortography,
angiography of peripheral vessels,
coronary angiography.

And here is more information about the treatment of cerebral atherosclerosis.

Tomographic research methods

With this technique, a contrast agent is injected intravenously, and then an image of the vascular arterial network is obtained using a tomograph. Using the device, disturbances in the structure, location and functioning of large and peripheral vessels are detected. To diagnose atherosclerosis the following is used:

MRI of extremity vessels;
CT scan of the aorta;
peripheral tomographic arteriography;
multislice CT of the aorta, coronary vessels, renal and extremity arteries.

MRI of vessels of the lower extremities

These methods are among the most informative; they are used to determine the scope of surgical intervention and in complex diagnostic cases.

To identify atherosclerosis, the patient’s complaints and examination data are taken into account, but in order to confirm the diagnosis, it is necessary to conduct an analysis of the lipid composition of the blood, as well as ultrasound and angiographic examination of the arterial network. The most informative are tomographic methods.

Useful video

For information on modern approaches to diagnosing atherosclerosis, watch this video:

Thrombosis/Embolism. Surveys. Ask a cardiologist a question. Atherosclerosis of neck vessels. By stenosis (or occlusion) of the carotid arteries we mean.

Thrombosis/Embolism. Surveys. Ask a cardiologist a question. . Atherosclerosis is a thickening and hardening of the walls of the arteries, in which it “quietly and slowly” narrows.

For a preliminary examination and prescription of medications, you need to contact a neurologist, and a nutritionist or nutritionist will help you choose nutrition for atherosclerosis.

Thrombosis/Embolism. Surveys. Ask a cardiologist a question. Why does obliterating atherosclerosis of the vessels of the lower extremities develop and how is it treated?

Diagnosis of cerebral vascular atherosclerosis consists of brain examinations and laboratory tests

We will publish information soon.

Biochemical analysis is one of the most accessible, fastest and inexpensive examination methods. It allows you to assess the condition of the whole organism. Any disturbances in the functioning of internal organs invariably affect the composition of the blood. This analysis is used in all areas of medicine, including cardiology. Almost any medical examination begins with.

A biochemical blood test includes many indicators. Most often, only a part of these indicators is assigned, since a detailed analysis is required extremely rarely.

The essence of the analysis is to determine the amount and concentration of chemicals in the blood. As you know, blood circulates in all tissues, therefore, when there is inflammation or disturbance in any of them, the composition of the blood also changes.

A biochemical therapeutic blood test can be prescribed if absolutely any disease is suspected. The examination is prescribed by therapists, hepatologists, gastroenterologists, and cardiologists.

Confirmation of diagnosis. The analysis allows us to identify specific violations and clarify an existing diagnosis.
Diseases of the liver, kidneys, and gastrointestinal tract. A biochemical therapeutic blood test is indispensable when examining the functioning of the gastrointestinal tract, since the indicators contain enzymes.
Pregnancy. During pregnancy, blood tests are taken constantly, once every 2 weeks. The examination allows you to identify dysfunctions of internal organs, prevent miscarriage, and diagnose preeclampsia in a timely manner.
Prevention. As a preventive examination, it is recommended to take a blood test annually. This will help detect a number of diseases at an early stage.
Checking the effectiveness of treatment. If a diagnosis is made and treatment is prescribed, a blood test is prescribed during the treatment process or after completion of the course to check the progress and effectiveness of the prescribed treatment methods.

More information about the lipid profile can be found in the video:

The advantages of laboratory testing include accessibility, low price, speed of the procedure, painlessness and high information content. The disadvantages include the possibility of error.

Blood reacts not only to internal changes, but also to external influences. Therefore, without proper preparation, the result may be erroneous. Also, despite the high information content of the analysis, it is difficult to make an accurate diagnosis based on the results without further examination.

Cardiological profile: what tests are included in it

Cardiovascular diseases require particularly careful examination. Currently, it is the most common cause of death among the population. For timely detection of diseases, an examination is prescribed.

A cardiac profile is a whole range of tests to check the condition of the heart and blood vessels. It is prescribed for any suspicion of a disorder of the cardiovascular system and is the initial stage of the examination.

A cardiological profile allows not only to detect existing diseases, but also to determine the risk and likelihood of their occurrence, predict the course of the disease, and select treatment or preventive measures.With the help of a cardiological profile, it is possible to detect diseases at an early stage, in a latent form, when there are still no symptoms.

The cardiac profile includes the following tests:

Lipidogram. This analysis allows you to determine the level of lipids in the blood, the tendency to. The indicators reveal disturbances in lipid metabolism. This includes cholesterol, HDL, LDL, triglycerides.
. The analysis includes indicators. Coagulation disorders can lead to thrombosis or bleeding. Monitoring these indicators is necessary.
AST. This enzyme is responsible for metabolism not only in liver tissue, but also in the heart muscle. The indicator is often used to diagnose myocardial infarction.
Creatine kinase. This is an enzyme responsible for energy exchange in cells and tissues. If the level of this enzyme increases significantly, this indicates a risk of myocardial infarction.
LDH. This enzyme is found in the heart muscle, kidneys, and liver tissues. Its level in the blood increases during myocardial infarction in the acute stage.

Indications for a cardiological profile are any heart disease, suspicion of myocardial infarction, and chest pain, high blood pressure.

Indicators of biochemical analysis and their application in cardiology

A complete biochemical analysis includes more than 20 indicators. Most often, the doctor specifies which indicators are necessary to make a diagnosis. The choice depends on the symptoms and the suspected disease.

