What blood tests are taken in cardiology. Blood - what tests should I take? When should you contact a cardiologist?

A cardiac profile is a set of specific blood tests that allows you to assess the likelihood of recent damage to myocardial cells and evaluate risk factors for the development of heart and vascular diseases.

Why do you need to do a cardiac profile?

A cardiological profile allows you to identify early and hidden lesions of the cardiovascular system, the risk of developing atherosclerosis, coronary heart disease and heart failure, and assess the likelihood of myocardial infarction.

What are the indications for the cardiac profile?

vascular atherosclerosis;
cardiac ischemia;
high blood pressure;
heart rhythm disturbances - tachycardia, arrhythmia;
stroke, heart attack.

What do cardiac profile indicators mean?

Lipid profile(lipid profile) is necessary for diagnosing atherosclerosis and coronary heart disease.

Coagulogram determines an increase in blood viscosity, which indicates an increased risk of developing complications of hypertension and coronary heart disease - heart attacks and strokes.

ASAT(AST, aspartate aminotransferase) is an intracellular enzyme involved in the metabolism of amino acids in liver tissue, heart muscle and other organs. During myocardial infarction, serum AST activity may increase significantly even before the appearance of typical signs of infarction on the ECG.

Normal AST values:

Women - up to 31 U/l
Men - up to 37 U/l.

Creatine kinase(creatine phosphokinase, CK, CPK) is an enzyme that is a catalyst - an accelerator of the rate of ATP conversion.

KFK-MV found in cardiac muscle cells. When myocardial cells are damaged, an increase in CK-MB activity is detected 4 hours after infarction.

Normal CK-MB values:

women -< 145 Ед/л
men -< 171 Ед/л

LDH(Lactate dehydrogenase) is a zinc-containing enzyme that is involved in the final stages of glucose conversion and is found in almost all human organs and tissues. The greatest activity of this enzyme is observed in the cells of the heart muscle, liver, and kidneys. In acute myocardial infarction, already 8-10 hours after the onset of pain, LDH activity sharply increases.

Normal LDH values:< 247 Ед/л

What preparation is needed for the study?

One day before taking blood, it is necessary to avoid drinking alcohol, and 1 hour before taking blood, smoking should be avoided. It is advisable to take blood samples on an empty stomach in the morning. There should be at least 12 hours between the last meal and the blood draw. Juice, tea, coffee are not allowed. You can drink water. It is necessary to exclude increased psycho-emotional and physical stress.

Chronic heart failure

Chronic heart failure (CHF) is a disease in which the heart is unable to pump enough blood to supply the body with oxygen. It can occur as a result of many diseases of the cardiovascular system, among which the most common are coronary heart disease, hypertension, rheumatoid heart defects, and endocarditis. A weakened heart muscle is unable to pump blood, releasing less and less of it into the vessels.

Heart failure develops slowly and in the initial stages appears only during physical activity. Characteristic symptoms at rest indicate a severe stage of the disease. As CHF progresses, it significantly worsens the patient’s condition, leading to decreased performance and disability. The result can be chronic liver and kidney failure, blood clots, and strokes.

Timely diagnosis and treatment can slow down the development of the disease and prevent dangerous complications. An important role in stabilizing the condition is given to a correct lifestyle: weight loss, low-salt diet, limiting physical and emotional stress.

Synonyms Russian

Congestive heart failure, heart failure.

Heart failure, congestive heart failure.

Clinical manifestations of heart failure depend on its duration and severity and are quite varied. The development of the disease is slow and takes several years. If left untreated, the patient's condition may worsen.

The main symptoms of chronic heart failure include:

shortness of breath during physical exertion, when moving to a horizontal position, and then at rest;
dizziness, fatigue and weakness;
lack of appetite and nausea;
swelling of the legs;
accumulation of fluid in the abdominal cavity (ascites);
weight gain due to edema;
fast or irregular heartbeat;
dry cough with pinkish sputum;
decreased attention and intelligence.

General information about the disease

By contracting, the heart ensures continuous circulation of blood through the vessels. Together with the blood, oxygen and nutrients are supplied to all organs and tissues, and the end products of metabolism, including fluid, are removed. This is achieved by alternating two phases: contraction of the heart muscle (called systole) and its relaxation (diastole). Depending on which phase of cardiac activity disrupts its functioning, we speak of systolic or diastolic heart failure.

Systolic heart failure is a consequence of weakness of the heart muscle and is characterized by insufficient ejection of blood from the chambers of the heart. Its most common causes are coronary heart disease and dilated myocardiopathy. More often observed in men.
Diastolic heart failure occurs when the heart muscle loses its ability to stretch. As a result, much less blood enters the atria. The most common causes: arterial hypertension, hypertrophic myocardiopathy and stenotic pericarditis.

The human heart can be roughly divided into right and left halves. Pumping blood into the lungs and saturating it with oxygen is ensured by the work of the right parts of the heart, and the left ones are responsible for delivering blood to the tissues. Depending on which departments fail to cope with their task, they speak of right ventricular or left ventricular heart failure. When the functioning of the left sections is impaired, shortness of breath and cough come to the fore. Right-sided failure manifests itself as systemic edema.

To select the necessary medications, it is very important to determine the mechanism of heart failure and its type.

Who is at risk?

The presence of at least one of the following risk factors is sufficient for the development of chronic heart failure. The combination of two or more factors significantly increases the likelihood of disease.

