What tests does the cardiologist prescribe at the initial appointment? What can tests say about the heart? Dizziness, nausea, headache

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.

1. Lipidogram. This is a blood test taken from a vein in the morning on an empty stomach to check for high cholesterol levels.
2. Coagulogram. Needed to determine blood clotting time and identify problems such as blood clots.
3. 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.
4. 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.
5. 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.

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.

What are tests? Tests are a confirmation or exclusion of a particular disease about which an opinion was formed after a clinical examination of the patient. With their help, the doctor will find out what exactly is preventing your body from living and working normally, and what is the condition of its individual organs and systems.

So, what do these same tests say if there is pain in the heart area? The determination of enzymes contained inside cells is important in the diagnosis of diseases associated with myocardial damage. And depending on which and how many cells die, their values ​​will change.

Biochemical blood test indicators:

ALT (alanine aminotransferase): up to 68U/l, when assessing the level of this enzyme, it is worth considering that it is contained not only in the myocardium, but to a greater extent in the liver, therefore AST and ALT are always determined together, which helps in distinguishing between damage to the heart and liver. The timing of ALT increases is similar to AST.

AST (aspartate aminotransferase): up to 45U/l, this enzyme is found in large quantities in the myocardium, and its increase, in most cases, indicates damage to cardiomyocytes - the muscle cells of the heart; An increase in AST in the blood serum is observed in myocardial infarction (95-98%) cases within 6-12 hours from the onset of the disease. The maximum increase is observed on days 2-4, and on days 5-7 the enzyme level returns to normal. There is a clear relationship between AST numbers and the size of the focus of cardiac muscle necrosis. Therefore, if the necrosis is less than 5 mm in diameter, it is possible to maintain the level of this enzyme within normal limits, which also must be taken into account.

LDH (lactate dehydrogenase) and its constituent fractions: up to 250 U/l, is considered a specific marker for AMI; an increase in the activity of the LDH1 and LDH2 isoenzymes, even with normal levels of general LDH activity, indicates the presence of minor necrosis in the heart muscle. With AMI, its level increases quickly on days 2-4, and normalizes only on weeks 2-3. LDH levels provide valuable information about MI throughout the course of the disease. Other fractions LDH3 and LDH4 are enzymes of the lung tissue, LDH5 - liver enzymes.

CPK (creatine phosphokinase) and the fractions that make up this enzyme: up to 190 U/l, creatine phosphokinase - is considered a specific marker (especially an increase of more than 10 times) in acute myocardial infarction. It increases in the acute period (in the first 4-8 hours from the onset of the disease), much faster than the activity of the above enzymes and is a marker for early diagnosis of AMI, especially the CPK-MB isoenzyme. After 8-14 hours, the CPK value can reach its maximum value, and normalization can occur after 3-4 days. Also, the CPK value may increase with myocarditis;

Troponin test: up to 0.4 µg/l. Troponin is a specific contractile protein that is part of the structure of the heart muscle and skeletal muscles. This test is a diagnostic marker for suspected acute damage to myocardial cells and is one of the key results in diagnosing “acute myocardial infarction”;

Myoglobin: 12-92 µg/l. A protein in muscle tissue involved in the process of cell respiration. If it appears in the blood, it is regarded as a product of the breakdown of the muscle tissue of the heart or skeleton, with the appropriate clinic, it may indicate necrosis (necrosis) of the heart muscle tissue, therefore it is also considered a specific marker of this pathology.

The indicators of ALT, AST, CPK, CPK-MB, LDH, myoglobin and troponin test closely correlate with the size of the necrosis focus in the heart muscle, and therefore have not only diagnostic, but also prognostic significance.

Acid phosphatase: 67-167 nmol/(s·l), increases in activity in patients with severe, complicated MI, mainly transmural;

C-reactive protein (CRP): up to 0.5 mg/l, its detection indicates the presence of a pathological process in the body, in particular inflammatory or necrotic. It belongs to the so-called “acute phase” proteins. A sharply positive reaction to CRP indicates the severity of the inflammatory process.

