How to check heart function with tests. What can tests say about the heart? Other Important Aspects
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 condition of cardio-vascular 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 diseases connective tissue, which can also be accompanied by cardiac disorders.
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 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 for more later, so myoglobin assessment 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). Strong increase 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 guidelines, it should be less than 4.5 mmol/l, although previously they talked about normal values 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 in 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) is used as a diagnostic criterion for myocardial infarction and unstable angina. normal level which is 0-171 U/l. 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 thing is to determine the level of potassium, which is normally 3.5-5.5 mmol/l. In cardiovascular diseases, it may decrease, for example, due to long-term use some diuretics, which help remove this electrolyte from the body.
My heart hurts, what tests should I take?
Hemostasiological studies. This complex tests are aimed at studying the blood coagulation system.
Biochemical blood test given to the doctor additional information about the work 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 become the 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, ears indicates the presence cardiopulmonary failure.
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 research: 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:
reduced level 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. ESR norm for men - 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 muscle cells heart, 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 breakdown muscle tissue heart or skeleton. 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) leads to heart rhythm disturbances, possible development ventricular excitation and 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 doesn't mean going to the gym every day, but... initial stage Walking, increasing the distance every few days, will suffice.
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. Vascular thrombosis, for example, is fought by acids contained in oily fish, walnuts and almonds.
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
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 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 progression of the disease and prevent dangerous complications. An important role in stabilizing the condition is played by the right image life: weight loss, low-salt diet, limiting physical and emotional stress.
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 on exertion, when going into horizontal position, and then at rest; dizziness, fatigue and weakness; lack of appetite and nausea; swelling of the legs; accumulation of fluid in 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. Most common reasons: 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.
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.
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 a result of rheumatic lesions heart 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 exclusion diabetes mellitus as one of the risk factors for heart failure. Cholesterol. high and low density lipoproteins. There is a clear relationship between increased level cholesterol and the development of atherosclerosis, coronary heart disease, hypertension. High level cholesterol and lipoproteins in heart failure may indicate more severe course diseases. 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 for outpatient stage 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 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 ( ultrasonography) 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 monitoring of blood pressure and ECG (Holter monitoring) Stress tests (velergometry, 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 must be given differential diagnosis pain due to diseases of the spine (osteochondrosis).
An important role in the survey is played by 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 artificial circulation or on a beating heart).
If spinal osteochondrosis is suspected, a consultation with a neurologist is required, who will determine the volume necessary research(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.) Deserves special attention endocrine causes increased blood pressure, especially in women over 45 years of age.
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 performing blood sampling 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:
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.
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 with acute poisoning when due 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); with loss of fluid 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 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. ESR indicator may vary 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 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.
Low hemoglobin (anemia) can be the result of large blood loss; a decrease in hemoglobin occurs with a lack of iron, required material for the construction of hemoglobin. Also low hemoglobin(anemia) is a consequence of blood diseases and many chronic diseases, not related to 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 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 a blood test finds leukocytes in increased quantity, then this may indicate 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, lung, kidney or spleen infarction, 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 can be shown by a blood test, may be evidence of viral and bacterial infections (flu, typhoid fever, viral hepatitis, sepsis, measles, malaria, rubella, parotitis, AIDS), rheumatoid arthritis, renal failure, radiation sickness, some forms of leukemia, diseases bone marrow, 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);
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.
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. Study 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 observed: total number 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.
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 failure.
ULTRASOUND DIAGNOSTICS
Electrocardiography (ECG) is a mandatory method for examining the heart. An ECG allows you to get an idea of the frequency and regularity of the heart rhythm, the presence of arrhythmias, as well as the sufficiency or deficiency of blood supply to the heart muscle (myocardium).
Holter ECG monitoring is a method of daily ECG recording using a special device - a recorder, which the patient wears for 22-24 hours, without being in the hospital. The method is used for in-depth analysis of arrhythmias and detection of episodes of myocardial ischemia.