Patients at risk include:

high blood pressure;
coronary heart disease;
myocardial infarction in the past;
heart rhythm disturbances;
diabetes mellitus;
congenital heart disease;
frequent viral diseases throughout life;
chronic renal failure;
alcohol addiction.

The diagnosis of chronic heart failure is made based on the medical history, characteristic symptoms and results of laboratory and other tests.

Laboratory research

There are most often no changes in the general blood test. In some cases, moderate anemia may be detected.
The erythrocyte sedimentation rate (ESR) may be elevated, especially when heart failure is the result of rheumatic heart disease or infective endocarditis.
A general urinalysis is important to diagnose renal complications and exclude the renal origin of edema. One of the possible manifestations of chronic heart failure is high levels of protein in the urine.
Total protein and protein fractions in the blood may be reduced due to their redistribution into the edematous fluid.
Blood glucose. Important for excluding diabetes mellitus as a risk factor for heart failure.
Cholesterol. high and low density lipoproteins. There is a clear relationship between elevated cholesterol levels and the development of atherosclerosis, coronary heart disease, and hypertension. High levels of cholesterol and lipoproteins in heart failure may indicate a more severe course of the disease.
Sodium and potassium in the blood. In chronic heart failure, their level in the blood serum can change significantly due to edema. Monitoring blood composition is especially important when prescribing diuretics.
Brain sodium

Cardiac examination

Often, a person who first feels any complaints from the cardiovascular system, upon initial treatment on an outpatient basis, immediately receives treatment, bypassing a full cardiological and related examination, which should include both instrumental and laboratory diagnostic methods.

Depending on the prevalence of clinical symptoms, three main groups of patients can be divided:

1. Patients with complaints of pain in the heart area

2. Patients with high blood pressure

3. Patients with rhythm disturbances, interruptions in heart function

Various combinations of clinical symptoms are also possible (rhythm disturbances and heart pain against the background of high blood pressure).

The minimum examination should include:

Examination by a cardiologist with detailed collection of complaints and physical examination (auscultation, percussion)

ECG (12-lead ECG, long strip ECG, cardiotopography, ECTG-60, ECG with isometric stress)

Ultrasound (ultrasound) of the heart, dopplerography of blood vessels, transesophageal ultrasound (often necessary for rhythm disturbances to exclude the presence of blood clots in the cavities of the heart), ultrasound of the kidneys, adrenal glands, thyroid gland

24-hour blood pressure and ECG monitoring (Holter monitoring)

Load tests (velergometric test, treadmill test, informational and pharmacological tests)

Consultations of related specialists (endocrinologist, gynecologist, ophthalmologist, gastroenterologist, neurologist, nephrologist, etc.)

Laboratory tests: biochemical blood test (glucose, electrolytes, lipid spectrum, cholesterol and other cardiac enzymes), determination of the level of certain hormones (thyroid gland, brain natriuretic peptide).

Heartache

The most common reasons:

Coronary heart disease (CHD)
Heart valve defects
Neurocirculatory dystonia (NCD)

A special role should be given to the differential diagnosis of pain in diseases of the spine (osteochondrosis).

An important role in the examination is given to ECG changes, including during stress tests and daily monitoring, as well as changes in biochemical blood tests (lipoproteins, triglycerides). If necessary, coronary angiography is performed to establish a final diagnosis and determine further treatment tactics. Treatment can be conservative (medication), endovascular (angioplasty and stent placement in the coronary arteries through the brachial or femoral artery), surgical (coronary artery bypass grafting with cardiopulmonary bypass or on-pump).

If spinal osteochondrosis is suspected, a consultation with a neurologist is required, who will determine the scope of necessary studies (CT, MRI, etc.)

High blood pressure

First of all, it is necessary to exclude the symptomatic nature of arterial hypertension (hypertension caused by diseases of specific organs). Such hypertension includes hypertension due to diseases of the kidneys and their vessels, tumors of the kidneys and adrenal glands, brain tumors, vascular diseases (coarctation of the aorta, other vascular pathology.) Endocrine causes of increased blood pressure deserve special attention, especially in women after 45 years.

If the cause of hypertension cannot be found (and this happens in approximately 95% of cases), such hypertension is considered idiopathic, or essential (is an independent disease), and requires treatment with special drugs. It is very important to understand that this disease requires systematic, often lifelong treatment. A very common mistake is the practice of taking antihypertensive drugs only to reduce high blood pressure, rather than taking them continuously and regularly. (See Guide to Lowering Blood Pressure.)

Rhythm disturbances, interruptions in heart function

Electrocardiogram (ECG) data play a key role in diagnosis. To find out the causes of arrhythmia, it is necessary to exclude organic causes (damage to the valvular apparatus of the heart) - for this, an ultrasound of the heart is performed - and coronary heart disease. Some arrhythmias may be congenital. A common cause of arrhythmia may be dysfunction of the thyroid gland, which requires a full endocrinological examination (consultation with an endocrinologist, determination of hormone levels in the blood). When establishing the cause and determining the nature of the rhythm disturbance, an electrophysiological study (EPS) of the heart may be necessary.

What do clinical blood test indicators indicate?

It is hardly possible to find a person who has not done a clinical (or general) blood test at least once in his life. This is one of the most commonly used tests for diagnosing various diseases; such a study, performed professionally, can tell the doctor a lot about the patient’s health status.