Sialic acids: 2.0-2.36 mmol/l, the content of sialic acids may increase with endocarditis, MI;

Electrolytes, are mainly represented by K+ ions (normal 3.6 - 5.2 mmol/l), Na+ (normal 135 - 145 mmol/l), Cl- (normal 100 - 106 mmol/l), Ca2+ (normal 2.15 -2.5 mmol/l). An increased amount of potassium in the serum may be accompanied clinically by cardiac arrhythmia, which is confirmed by an ECG. Atrioventricular blockade of the conduction system of the heart may develop, the syndrome of premature excitation of the ventricles, ventricular fibrillation, and such a serious disorder as cardiac arrest may develop. Therefore, patients with heart rhythm disturbances need to monitor the content of K+ ions in the body. On the other hand, a decrease in potassium in the blood can also lead to adverse consequences in these patients - myocardial hyporeflexia. A decrease in the level of sodium ions may be accompanied by the development of cardiovascular system failure, since the ratio of K+ and Na+ ions, as regulators of processes in the cell, is in constant interaction and a decrease in one leads to an increase in the other ion. Hyperchloremia occurs in patients with kidney disease and may also lead to the development of cardiovascular disease;

Lipid spectrum, is associated by the common man with the word "cholesterol". In this case, substances (lipoproteins of various densities, triglycerides) that are involved in the metabolism of cholesterol (CH) are determined (the norm in the blood is 3.1 - 5.2 mmol/l). In addition to the value of total cholesterol, an important indicator is the atherogenicity coefficient (norm up to 4), which shows the ratio of “good” and bad lipids involved in the metabolism of fats and cholesterol, and the threat of development or progression of atherosclerosis and all the ensuing consequences. An increase in the fractions of lipoproteins and triglycerides can be either a physiological condition (of a nutritional nature) or a pathological condition. Increased lipids are characteristic of widespread atherosclerosis, obesity that accompanies and causes arterial hypertension. But it would be more accurate to say that this disruption of the functioning of internal organs and intermediate links in the metabolism of lipids and triglycerides, expressed in an increase in the atherogenicity index, causes the deposition of cholesterol in vessels of various diameters, the deposition of “spare fat,” which leads to the above diseases. Therefore, with widespread atherosclerosis, in this blood test, you can see increased values ​​of ß-lipoproteins and total cholesterol. At the same time, a decrease in phospholipid concentration can be seen. But it is also necessary to take into account that there are age-related fluctuations in blood fats.

Coagulogram- an analysis by which you can look at the “viscosity” of the blood, or in other words, whether there is a threat of blood clots, which can lead to the formation of blood clots with different localizations, which in turn can be complicated by pulmonary embolism, which causes instant death. Or, on the contrary, see how high the probability of bleeding is and whether it can stop on its own after surgery, for example, heart valve replacement.

Any analysis or research provides the doctor with additional information that helps to more accurately make a diagnosis, determine the stage of the disease, and prescribe treatment. Tests also help to monitor the course of the disease, the effectiveness of the prescribed treatment, and ensure the safety of therapy. But sometimes additional research is required to confirm or complement the results of past analyzes.

Fedorova Lyubov Alekseevna, doctor of the first category, therapist, cardiologist

What can they say laboratory tests for heart disease? Someone will say “nothing!”, and someone will say “a lot!” Each of the respondents will be right in their own way, both the one for whom the tests alone mean nothing, and the one for whom the data obtained mean everything! What are tests? This is only a laboratory explanation, or more precisely, confirmation of the thoughts of the doctor examining you about a particular disease, be it acute appendicitis, or an attack of angina. To a simple question from a patient - “What are my leukocytes?”, the doctor’s answer “10.1” can confuse you, since you know that with appendicitis, leukocytes are elevated, and 10.1x109 is higher than normal. In fact, this is what future doctors are taught at the university, first for six years, then for another year in internship, and then in advanced training courses, so that they also understand that tests are only a confirmation or exclusion of a particular disease about which an opinion has been formed after clinical examination of the patient.

All laboratory tests that are performed during pathologies of the cardiovascular system, namely in patients with heart disease, can probably be divided into different groups: studies that are done in a clinic and a hospital, a private medical center. The difference, in most cases, will be in volume and, most unpleasantly, in quality. The results in the clinics themselves may also differ: somewhere they do it using hardware, and somewhere they do it the old fashioned way, by eye, somewhere they do 2-3 indicators, somewhere 5-8, and somewhere - for your money, whatever your heart desires. Even in hospitals themselves, the range of laboratory tests performed may differ: in specialized cardiology centers and hospitals providing emergency care to patients with heart disease, as a rule, a complete list of laboratory items of interest is performed, necessary to clarify the diagnosis and determine further treatment tactics, while general hospitals will only standard set. And this is due not so much to the fact that the doctors of the worst qualifications work there, but to the fact that today laboratory diagnostics is a very expensive share of the budget of any hospital. And the faster this blood test can be done and of better quality, the less blood is taken and the more data can be obtained, the more expensive it will cost. Alas, this is the reality of modern technology!