Daily blood pressure monitoring (ABPM) is a method of daily recording of blood pressure using an automatic computerized tonometer. The study is carried out in everyday life and makes it possible to judge the presence or absence of arterial hypertension in the patient, as well as the adequacy of the therapy.
Echocardiography (ECHOCG or ultrasound of the heart) - determines the size of the cavities and the thickness of the walls of the heart, evaluates the functioning of the valve apparatus, identifies disorders of contractile and relaxation functions, and characterizes the movement of blood flows inside the heart.
Allows you to diagnose coronary heart disease, angina pectoris, myocardial infarction, diseases of the muscular and outer membranes of the heart. And also for the purposes preventive examination, since the method makes it possible to identify disorders of the heart at the most early stages.
Indications for echocardiography can be varied: pain in the heart area, changes in the electrocardiogram, heart murmurs, cardiac arrhythmias, hypertonic disease, birth defects heart, signs of heart failure, etc.
Stress echocardiography (stress echocardiography) is a highly informative study that allows you to obtain not only electrocardiographic signs of myocardial ischemia, but also to evaluate disorders of the contractile function of the heart, changes in intracardiac hemodynamics after exercise (physical or medicinal).
Vascular Doppler ultrasound (USDG) is used to detect blood flow disorders in vessels. The ultrasound examination is carried out on the vessels of the head, neck, lower and lower veins. upper limbs.
The examination is informative for both venous and arterial circulatory systems. Using ultrasound, you can study the nature of blood flow in the vessels, its disturbances caused by atherosclerotic plaques, blood clots and inflammation.
Results obtained using Doppler ultrasound, allow you to successfully treat heart disease and neurological diseases.
A visit to a phlebologist or angiologist should not be delayed if the venous pattern in the legs becomes more and more pronounced, and in the evening the legs swell, and a feeling of fatigue and heaviness in the legs lower limbs give no rest.
As a rule, the doctor begins the appointment by identifying visual signs of changes skin. But in order to make an accurate diagnosis, it is important to have information about the condition of the connective tissue and deep saphenous veins and their valves.
Let's not repeat about duplex ultrasound scanning, which is universal method examination of blood vessels, when there are also specific methods for examining the veins of the lower extremities.
There are many functional tests that do not have precise information content, but make it possible at a certain stage of the disease to determine the degree of patency of the deep veins. So, for example, during the Delbe-Perthes marching test, when the superficial veins are full, a tourniquet is applied to the upper thigh and asked to walk for 10 minutes.
With good patency, the superficial veins subside within a minute.
Phlebography
More accurate information can be obtained by examining the veins using radiography (phlebography, venography) with the introduction of a contrast agent. This process is quite labor-intensive, since the x-ray is taken in different projections. The patient must change body position, then hold his breath, then exhale in time.
Functional-dynamic phlebomanometry
This method provides more accurate information, since venous pressure is measured under various physical activities. At rest, in vertical position, venous pressure in the legs cannot exceed hydrostatic pressure.
But to detect damaged valves, you should still turn to an ultrasonic Doppler detector. According to the ultrasonic wave, the sensor produces various sounds.
Several research modes are used to assess the vein diameter, lumen, and presence of a valve. Quite often, doctors use a two-color Doppler analyzer to diagnose venous enlargement, which highlights the veins blue, and the arteries are red, but it is considered ineffective.
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.
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 (the norm for men is 130-160 g/l, for women - 120-140 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.
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.
Indications for testing
To reveal congenital pathologies heart vessels, coronary angiography of the heart vessels is indicated. If bypass surgery is prescribed, then using the technique in question, the doctor determines the area for future operations.
Indications for cardiac coronary angiography are as follows:
- manifestation of symptoms of narrowing of the blood vessels of the heart;
- ineffective drug therapy;
- valve replacement;
- surgical intervention on an open heart;
- heart failure;
- serious chest injury.
If pain syndrome spread to the stomach, back and neck, then cardiography is performed. It is recommended to have a cardiogram done during a preventive examination during pregnancy. Cardiography, unlike coronary angiography, allows you to identify hidden heart rhythm disturbances. Using these techniques, the doctor detects vascular coronation and infarction.