Most often, people, independently receiving the results of a clinical blood test in the laboratory or listening to their interpretation from a doctor, do not understand what this or that indicator means and how it relates to their condition. Of course, the patient should not “replace” the doctor and try to diagnose himself, etc., based on the results obtained. The purpose of this article is to familiarize a wide range of readers with the main indicators of a general blood test, so that the terminology used by doctors when communicating with patients is not a “closed secret,” and the doctor and patient would better understand each other.

For a general blood test, blood is taken from a finger (or from a vein) in the morning on an empty stomach. It is recommended to avoid fatty foods the night before as this may affect your white blood cell count. Stress can also distort the blood picture - even a quarrel with someone on the way to the clinic.

To take the analysis, disposable sterile instruments are used. The laboratory technician who draws blood must work either in disposable gloves or rubber gloves, which are disinfected with disinfectant solutions after each blood draw, and which he changes as necessary.

Traditionally, blood is taken from the fourth finger of the left hand, which is thoroughly wiped with cotton wool and alcohol, after which an injection is made with a special needle into the flesh of the finger to a depth of 2-3 mm. The first drop of blood is removed with cotton wool soaked in ether. First, blood is drawn to determine hemoglobin and ESR, then to determine the number of erythrocytes and leukocytes, after which blood smears are made using slides and the structure of cells is studied under a microscope.

In addition, you need to take into account that each laboratory has its own “standards” for a general (clinical) blood test, so it is better to ask your doctor all your questions.

A general blood test helps a doctor of any specialty. Based on the results of a blood test (hemogram), the doctor can competently assess the condition of the body, make a preliminary diagnosis and promptly prescribe appropriate treatment.

So, A general (clinical) blood test shows:

number of red blood cells,
erythrocyte sedimentation rate (ESR),
hemoglobin content,
number of leukocytes,
leukocyte formula
and other indicators, each of which we will dwell on in detail.

Red blood cells also known as red blood cells. In humans, 1 mm³ of blood contains 4.5-5 million red blood cells. Red blood cells contain hemoglobin and carry oxygen and carbon dioxide. An increase in the number of red blood cells is a sign of diseases such as leukemia, chronic lung diseases, and congenital heart defects. Anemia (decreased number of red blood cells) can be caused by stress, increased physical activity, and fasting. If you cannot immediately determine the cause of the decrease in the number of red blood cells, then it is better to go to a hematologist and undergo additional examination.

A significant increase in the content of red blood cells may indicate erythremia (one of the blood diseases). In addition, an increase in the number of red blood cells (erythocytosis, polycythemia) is observed in acute poisoning, when due to severe vomiting and diarrhea there is a large deficiency of fluid in the body; with acidosis (due to metabolic disorders during exacerbation of certain diseases); when losing fluid for various reasons (heat, illness, heavy physical activity); with long-term cardiovascular or pulmonary diseases, when the body is not sufficiently supplied with oxygen and increases the number of red blood cells in an attempt to still deliver oxygen to the tissues; or when a person is in the highlands, when he no longer has enough oxygen.

Color index- its normal value for people of any age is 0.85-1.15. The blood color index is an indicator of the degree of saturation of red blood cells with hemoglobin and reflects the relationship between the number of red blood cells and hemoglobin in the blood. When its values differ from the norm, this generally indicates the presence of anemia. In this case, anemia is divided into:

— hypochromic — color index less than 0.85;

- hyperchromic - color index greater than 1.15.

However, anemia can also be normochromic - when the color indicator remains within the normal range.

Reticulocytes- These are young forms of red blood cells. Children have more of them, adults have less, because the formation and growth of the body has already been completed. An increase in the number of reticulocytes can be observed in anemia or malaria. A decrease in the number of reticulocytes or their absence is an unfavorable sign in anemia, indicating that the bone marrow has lost the ability to produce red blood cells.

Erythrocyte sedimentation rate (ESR) determines how quickly red blood cells settle in a test tube, separating from the blood plasma. In women, the ESR rate is slightly higher than in men; during pregnancy, the ESR increases. Normally, the ESR value in men does not exceed 10 mm/hour, and in women - 15 mm/hour. The ESR indicator may change depending on various factors, including due to various diseases.

An increase in ESR in a blood test is one of the indicators that makes the doctor assume that the patient has an acute or chronic inflammatory process (pneumonia, osteomyelitis, tuberculosis, syphilis), and an increase in ESR is characteristic of poisoning, myocardial infarction, trauma, bone fractures, anemia, kidney diseases, cancer. It is observed both after operations and as a result of taking certain medications. A decrease in ESR occurs during fasting, with a decrease in muscle mass, and when taking corticosteroids.

Hemoglobin- a complex iron-containing protein found in red blood cells - erythrocytes - of animals and humans, capable of reversibly binding to oxygen, ensuring its transfer to tissues. The normal content of hemoglobin in human blood is considered to be: for men 130-170 g/l, for women 120-150 g/l; in children - 120-140 g/l. Blood hemoglobin is involved in the transport of oxygen and carbon dioxide and maintains pH balance. Therefore, determining hemoglobin is one of the most important tasks of a general blood test.

Low hemoglobin (anemia) can be the result of large blood loss; a decrease in hemoglobin occurs when there is a lack of iron, a necessary material for the construction of hemoglobin. Also, low hemoglobin (anemia) is a consequence of blood diseases and many chronic diseases not associated with them.