When examining cardiovascular diseases, cardiac profile indicators are most often assessed. But other indicators may also be important in assessing the impact of heart disease.

The list of frequently prescribed biochemical blood test indicators includes:

Glucose. People with suspected diabetes mellitus need to donate blood for sugar testing in order to control the metabolism in the body. Disorders of carbohydrate metabolism, as a rule, indicate a malfunction in the endocrine system, as well as various liver diseases.
. Cholesterol has several varieties (high and low density lipids). Not all types of cholesterol are harmful to health. Everyone needs to monitor their cholesterol levels, especially people over 50, as the risk of atherosclerosis increases.
Bilirubin. Bilirubin is a protein that is broken down in liver tissue. When there is a large accumulation of bilirubin in the blood, it becomes toxic. This indicator is used to check the functioning of the liver and bile ducts.
AST. An enzyme that relates to both liver function tests and cardiac profiles. Used in the diagnosis of heart attacks and liver diseases (cirrhosis, hepatitis, etc.)
ALT. This indicator refers to liver tests. Small amounts of the enzyme are present in the kidneys and heart muscle.
Albumen. Albumin is a protein that is found in large quantities in blood plasma. The albumin level is taken into account when an infectious disease, systemic and autoimmune diseases are suspected.

During a cardiac examination, the lipids, cholesterol and enzymes contained in the heart muscle are primarily assessed.

Preparation and blood collection procedure

Donating blood is standard procedure. A person goes through it several times throughout his life. It is worth remembering that the blood reacts to any influence, therefore, to obtain reliable results, you must adhere to the doctor’s recommendations regarding preparation.

A biochemical blood test does not require complex or lengthy preparation. It is enough to watch your diet for a couple of days and refuse some procedures (visiting a solarium, physical activity).

If the result raises doubts among the doctor or if there were errors in preparation, it is recommended to retake the analysis.

Preparation includes the following aspects:

It is important that the blood does not clot for a certain time. It is better to take the test in the morning and on an empty stomach. If urgent analysis is required, it is carried out at any time of the day.
In the morning before the procedure, you should not have breakfast, drink coffee, tea, or sweet carbonated drinks, but you can drink a glass of pure still water. When testing blood for sugar, it is better not to brush your teeth, since the toothpaste contains a certain amount of glucose.
Smoking and alcohol negatively affect the condition of the body, which invariably affects the composition of the blood. You must stop smoking on the day of the examination (or at least an hour before it); drinking alcoholic beverages is not recommended a day or two before visiting the laboratory.
A couple of days before blood sampling, you need to follow a simple diet (especially when taking liver tests). You need to stop eating fatty, fried, spicy foods, and reduce your consumption of sweets. It’s also better not to overdo it with the amount of protein foods (mushrooms, eggs, meat).

The procedure itself is quite simple. The patient's blood is taken from a vein with a special syringe. Blood is drawn into a test tube, on which the patient's serial number is placed. The person does not experience pain, but there may be slight dizziness caused by a feeling of hunger or the sight of blood. If you experience any discomfort, you should notify the nurse.

Norm and deviations from the norm

The result of a biochemical blood test is ready within 24 hours. Only a doctor should do the decoding. Even with knowledge of the norms of indicators, only a specialist can assess the overall picture. Each individual indicator is taken into account in conjunction with others. It is impossible to diagnose yourself in this way.

The norm may change with age and also depending on gender. The norm also changes in a pregnant woman depending on the period.

Deviations may indicate certain diseases, depending on the degree of increase or decrease in the indicator relative to the norm.

In cardiology, deviations in the following indicators are taken into account:

. If we talk about total cholesterol, the norm for an adult is 3.18 – 5.96 mol/l. In this case, it is necessary to take into account which lipids predominate in this amount (high or low density). Elevated cholesterol levels indicate a high risk of developing . A reduced level, as a rule, is not considered a serious pathology.
AST. This enzyme is involved in the synthesis of amino acids. Its norm is 34-40 IU, depending on gender. Elevated AST levels are observed during heart attack and injury to the heart muscle. A decrease in the indicator has no diagnostic value.
Triglycerides. TG is a source of energy for the body. This indicator is used in the diagnosis of atherosclerosis. Normally, the TG level is 0.34 – 3 mmol/l, depending on age and gender. The TG level is increased in atherosclerosis and heart attack. Reduced TG occurs in diseases of the liver, kidneys, and lungs.
Creatine kinase. The normal level of this enzyme is 146 U/L for women and 172 U/L for men. Exceeding this indicator indicates myocardial infarction or possible thyroid diseases.

If abnormalities are detected, the doctor may recommend retaking the test or prescribing further examination to clarify the diagnosis.

What tests can detect problems with the heart and blood vessels?

Lipidogram. This is a blood test taken from a vein in the morning on an empty stomach to check for high cholesterol levels.
Coagulogram. Needed to determine blood clotting time and identify problems such as blood clots.
Aspartate aminotransferase (AST). Such an analysis is required to detect changes in the activity of the AST enzyme involved in amino acid metabolism. An increase in activity several times is a sign of a pre-infarction state.
Creatine kinase. This is the establishment in the blood of indicators of the intracellular enzyme crest kinase, which acts as an indicator of myocardial damage.
Lactate dehydrogenase. This is also an enzyme that is present in the muscles of the heart, and enters the blood only when they are destroyed.

Thus, identifying and identifying some catalysts and anomalies in hematopoietic processes is very important and can save a person’s life.