How is a cardiogram done? First, the patient takes a lying position. A specialist attaches electrodes to the arms, legs and chest. Then the heart function is recorded. The examination lasts 5-10 minutes. A cardiologist or therapist analyzes the patient’s condition.
This type of examination is often prescribed for children. But the normal value of their cardiogram indicators differs from those of adults. In children under one year of age, fluctuations in heart rate depend on their lifestyle. Cardiography at the age of 1-6 years displays the normal, vertical or horizontal location of the EOS. From 7-15 years of age, the position of the EOS is normal or vertical.
Coronary angiography of the heart vessels is contraindicated in the following cases:
- for pathologies of the circulatory system, lungs, kidneys;
- if the patient experiences bleeding or high body temperature;
- with diabetes mellitus.
Older people should know what coronary angiography is and how it is performed. They can undergo such examination only after consultation with a doctor. After coronary angiography of the heart, the following complications may occur:
- heart attack;
- rupture of an artery or heart;
- heart attack or stroke;
- arrhythmia;
- kidney damage;
- profuse bleeding.
How is coronary angiography done? Before the procedure you will need the following:
- pass biochemical and clinical tests;
- undergo a coagulogram;
- identify blood group;
- determine the Rh factor.
Checking the heart vessels requires a preliminary complete examination of the patient:
- electrocardiogram;
- chest x-ray.
Preparing the patient for the examination includes the following:
- refusal to eat and drink 12 hours before the test;
- emptying the bladder;
- It is recommended to remove jewelry and contact lenses before the examination.
There are no characteristic signs of vascular damage. Arteries and veins are connected to various organs, and when there is a disruption in the blood flow, they affect “their” organ. Therefore, the disease acquires symptoms characteristic of the pathology of this organ, which, of course, complicates diagnosis.
The most common indications for vascular examination are the following conditions:
- Anomalous arterial pressure.
- Increased intracranial pressure.
- Any traumatic brain injury.
- Migraines and headaches, the cause of which is unknown.
- Brain tumors.
- Preparing for heart surgery.
- Any signs of ischemia.
- Varicose veins.
- Swelling and heaviness of the limbs, chilliness, convulsions.
- Risk factors: smoking, overweight, diabetes and the like.
Various heart and vascular diseases are the most common cause of death in all countries of the world, even oncological diseases are not yet ahead of them in this sad ranking.
A lot of time and attention to various sources and professional medicine They focus on cancer prevention; there are even vaccines against certain tumors.
And the main problem of modern humanity - diseases of the cardiovascular system - do not receive the necessary level of attention, and their prevention especially suffers.
In order to start treatment on time, every person should know the signs of diseases of the cardiovascular system and seek treatment on time. medical care when they occur.
Basic examination methods at home and careful attention to your well-being will help you see a doctor in time and begin treatment.
Main symptoms
Delay in seeking medical help when problems with the heart and blood vessels occur is due to the fact that the symptoms for most of these diseases are vague, they are confused with diseases of the stomach, lungs, or are not paid attention to them at all.
Even if a person understands that he has problems with the heart and blood vessels, he turns to a pharmacy for help, where they sell him whatever they want, best case scenario the symptoms go away, but the cause remains and the disease progresses.
We list the main alarming signs, the appearance of which requires consultation with a cardiologist and additional examination methods:
Shortness of breath or feeling of lack of oxygen.
The appearance of shortness of breath when running or any other physical activity is normal. physiological mechanism, which allows you to provide the body with oxygen when there is an increased need for it.
In diseases of the heart and blood vessels, a feeling of lack of air and rapid breathing appears in situations that previously did not require this; in other words, shortness of breath appears during moderate physical activity. In cases of severe heart failure, shortness of breath appears at rest and with little physical activity.
Attacks of shortness of breath at night.
When the body position changes from horizontal to vertical, such attacks decrease or disappear altogether. As a result, a person begins to gradually increase the size and number of pillows, and eventually begins to sleep while sitting.