A hemoglobin level higher than normal can be an indicator of many blood diseases, and a complete blood count will also show an increase in red blood cells. Increased hemoglobin is typical for people with congenital heart defects and pulmonary heart failure. An increase in hemoglobin can be caused by physiological reasons - in pilots after flights, mountain climbers, after significant physical activity, the hemoglobin level is higher than normal.

Leukocytes- These are the protectors of our body from foreign components. The blood of an adult contains an average of 4-9x10 9 leukocytes/l. White blood cells fight viruses and bacteria and cleanse the blood of dying cells. There are several types of leukocytes (monocytes, lymphocytes, etc.). The leukocyte formula allows you to calculate the content of these forms of leukocytes in the blood.

If leukocytes are found in increased numbers in a blood test, this may mean the presence of viral, fungal or bacterial infections (pneumonia, tonsillitis, sepsis, meningitis, appendicitis, abscess, polyarthritis, pyelonephritis, peritonitis), and also be a sign of poisoning of the body (gout ). Previous burns and injuries, bleeding, postoperative condition of the body, myocardial infarction, lung, kidney or spleen, acute and chronic anemia, malignant tumors - all these “troubles” are accompanied by an increase in the number of blood leukocytes.

In women, a slight increase in leukocytes in the blood is also observed in the period before menstruation, in the second half of pregnancy and during childbirth.

A decrease in the number of white blood cells, which a blood test can show, may be evidence of viral and bacterial infections (influenza, typhoid fever, viral hepatitis, sepsis, measles, malaria, rubella, mumps, AIDS), rheumatoid arthritis, kidney failure, radiation sickness, some forms of leukemia, bone marrow diseases, anaphylactic shock, exhaustion, anemia. A decrease in the number of leukocytes can also be observed while taking certain medications (analgesics, anti-inflammatory drugs).

Platelets- these cells are also called blood plates. They are the smallest blood cells. The main role of platelets is participation in blood clotting processes. In blood vessels, platelets can be located near the walls and in the bloodstream. At rest, platelets have a disc-shaped shape. If necessary, they become like a sphere and form special outgrowths (pseudopodia). With their help, blood platelets can stick to each other or stick to a damaged vascular wall.

A decrease in the number of platelets is observed in women during menstruation and during normal pregnancy, and an increase occurs after physical activity. Also, the number of platelets in the blood has seasonal and daily fluctuations. Typically, platelet monitoring is prescribed when taking certain medications, when a person has burst capillaries for no reason, has frequent nosebleeds, or when being examined for various diseases.

An increase in the number of platelets in the blood (so-called thrombocytosis) occurs when:

- inflammatory processes (acute rheumatism, tuberculosis, ulcerative colitis);

- acute blood loss;

- hemolytic anemia (when red blood cells are destroyed);

— conditions after removal of the spleen;

- observed during treatment with corticosteroids;

- some rarer diseases.

A decrease in the number of platelets (thrombocytopenia) is observed in a number of hereditary diseases, but appears much more often in acquired diseases. The number of platelets decreases when:

- severe iron deficiency anemia;

- some bacterial and viral infections;

- liver diseases;

- diseases of the thyroid gland;

- the use of a number of medications (vinblastine, chloramphenicol, sulfonamides, etc.);

- systemic lupus erythematosus.

Hematocrit- this is the proportion (as a percentage) of the total blood volume that is made up of red blood cells. Normally, this figure is 40-48% for men, 36-42% for women.

The volume of erythrocytes compared to plasma increases with:

- dehydration (dehydration), which occurs with toxicosis, diarrhea, vomiting;

- congenital heart defects, accompanied by insufficient oxygen supply to the tissues;

— a person being in high altitude conditions;

- insufficiency of the adrenal cortex.

The volume of red blood cells relative to plasma decreases with blood thinning (hydremia) or with anemia.

Hydremia can be physiological if a person immediately drinks a lot of liquid. After significant blood loss, compensatory hydremia occurs when blood volume is restored. Pathological hydremia develops when water-salt metabolism is disturbed and occurs with glomerulonephritis, acute and chronic renal failure, and with heart failure during the period of swelling.

Blood formula. The study of the leukocyte formula has important diagnostic value, showing characteristic changes in a number of diseases. But these data should always be assessed together with other indicators of the blood system and the general condition of the patient.

For various diseases, a combination of the following signs is looked at: the total number of leukocytes; the presence of a nuclear shift of neutrophils (the so-called “shift according to the formula to the left”, that is, the appearance of young, immature forms of neutrophils in the blood); percentage of individual leukocytes; the presence or absence of degenerative changes in cells.

There are more than two dozen indicators of biochemical analysis, so for convenience they are combined into several groups: proteins, carbohydrates, lipids, enzymes, inorganic substances, pigments and products of nitrogen metabolism.

Among the protein substances, total protein, albumin, myoglobin, C-reactive protein and rheumatoid factor are most often determined. Total protein and albumin are indicators of normal protein metabolism. The first of them is normally 60-85 g/l (grams per liter), the second - 35-50 g/l. These indicators do not directly relate to the state of the cardiovascular system; they change during oncological processes, nutritional disorders, diffuse connective tissue diseases, etc. However, people, especially older people, rarely get sick with just one thing. The patient may well have a tumor and coronary heart disease. In such cases, the lower the protein level, the more severe the person's condition. Proteins retain fluid in the bloodstream; when they decrease, it passes into the tissues, and edema forms. If a patient has heart failure, accompanied by edema and accumulation of fluid in the cavities, a deficiency of protein substances further aggravates his condition.