Before talking about the test results, I would like to note and draw your attention once again that the results of laboratory tests themselves, without a characteristic clinical picture, without instrumental data, sometimes taken once, do not mean anything. But, if, nevertheless, you are interested in the numbers on a piece of paper with the inscription “blood test...”, then not everything is so bad, and it turns out that you care about your health! And we will try to help you understand these mysterious numbers! So, what do these same tests say if there is pain in the heart area?

General blood test indicators, common for men and women

erythrocyte sedimentation rate (ESR): 1 - 15 mm/h; in case of acute myocardial damage, it begins to increase, starting from the first three days, maintaining high values ​​for 3-4 weeks, rarely longer. At the same time, it is necessary to take into account its initial value, since in adults it is possible to increase ESR due to concomitant pathology. A return to normal indicates the end of nonspecific inflammation in the area affected by necrosis. As a result of the fact that ESR begins to increase during the first three days, remaining at this level in the future, and blood leukocytes at the end of the first week or from the beginning of the second tend to decrease, a kind of “scissors” is formed from these two indicators. An increase in ESR is also observed in acute pericarditis and cardiac aneurysm.

total white blood cell count: 4.0 - 9.0*109/l; in case of acute myocardial infarction (AMI), leukocytosis (up to 15-20*109/l) may be observed by the end of the first day. At the same time, some authors point to parallels between the level of leukocytes and the extent of necrosis of the heart muscle. And at the same time, leukocytosis may be absent in an areactive state and in elderly people. An increase in the level of leukocytes can be observed in acute pericarditis and cardiac aneurysm.

total red blood cell count: 4.5*1012/l; As a rule, with a decrease in red blood cells and hemoglobin, patients with chronic heart diseases develop cardiac complaints: chest pain, tingling, tightness.

hemoglobin level: 120 - 160g/l; reflects the saturation of red blood cells with a special protein - hemoglobin, which binds oxygen and participates in its transfer to tissues. With low hemoglobin levels, tissues, including the myocardium, experience oxygen “starvation”, against which ischemia develops, often, under existing conditions, leading to myocardial infarction (MI).

hematocrit 0.36 - 0.48; Based on this and the two indicators listed above, the degree of anemia can be determined. In case of acute anemia, a history of an aneurysm of the heart or aorta and the availability of an appropriate clinic, one can think about rupture of this same aneurysm and bleeding. This is confirmed by performing an ECG, EchoCG;

platelets: 180 - 320*109/l; blood cells that are involved in stopping bleeding. An excessive amount of them can lead to blockage of small vessels due to the formation of blood clots, or, in combination with disorders of the blood coagulation system, to the formation of large blood clots, which can lead to more serious consequences, such as pulmonary embolism. A reduced amount is accompanied by increased bleeding;

« Blood formula", which indicates the relative ratio of other formed blood cells: plasma cells, young forms of leukocytes, basophils, myelocytes, band and segmented leukocytes, and also includes eosinophils, monocytes, lymphocytes. This formula, most often, is an indicator of the inflammatory process and the degree of its severity, or, as another option, blood disease. And on its basis, various intoxication indices (LII, GPI) can be calculated. In acute myocardial infarction, by the end of the first day there may be neutrophilia with a shift to the left. Eosinophils in AMI may decrease until they disappear, but then, as the myocardium regenerates, their number increases in the peripheral blood. An increase in neutrophils is also observed in acute pericarditis.

Biochemical blood test indicators

total protein: 65-85g/l, an indicator of the content of all proteins in the blood, a more detailed ratio of individual proteins that help in the diagnosis of heart disease is determined in the proteinogram;

bilirubin: 8.6-20.5 mkol/l, one of the indicators of liver function, in particular, pigment metabolism, and specifically for cardiac pathology, in its pure form, does not provide information for diseases of the cardiovascular system;

urea: 2.5-8.3 mmol/l, in most cases shows kidney function, and is always considered in combination with the following indicator - creatinine;

creatinine: 44-106 µmol/l, a product of protein metabolism, depends not only on the amount of protein in the body, but also on the speed of its metabolic processes;

The determination of enzymes contained inside cells is important in the diagnosis of diseases associated with myocardial damage. And depending on which and how many cells die, their values ​​will change:

ALT (alanine aminotransferase): up to 68U/l, when assessing the level of this enzyme, it is worth considering that it is contained not only in the myocardium, but to a greater extent in the liver, therefore AST and ALT are always determined together, which helps in distinguishing between damage to the heart and liver. The timing of ALT increases is similar to AST.