Few people understand that this problem is associated with heart failure; usually such patients are brought by ambulance with a suspected attack of bronchial asthma or lung diseases. Indeed, these attacks can be called asthma attacks, only cardiac ones. This is how acute left ventricular failure manifests itself.
The appearance of edema.
There are many reasons for their appearance. Edema associated with heart disease first appears on the legs in the evening and gradually rises from bottom to top.
Patients often turn to doctors for help when swelling appears in women on the anterior wall of the abdomen, and in men in the scrotum area. It is clear that the appearance of edema in such volumes is associated with a severe form of heart failure and such patients are treated with great difficulty.
Pain in the chest area.
Real heart pain, described in classical literature as attacks of “angina pectoris”, can be called pain at a stretch; these sensations are more reminiscent of heaviness, squeezing behind the sternum.
They occur only during physical activity, go away after 5 minutes at rest, or disappear immediately after taking nitroglycerin under the tongue. Angina pectoris progresses over time, pain appears with less physical activity, and may eventually appear at rest. The disease appears when the heart vessels fail to cope, and a lack of oxygen occurs in the heart.
Pain in the heart area.
With vegetative-vascular dystonia they can be different. People are often very bothered by stabbing pains in the heart area, which as a result turn out to be osteochondrosis or other diseases of the spine. you need to pay attention to increased pain in chest when turning and bending the body. Heart pain is not associated with body movements.
Headaches, nausea, spots flashing before the eyes, tinnitus.
All these complaints are characteristic of arterial hypertension. Increased blood pressure very often appears in people after 50 years of age and often goes unnoticed and is discovered during the manifestation of complications.
Therefore, all people, especially those with a hereditary predisposition, need to control their blood pressure levels starting at age 40.
Rhythm disturbances.
Feelings of irregular heartbeat are a reason to consult a cardiologist. In accordance with modern recommendations for the treatment of such conditions, drug therapy is used in all patients who experience interruptions in the functioning of the heart.
Important! In addition to irregular heartbeats, you should see a doctor if your resting heart rate is above 90 beats per minute or below 60 beats per minute.
How to check your heart function at home?
All people over 40 years of age, regardless of the presence of the above symptoms, need to monitor blood pressure levels, pulse rate and regularity.
Any affordable device is suitable for measuring blood pressure. Blood pressure must be measured while sitting, at rest, on both arms and only on the shoulder. If you have recorded pressure several times higher or lower than 110/70 – 140/90, you need to contact a cardiologist.
It is not difficult to measure your pulse at home; you must adhere to the following rules: measure at rest for 60 seconds. This will also help to detect irregular heartbeats, if any. In some cases, rhythm disturbances cannot be determined by the pulse. Some blood pressure measuring devices are also equipped with a pulse counting option.
What tests will help detect problems?
If you find the above complaints in yourself, or record changes in blood pressure or pulse, you need to contact a cardiologist to make an accurate diagnosis. The doctor will prescribe additional tests that will help make an accurate diagnosis.
A mandatory test that everyone needs is an electrocardiogram. It can be used to determine problems with rhythm, disturbances in the conduction of impulses in the heart and insufficient blood supply to the heart muscle. If there are long-standing problems that have led to changes in the size of the heart muscle, then this can also be detected during the study.
The most informative method is ultrasound of the heart; during the study, large vessels and changes in them are also clearly visible. With the help of this study, it is possible to determine almost all heart diseases: the exact dimensions of all sections and cavities, blood supply disorders in certain areas, the condition of the heart valves and large vessels.
If there are blood clots in the heart cavity, this will also be visible during the study.
To clarify a diagnosis such as coronary heart disease and determine the functional class of angina, bicycle ergometry is used. During physical activity on an exercise bike, an electrocardiogram is recorded; if the subject has angina, then changes in the heart will be recorded during pain.
A study such as Holter monitoring is an ECG recording over a 24-hour period.
When decrypting daily ECG changes during physical activity can be determined and compared with the sensations of the subject; all changes in the state of health are recorded in a diary indicating the exact time of occurrence of the sensations.