C-reactive protein is a nonspecific indicator that reflects the strength of the immune system. Normally, it is contained in the blood in an amount of 0-5 mg/l (milligrams per liter). Its increase occurs during inflammatory processes, activation of immune processes, tumors, etc. In the context of cardiovascular pathology, it increases in response to diseases such as myocardial infarction, infective endocarditis, myocarditis, pericarditis, diffuse connective tissue diseases, which can also accompanied by heart problems.

Rheumatoid factor is a special protein, the level of which increases in the blood during connective tissue diseases (lupus, rheumatoid arthritis, etc.), inflammatory processes (infective endocarditis), as well as many other diseases not related to the heart. Sometimes it can increase with the formation of cardiac cirrhosis - liver destruction caused by severe heart failure. In some cases, it is found even in healthy people. Normally, the amount of this substance does not exceed 10 U/ml (units per milliliter).

Of all the protein substances, myoglobin is most directly related to the heart. It is found in muscles and myocardium and reacts by increasing when they are destroyed. A short-term increase in its level occurs during myocardial infarction. Normally, in women it is contained in the blood in the amount of 12-76 mcg/l (micrograms per liter), in men - 19-92 mcg/l. However, it is rarely used to diagnose a heart attack, since, firstly, it can increase in other situations, for example, due to extensive damage to skeletal muscles or burns. Secondly, its increase is quite short-lived: the level of this protein returns to normal within 12 hours after the onset of the disease. Sometimes patients are admitted to the hospital at a later stage, so the assessment of myoglobin is sometimes useless.

Among the substances responsible for carbohydrate metabolism, the most useful indicator is glucose level. Normally it is 3.3-5.5 mmol/l (millimoles per liter). A strong increase in glucose levels may indicate diabetes mellitus, which is very often associated with cardiovascular diseases. In patients who simultaneously suffer from two pathologies, glucose control is very important, since uncontrolled diabetes accelerates pathological changes in the heart and blood vessels during coronary artery disease.

When it comes to lipids, cholesterol levels are the most important. Ideally, according to the latest clinical recommendations, it should be less than 4.5 mmol/l, although previously they talked about normal levels of up to 6 mmol/l. As it turned out, the lower the cholesterol level, the lower the likelihood of cardiovascular accidents. Let us recall that cholesterol is responsible for the development of atherosclerosis and a number of conditions that arise as a result: hypertension, angina pectoris, heart attacks, strokes. All patients with coronary heart disease must monitor their cholesterol levels and, if necessary, correct them with diet and medications.

In addition to cholesterol, biochemical analysis also detects other “harmful” lipids in the blood, such as low-density lipoproteins (LDL) and triglycerides. LDL should be contained in the blood in an amount of less than 2 mmol/l (according to American recommendations - less than 1.8 mmol/l), atriglycerides - less than 1.7 mmol/l. They need to be monitored according to the same principles as cholesterol levels. Among lipids, there is another fraction - high-density lipoproteins. On the contrary, they fight the manifestations of atherosclerosis and prevent the growth of vascular plaques. A healthy man should have more than 1.0 mmol/l in his blood, and a woman should have more than 1.2 mmol/l.

The pigments determined during a biochemical blood test are bilirubin and its varieties. They are most important in diagnosing liver diseases. The normal level of total bilirubin is 8-20.5 µmol/l (micromoles per liter).

The products of nitrogen metabolism - urea and creatinine - most reflect the function of the kidneys, not the heart. However, their increase can occur in severe chronic or acute heart failure, when the body stops removing metabolic products and they begin to accumulate inside. In addition, creatinine may increase when taking drugs from the group of angiotensin-converting enzyme inhibitors. This includes medications such as captopril (Capoten), enalapril (Enap), fosinopril, perindopril (Prestarium) and others. They are used to treat arterial hypertension or chronic heart failure. Normally, creatinine is contained in the blood in an amount of 62-115 µmol/l in men and 53-97 µmol/l in women. For urea, regardless of gender, the norm is considered to be 2.5-8.3 mmol/l.

Among the enzymes in a biochemical blood test, many indicators can be determined, but not all of them are useful for diagnosing heart disease. For example, amylase reflects the state of the pancreas, gamma-glutamate transpeptidase - the liver. But an increase in transaminases may indicate a disorder in the functioning of the heart. These enzymes are found in the liver, muscles and myocardium and increase in diseases of these organs. Among transaminases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are determined. Their normal value is 10-35 and 10-45 U/l (units per liter), respectively. Their levels may increase with myocardial infarction, angina pectoris and heart failure.

In most hospitals, the determination of an enzyme such as creatine phosphokinase (CPK), the normal level of which is 0-171 U/L, is used as a diagnostic criterion for myocardial infarction and unstable angina. CPK is also found in the liver and muscles, so it is more specific to determine only one of its fractions, which is called CPK-MB (muscle-brain fraction). Its normal level is 0-24 U/l. Myocardial infarction is indicated in cases where the CPK-MB level increases by 2 or more times.

Among inorganic substances, the most important is to determine the level of potassium, which is normally 3.5-5.5 mmol/l. In case of cardiovascular diseases, it can decrease, for example, due to long-term use of certain diuretics, which help remove this electrolyte from the body.