AST (aspartate aminotransferase): up to 45E/l, this enzyme is found in large quantities in the myocardium, and its increase, in most cases, indicates damage to cardiomyocytes - the muscle cells of the heart; An increase in AST in the blood serum is observed in myocardial infarction (95-98%) cases within 6-12 hours from the onset of the disease. The maximum increase is observed on days 2-4, and on days 5-7 the enzyme level returns to normal. There is a clear relationship between AST numbers and the size of the focus of cardiac muscle necrosis. Therefore, if the necrosis is less than 5 mm in diameter, it is possible to maintain the level of this enzyme within normal limits, which also must be taken into account.

LDH (lactate dehydrogenase) and the fractions that make up this indicator: up to 250 U/l, is considered a specific marker for AMI, an increase in the activity of the LDH1 and LDH2 isoenzymes, even with normal levels of general LDH activity, indicates the presence of minor necrosis in the heart muscle. With AMI, its level increases quickly on days 2-4, and normalizes only on weeks 2-3. LDH levels provide valuable information about MI throughout the course of the disease. Other fractions LDH3 and LDH4 are enzymes of the lung tissue, LDH5 - liver enzymes.

CPK (creatine phosphokinase) and the fractions that make up this enzyme: up to 190 U/l, creatine phosphokinase - is considered a specific marker (especially an increase of more than 10 times) in acute myocardial infarction. It increases in the acute period (in the first 4-8 hours from the onset of the disease), much faster than the activity of the above enzymes and is a marker for early diagnosis of AMI, especially the CPK-MB isoenzyme. After 8-14 hours, the CPK value can reach its maximum value, and normalization can occur after 3-4 days. Also, the CPK value may increase with myocarditis;

troponin test: up to 0.4 µg/l. Troponin is a specific contractile protein that is part of the structure of the heart muscle and skeletal muscles. This test is a diagnostic marker for suspected acute damage to myocardial cells and is one of the key results in diagnosing “acute myocardial infarction”;

myoglobin: 12-92 µg/l. A protein in muscle tissue involved in the process of cell respiration. If it appears in the blood, it is regarded as a product of the breakdown of the muscle tissue of the heart or skeleton, with the appropriate clinic, it may indicate necrosis (necrosis) of the heart muscle tissue, therefore it is also considered a specific marker of this pathology. Already 2-4 hours after the onset of the disease, its concentration increases. The maximum concentration of myoglobin in the blood reaches 6-8 hours of AMI. Normalization of its level occurs after 20-40 hours. Based on the degree and duration of its elevated level, one can judge the size of necrosis and the prognosis.
The indicators of ALT, AST, CPK, CPK-MB, LDH, myoglobin and troponin test closely correlate with the size of the necrosis focus in the heart muscle, and therefore have not only diagnostic, but also prognostic significance.

Acid phosphatase: 67-167 nmol/(s·l), increases in activity in patients with severe, complicated MI, mainly transmural;

C-reactive protein (CRP): up to 0.5 mg/l, its detection indicates the presence of a pathological process in the body, in particular inflammatory or necrotic. It belongs to the so-called “acute phase” proteins. A sharply positive reaction to CRP indicates the severity of the inflammatory process.

sialic acids: 2.0-2.36 mmol/l, the content of sialic acids may increase with endocarditis, MI;

electrolytes, are mainly represented by K+ ions (normal 3.6 - 5.2 mmol/l), Na+ (normal 135 - 145 mmol/l), Cl- (normal 100 - 106 mmol/l), Ca2+ (normal 2.15 -2.5 mmol/l). An increased amount of potassium in the serum may be accompanied clinically by cardiac arrhythmia, which is confirmed by an ECG. Atrioventricular blockade of the conduction system of the heart may develop, the syndrome of premature excitation of the ventricles, ventricular fibrillation, and such a serious disorder as cardiac arrest may develop. Therefore, patients with heart rhythm disturbances need to monitor the content of K+ ions in the body. On the other hand, a decrease in potassium in the blood can also lead to adverse consequences in these patients - myocardial hyporeflexia. A decrease in the level of sodium ions may be accompanied by the development of cardiovascular system failure, since the ratio of K+ and Na+ ions, as regulators of processes in the cell, is in constant interaction and a decrease in one leads to an increase in the other ion. Hyperchloremia occurs in patients with kidney disease and may also lead to the development of cardiovascular disease;

serum glucose: 3.3 - 5.5 mmol/l, excess glucose levels, repeated in several tests, may indicate the development of diabetes mellitus (DM). The result of another analysis - glycosylated hemoglobin (HbA1c), allows us to assess the degree of compensation of carbohydrate metabolism in the patient over the past 3 months. This is important because in the case of initially diagnosed diabetes, 11% of people already have damage to the conduction system of the heart. And many patients don’t even know about it. Another complication of diabetes is damage to vessels not only of the main type, but also small ones that directly bring nutrients to the tissues. In this regard, patients with high blood sugar need to undergo additional instrumental examination, primarily electrocardiography and ultrasound examination of the arteries of the legs.