This study is of particular value for determining rhythm disturbances, especially such as extrasystole or paroxysmal forms of atrial fibrillation.
There are no specific characteristic changes in blood tests for diseases of the cardiovascular system. There may be changes in blood tests for cholesterol and in the coagulation system. There are markers that can be used to determine the acute stage of myocardial infarction.
However, the presence of all these changes, both in analyzes and in examination data, does not necessarily mean a disease. All these studies can only be used as additional data and assessed in conjunction with complaints and medical history by a cardiologist.
The table shows some clinics in Moscow and St. Petersburg where you can check the heart and blood vessels, and the price for an electrocardiographic study of the heart is indicated.
| Clinic name | City | Address | Phone in Moscow 8 (499) | Price, rub. |
|---|---|---|---|---|
| Open Clinic | Moscow | st. Partizanskaya house 41 | 969-24-06 | 1200 |
| Asteri-honey | Moscow | Shokalsky passage, house 39, Stolyarny lane, 3/3, st. Velozavodskaya, 13, building 2 | 519-31-50 | 1050 |
| Medicine + | Moscow | Volgogradsky pr, 4A | 519-39-71 | 600 |
| Nouvelle clinic | Moscow | Second Vladimirskaya, house 15, bldg. 4 | 519-39-98 | 1350 |
| Madikan | Moscow | Pskovskaya, house 5, building 1 | 519-39-82 | 1000 |
| ProMedicine | Moscow | Krasnoprudnaya, 13 | 519-39-54 | 1000 |
| American Medical Clinic | Saint Petersburg | Moika embankment, 78 | 740-20-90 | 1100 |
| Madis | Saint Petersburg | Fifth Sovetskaya, 23 | 337-24-82 | 650 |
| Amedaklinic | Saint Petersburg | Kovensky Lane, 5-B | 336-63-75 | 850 |
| Preventive clinic | Saint Petersburg | Engelsa, 50 | 293-22-76 | 800 |
| Guide clinic | Saint Petersburg | Nauki Avenue 17, bldg. 6 | 944-31-49 | 500 |
| UMC | Saint Petersburg | Dibunovskaya, 50 | 640-28-68 | 550 |
Considering all of the above, if you decide to check the heart and blood vessels, determine the presence serious illnesses yourself, you will be able to detect various symptoms, both directly related to diseases of the cardiovascular system, and reminiscent of heart disease. Only a doctor can make an accurate diagnosis, much less prescribe the necessary treatment.
In diagnostics cardiovascular diseases play an important role timely diagnosis. Often it is enough to conduct a standard ECG to make the correct diagnosis. In other cases, a diverse examination of the heart is required, which makes it possible to establish the exact cause of the disease and carry out effective treatment.
Heart examinations help identify various levels of cardiovascular disease. If previously only physical examination was used, today the most different methods research and advanced technologies.
Timely examination of the heart can reduce the risk of developing cardiovascular disease, a group of which ranks first among the leading causes of mortality.
Every patient admitted to the cardiology department or visiting a doctor at the clinic due to heart disease undergoes a standard set of tests. If after this it is not possible to establish the root cause of the pathology, then narrowly targeted diagnostic methods are used.
Video Is your heart worried? Where to start the examination?
Primary examination of the patient's heart
The very first method of diagnosing a patient with cardiovascular pathology is a physical examination at the first appointment with a doctor. First, an examination is carried out to identify visual changes (edema, cyanosis, pulsation in the neck). Afterwards, using tapping, the doctor determines the boundaries of the heart, which change in pathological cases.
Auscultation of the heart is an important method of physical examination, with the help of which pathological rhythms and noises and the severity of heart sounds are determined.
A phonendoscope is used to perform auscultation. The same instrument, in combination with a tonometer, measures blood pressure. In the process of listening to heart tones, their sound and order are studied. In the normal state, two constant tones are heard, the first and second. With a particular pathology, additional, as well as third and fourth tones may be detected.