My heart hurts, what tests should I take?

Hemostasiological studies. This set of tests is aimed at studying the blood coagulation system.

A biochemical blood test gives the doctor additional information about the functioning of the heart and blood vessels, since it provides results for a larger number of enzymes.

The Invivo VDP diagnostic center will help identify heart diseases thanks to modern MRI and CT machines

Cardiovascular diseases are widespread among our population, regardless of gender and age. In addition, they very often cause premature death. You can protect yourself by regularly taking the simplest tests. In this article we will look at what kind of examination you need to undergo in a particular case.

Symptoms of heart and vascular diseases

Very often, people do not pay attention to the presence of the symptoms listed below, attributing their occurrence to fatigue and other ailments. Of course, you shouldn’t rush headlong to a cardiologist if you find one of the described symptoms. But it would not be a bad idea to consult a doctor if these manifestations are observed over a long period of time and do not go away.

Pale and weak

Anxiety, fatigue, poor sleep can be symptoms of cardiac neurosis. Pale skin indicates anemia and vasospasm, and blue discoloration of the limbs, nose, cheeks, and ears indicates the presence of cardiopulmonary insufficiency.

Edema

Kidney problems, which people blame for regular swelling at the end of the day, are not the only reason for enlarged lower limbs. This is due to a large amount of salty food, which affects both the kidneys and the heart. It becomes unable to pump blood, which subsequently accumulates in the legs and causes heart failure.

Dizziness, nausea, headache

The frequent occurrence of these symptoms may be the first “bell” of an approaching stroke, and also indicates an increase in blood pressure.

Dyspnea

One of the signs of heart failure and angina pectoris may be shortness of breath and a feeling of lack of air.

Cardiopalmus

If you have not been involved in physical activity and have not experienced emotional uplift, and your heart is “jumping out of your chest,” this sign may indicate a malfunction of the heart: impaired blood supply, heart failure, tachycardia, angina pectoris.

Chest pain

This is one of the surest signs of heart problems. Acute chest pain that occurs even at rest may be a sign of angina, which, in turn, is a precursor to coronary heart disease and myocardial infarction.

What tests are taken to detect heart and vascular diseases?

Oddly enough, to diagnose the state of the cardiovascular system, the doctor prescribes the most common laboratory tests: general and biochemical blood tests. Based on their results, one can judge the main processes occurring in the body.

Complete blood count (CBC): interpretation of results

It gives an idea of the level of hemoglobin, the number of leukocytes, red blood cells, platelets, erythrocyte indices, erythrocyte sedimentation rate (ESR) and other indicators. By deciphering the results of this seemingly simple analysis, the doctor can detect several disorders in the body at once:

a low level of hemoglobin (normal for men - g/l, for women - g/l) indicates kidney problems, anemia, internal bleeding may indicate; an increase in the number of leukocytes (the norm is from 4 to 9 x109 cells per liter) suggests the development of an inflammatory process; a decrease in red blood cells (the norm for men is 4.4-5.0 x1012/l, for women - from 3.8 to 4.5 x1012/l) is a sign of chronic inflammatory processes and cancer, and their increase indicates dehydration of the body; a lack of platelets (in men the norm is 200–400 thousand U/μL, in women - 180–320 thousand U/μL) leads to problems with blood clotting, and too much leads to the formation of blood clots; a high erythrocyte sedimentation rate (ESR) is a clear sign of an inflammatory process. The ESR norm for men is 1-10 mm/h, for women – 2-15 mm/h.

Biochemical blood test: what do deviations from the norm indicate?

Thanks to it, the doctor receives additional information about the functioning of the heart and blood vessels, since it provides results for a larger number of enzymes.

ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are always tested in pairs so that the doctor can see and separate lesions in the heart and liver. Their increase, in most cases, indicates problems with the muscle cells of the heart and the occurrence of myocardial infarction. The ALT norm in women is up to 31 U/l, in men - up to 41 U/l. The AST norm in women is also up to 31 U/l), and in men - up to U/l.

LDH - lactate dehydrogenase (for women the norm is U/l, for men - U/l) and CK - creatine phosphokinase and especially its MB-fraction (MB-CPK) increase during acute myocardial infarction. The laboratory norm for CPK is 10-110 IU, and CPK-MB isoenzymes are 4-6% of total CPK. Myoglobin increases in the blood as a result of the breakdown of cardiac or skeletal muscle tissue. The norm for men is 19 – 92 µg/l (average – 49 ± 17 µg/l), for women – 12 – 76 µg/l (average – 35 ± 14 µg/l). Electrolytes (K+, Na+, Cl-, Ca2+ ions) also tell a lot: an increase in potassium content in the blood serum (normal 3.6 - 5.2 mmol/l) entails heart rhythm disturbances, the possible development of excitation and ventricular fibrillation ; low K+ levels can cause decreased myocardial reflexes; insufficient content of Na+ ions (normal 135 – 145 mmol/l) and an increase in chlorides (normal 100 – 106 mmol/l) are fraught with the development of cardiovascular failure. Cholesterol, contained in large quantities in the blood, serves as a risk for the development of atherosclerosis and coronary heart disease. On average, the norm for total cholesterol is considered to be from 3.61 to 5.21 mmol/liter, the level of “bad” cholesterol (LDL) should be in the range from 2.250 to 4.820 mmol/liter, and high-density cholesterol (HDL) - from 0.71 to 1.71 mmol/liter. C-reactive protein appears in the body during an inflammatory process or tissue necrosis that has already occurred, since it is contained in minimal levels in the blood serum of a healthy person. The norm for children and adults is the same - less than 5 mg/l.