indicators of ASB (acid-base balance) have an indirect effect on the state of the cardiovascular system due to changes in homeostasis and are important, first of all, for specialists to correct the prescribed treatment;

proteinogram profile, is a spectrum of various proteins (albumin, α1, α2, ß, γ-globulins, albumin-globulin index) that are part of the blood, and under various conditions (acute myocardial injury, inflammation, burns, cancer, etc.) , their ratio may change, even a pathological protein - paraprotein - will appear. Thus, an increase in α1 and α2-globulins occurs in patients with extensive myocardial infarction.

An increase in the amount of γ-globulin may be associated with excessive accumulation of cardiac antibodies in the body and precede the occurrence of post-infarction syndrome (Dressler syndrome). A long-term high content of α2-globulins (for a month) indicates a weak intensity of reparative processes in the necrosis zone, which causes a protracted course of MI and aggravates the prognosis of the disease.

lipid spectrum, is associated by the common man with the word “cholesterol”. In this case, substances (lipoproteins of various densities, triglycerides) that are involved in the metabolism of cholesterol (CH) are determined (the norm in the blood is 3.1 - 5.2 mmol/l). The number of deaths from coronary heart disease in recent years has increased from 5:1000 people with a total cholesterol level of 5.2 mmol/l, with 6.2-6.5 mmol/l - 9:1000 people, and 17:1000 with 7 .8 mmol/l. In addition to the value of total cholesterol, an important indicator is the atherogenicity coefficient (norm up to 4), which shows the ratio of “good” and bad” lipids involved in the metabolism of fats and cholesterol, and the threat of development or progression of atherosclerosis and all the ensuing consequences. An increase in the fractions of lipoproteins and triglycerides can be either a physiological condition (of a nutritional nature) or a pathological condition. Increased lipids are characteristic of widespread atherosclerosis, obesity that accompanies and causes arterial hypertension. But it would be more accurate to say that this disruption of the functioning of internal organs and intermediate links in the metabolism of lipids and triglycerides, expressed in an increase in the atherogenicity index, causes the deposition of cholesterol in vessels of various diameters, the deposition of “spare fat,” which leads to the above diseases. Therefore, with widespread atherosclerosis, in this blood test, you can see increased values ​​of ß-lipoproteins and total cholesterol. At the same time, a decrease in phospholipid concentration can be seen. But it is also necessary to take into account that there are age-related fluctuations in blood fats. Thus, in elderly men, the level of total cholesterol, triglycerides, and ß-lipoproteins is increased compared to those in middle age, but in old men, on the contrary, they decrease.

coagulogram- an analysis by which you can look at the “viscosity” of the blood, or in other words, whether there is a threat of blood clots, which can lead to the formation of blood clots with different localizations, which in turn can be complicated by pulmonary embolism, which causes instant death. Or, on the contrary, see how high the probability of bleeding is and whether it can stop on its own after surgery, for example, heart valve replacement.

Thus, if you look, there is a need for almost everyone seeking medical help to perform, at a certain frequency, especially with chest pain, at least an ECG, on which heart disease will be suspected or determined, which will be confirmed after taking blood tests and their final confirmation. A good option for monitoring heart function is the Cardiovisor device, as it allows you to monitor the work of the heart at home and inform a person in advance about impending pathological changes in the functioning of the cardiovascular system. Thanks to the service, an impending pathology in the heart will be noticed in advance, which helps prevent complications that often do not go away without consequences for human health. Additionally, in terms of heart examination, it is possible to perform Echocardiography, AngioCT, angiography, radionuclide stress test (thallium examination), and functional tests.

But I would like to repeat it again, if you sometimes look at your tests, you can see so many diseases in yourself! But if we compare them with the clinical picture and data from instrumental studies, it turns out that perhaps this is just a variant of the norm...

Rostislav Zhadeiko, especially for the project.

To the list of publications

For cardiovascular diseases, this analysis provides a lot of important information.

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 (infectious 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. They, on the contrary, 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.