Coagulogram

The results of this analysis, which is sometimes prescribed in addition to the main ones, give the doctor an idea of the process of blood clotting, its viscosity, the possibility of blood clots or, conversely, bleeding. The table below shows the main indicators of this analysis.

Note that during pregnancy, the results of a coagulogram differ from the norms presented above.

A referral for a CBC, a biochemical blood test and a coagulogram is prescribed by the attending physician, and the results of the study can be obtained within 1-2 days, depending on the equipment of the laboratory.

How to protect yourself from heart and vascular diseases?

Getting rid of excess weight, which significantly increases the risk of developing diseases of the cardiovascular system, comes first. For normal blood circulation and to prevent the formation of blood clots, it is necessary to expose your body to physical activity every day. This does not mean going to the gym every day; initially, walking will suffice, increasing the distance every few days.

Following a diet reduces cholesterol levels in the blood and thereby has a positive effect on the condition of blood vessels. Fresh vegetables, berries and fruits, which contain antioxidants beneficial to our body, cleanse and strengthen the walls of blood vessels. For example, acids contained in fatty fish, walnuts and almonds fight vascular thrombosis.

Quitting the use of alcohol and tobacco will certainly be beneficial not only to the heart and blood vessels, but will also have a beneficial effect on the health of all body systems.

Knowledge base: Chronic heart failure

Chronic heart failure

Congestive heart failure, heart failure.

Heart failure, congestive heart failure.

The main symptoms of chronic heart failure include:

shortness of breath during physical exertion, when moving to a horizontal position, and then at rest; dizziness, fatigue and weakness; lack of appetite and nausea; swelling of the legs; accumulation of fluid in the abdominal cavity (ascites); weight gain due to edema; fast or irregular heartbeat; dry cough with pinkish sputum; decreased attention and intelligence.

General information about the disease

Systolic heart failure is a consequence of weakness of the heart muscle and is characterized by insufficient ejection of blood from the chambers of the heart. Its most common causes are coronary heart disease and dilated myocardiopathy. More often observed in men. Diastolic heart failure occurs when the heart muscle loses its ability to stretch. As a result, much less blood enters the atria. The most common causes: arterial hypertension, hypertrophic myocardiopathy and stenotic pericarditis.

To select the necessary medications, it is very important to determine the mechanism of heart failure and its type.

Patients at risk include:

high blood pressure; coronary heart disease; myocardial infarction in the past; heart rhythm disturbances; diabetes mellitus; congenital heart disease; frequent viral diseases throughout life; chronic renal failure; alcohol addiction.

The diagnosis of chronic heart failure is made based on the medical history, characteristic symptoms and results of laboratory and other tests.

There are most often no changes in the general blood test. In some cases, moderate anemia may be detected. The erythrocyte sedimentation rate (ESR) may be elevated, especially when heart failure is the result of rheumatic heart disease or infective endocarditis. A general urinalysis is important to diagnose renal complications and exclude the renal origin of edema. One of the possible manifestations of chronic heart failure is high levels of protein in the urine. Total protein and protein fractions in the blood may be reduced due to their redistribution into the edematous fluid. Blood glucose. Important for excluding diabetes mellitus as a risk factor for heart failure. Cholesterol. high and low density lipoproteins. There is a clear relationship between elevated cholesterol levels and the development of atherosclerosis, coronary heart disease, and hypertension. High levels of cholesterol and lipoproteins in heart failure may indicate a more severe course of the disease. Sodium and potassium in the blood. In chronic heart failure, their level in the blood serum can change significantly due to edema. Monitoring blood composition is especially important when prescribing diuretics. Brain sodium

Cardiac examination

Depending on the prevalence of clinical symptoms, three main groups of patients can be divided:

1. Patients with complaints of pain in the heart area

2. Patients with high blood pressure

3. Patients with rhythm disturbances, interruptions in heart function

Various combinations of clinical symptoms are also possible (rhythm disturbances and heart pain against the background of high blood pressure).

The minimum examination should include:

Examination by a cardiologist with a detailed collection of complaints and physical examination (auscultation, percussion) ECG (ECG in 12 leads, ECG on a long tape, cardiotopography, ECTG-60, ECG with isometric stress) Ultrasound (ultrasound examination) of the heart, vascular dopplerography, transesophageal Ultrasound (often necessary for rhythm disturbances to exclude the presence of blood clots in the cavities of the heart), ultrasound of the kidneys, adrenal glands, thyroid gland Daily monitoring of blood pressure and ECG (Holter monitoring) Stress tests (velergometry, treadmill test, information and pharmacological tests) Consultations of related specialists (endocrinologist, gynecologist, ophthalmologist, gastroenterologist, neurologist, nephrologist, etc.) Laboratory tests: biochemical blood test (glucose, electrolytes, lipid spectrum, cholesterol and other cardiac enzymes), determination of the level of certain hormones (thyroid gland, brain natriuretic peptide) .

Heartache

The most common reasons:

Coronary heart disease (CHD) Heart valve defects Neurocirculatory dystonia (NCD)

A special role should be given to the differential diagnosis of pain in diseases of the spine (osteochondrosis).

If spinal osteochondrosis is suspected, a consultation with a neurologist is required, who will determine the scope of necessary studies (CT, MRI, etc.)

High blood pressure

Rhythm disturbances, interruptions in heart function

What do clinical blood test indicators indicate?

In addition, you need to take into account that each laboratory has its own “standards” for a general (clinical) blood test, so it is better to ask your doctor all your questions.

So, a general (clinical) blood test shows:

the number of red blood cells, erythrocyte sedimentation rate (ESR), hemoglobin content, white blood cell count, leukocyte formula and other indicators, each of which we will dwell on in detail.

Red blood cells are also known as red blood cells. In humans, 1 mm³ of blood contains 4.5-5 million red blood cells. Red blood cells contain hemoglobin and carry oxygen and carbon dioxide. An increase in the number of red blood cells is a sign of diseases such as leukemia, chronic lung diseases, and congenital heart defects. Anemia (decreased number of red blood cells) can be caused by stress, increased physical activity, and fasting. If you cannot immediately determine the cause of the decrease in the number of red blood cells, then it is better to go to a hematologist and undergo additional examination.

Color index - its normal value for people of any age is 0.85-1.15. The blood color index is an indicator of the degree of saturation of red blood cells with hemoglobin and reflects the relationship between the number of red blood cells and hemoglobin in the blood. When its values differ from the norm, this generally indicates the presence of anemia. In this case, anemia is divided into:

Hypochromic - color index less than 0.85;

Hyperchromic - color index greater than 1.15.

However, anemia can also be normochromic - when the color indicator remains within the normal range.

Reticulocytes are young forms of red blood cells. Children have more of them, adults have less, because the formation and growth of the body has already been completed. An increase in the number of reticulocytes can be observed in anemia or malaria. A decrease in the number of reticulocytes or their absence is an unfavorable sign in anemia, indicating that the bone marrow has lost the ability to produce red blood cells.

The erythrocyte sedimentation rate (ESR) determines how quickly red blood cells settle in a test tube and separate from the blood plasma. In women, the ESR rate is slightly higher than in men; during pregnancy, the ESR increases. Normally, the ESR value in men does not exceed 10 mm/hour, and in women - 15 mm/hour. The ESR indicator may change depending on various factors, including due to various diseases.

Hemoglobin is a complex iron-containing protein found in red blood cells - erythrocytes - of animals and humans, capable of reversibly binding to oxygen, ensuring its transfer to tissues. The normal content of hemoglobin in human blood is considered to be: for men 130-170 g/l, for women 120-150 g/l; in children - 120-140 g/l. Blood hemoglobin is involved in the transport of oxygen and carbon dioxide and maintains pH balance. Therefore, determining hemoglobin is one of the most important tasks of a general blood test.

Leukocytes are the protectors of our body from foreign components. The blood of an adult contains an average of 4-9x10 9 leukocytes/l. White blood cells fight viruses and bacteria and cleanse the blood of dying cells. There are several types of leukocytes (monocytes, lymphocytes, etc.). The leukocyte formula allows you to calculate the content of these forms of leukocytes in the blood.

In women, a slight increase in leukocytes in the blood is also observed in the period before menstruation, in the second half of pregnancy and during childbirth.

Platelets - these cells are also called blood plates. They are the smallest blood cells. The main role of platelets is participation in blood clotting processes. In blood vessels, platelets can be located near the walls and in the bloodstream. At rest, platelets have a disc-shaped shape. If necessary, they become like a sphere and form special outgrowths (pseudopodia). With their help, blood platelets can stick to each other or stick to a damaged vascular wall.

An increase in the number of platelets in the blood (so-called thrombocytosis) occurs when:

Inflammatory processes (acute rheumatism, tuberculosis, ulcerative colitis);

Hemolytic anemia (when red blood cells are destroyed);

Conditions after removal of the spleen;

It is observed during treatment with corticosteroids;

Some rarer diseases.

A decrease in the number of platelets (thrombocytopenia) is observed in a number of hereditary diseases, but appears much more often in acquired diseases. The number of platelets decreases when:

Severe iron deficiency anemia;

Some bacterial and viral infections;

Diseases of the thyroid gland;

The use of a number of medications (vinblastine, chloramphenicol, sulfonamides, etc.);

Systemic lupus erythematosus.

Hematocrit is the percentage (as a percentage) of the total blood volume that is made up of red blood cells. Normally, this figure is -% for men and -% for women.

The volume of erythrocytes compared to plasma increases with:

Dehydration (dehydration), which occurs with toxicosis, diarrhea, vomiting;

Congenital heart defects, accompanied by insufficient oxygen supply to the tissues;

A person being in high altitude conditions;

Insufficiency of the adrenal cortex.

The volume of red blood cells relative to plasma decreases with blood thinning (hydremia) or with anemia.

Blood formula. The study of the leukocyte formula has important diagnostic value, showing characteristic changes in a number of diseases. But these data should always be assessed together with other indicators of the blood system and the general condition of the patient.

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.

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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.

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.

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 - bulging of the area, most often on the left;
elongation of the aorta, pathological bend, increased shadow contrast, areas;
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, symptoms on an ECG during a routine study are not very specific, especially in the initial stages: 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);
– riding a special bicycle;
– 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. is calculated by dividing the systolic pressure indicators - ankle by brachial. The norm at rest is from 1 to 1.3.

ABI measurement

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.

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:

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.