Video Basic physical methods for examining the heart
Instrumental diagnostic methods
Advanced technologies today make it possible to conduct the most complex and previously inaccessible research. This is extremely important for prescribing the correct treatment, since an accurate diagnosis is the key to effective therapy. As a rule, they start with standard methods - electrocardiography, ultrasound of the heart. If necessary, the examination is supplemented with an electrophysiological study, MRI, CT, and angiocardiography.
Often used instrumental methods diagnostics:
- Electrocardiography.
- Echocardiography.
- Angiocardiography.
Some of the listed methods are painless techniques, while others, on the contrary, relate to invasive diagnostics. But without exception, all are carried out using special equipment, which, to a greater or lesser extent, affects the human body.
Electrocardiography
It is a valuable research method in cardiology, with which most cardiovascular diseases are diagnosed. The electrocardiogram was first recorded by Willem Einthoven, who developed a string galvanometer, which in the 20th century recorded almost the same ECG as is done today. The same researcher developed a designation system for the resulting teeth, which is still widely used.
The electrical activity of the heart is recorded using an electrocardiograph, which today uses thermal paper for recording. If the device is completely electronic, then the received data can be stored in a computer.
Electrical indicators are determined using electrodes, which show the potential difference in the form of teeth on an electrocardiograph. To obtain them, standard leads (I, II and III) are used, which, in accordance with the charges, are superimposed on right hand And left leg(+) and left hand(-). Also recorded are enhanced leads, designated as aVR, aVL, aVF, which are taken from the limbs. In addition to these six leads, unipolar leads are recorded chest leads, from V1 to V9, but most often defined as V1-V6.
An ECG allows you to determine:
- scar changes;
- disturbance of blood supply;
- dystrophic manifestations;
- signs of myocardial infarction;
- indications of rhythm disturbance.
A standard ECG does not always make it possible to accurately determine pathological changes in the heart, therefore, if necessary, other studies based on electrocardiography are used:
- Daily ECG monitoring - detects mild cardiac arrhythmias that are difficult to detect using a standard ECG. The patient is required to wear a portable electrocardiograph for 24 hours to 5-7 days, which records the activity of the heart, after which the doctor analyzes the data obtained.
- ECG mapping, or precordial mapping - when used large quantity Long-term examination of the electrodes is carried out, as a result of which even the most severe and difficult to diagnose diseases can be successfully identified. All information received by the device is processed by a computer, so the results obtained are highly accurate.
- Load tests (bicycle ergometry, treadmill test) - are performed to determine heart lesions that are not normally detected. When performing physical activity, favorable conditions are often created for the occurrence of arrhythmia or another disorder of the heart. In particular, with the help of bicycle ergometry, angina pectoris, coronary heart disease, etc. are determined. With repeated examination, it is possible to find out tolerance to physical activity, the effectiveness of previous treatment, and prognostic value.
- Intraesophageal electrocardiography - an active electrode is inserted into the esophagus, which is brought as close as possible to the heart. Using this method, it is possible to assess the performance of the atrioventricular connection and the atria. Often used at the diagnostic stage various types rhythm disturbances, especially heart block.
- Vectorcardiography - when using a projection graph, a three-dimensional figure is built that reflects the electrical activity of the heart. If there is a rhythm disturbance, corresponding changes in the vector of cardiac activity are recorded.
- Gastrocardiomonitoring is a method of simultaneous study of the electrical activity of the heart and acidity in the stomach and esophagus. The method of implementation is similar to non-Holter monitoring, only throughout the day not only an electrocardiogram is recorded, but also pH-metry. The examination is often used in the diagnosis of gastrointestinal and cardiovascular diseases.
Electrocardiography is one of the safest and easiest to perform research methods. It is available at any level of medical care, so if possible and desired, you can get quite a lot of reliable information about the condition of the heart.
Video Methods for studying the heart. ECG and FCG
Echocardiography
This method is better known as ultrasound, or ultrasound of the heart. The operating principle of the study is based on capturing signals that were reflected from various structures of the heart. Depending on the acoustic density, the signal is perceived differently, but in the end the corresponding image is formed.
Used to identify organic lesions heart, congenital and acquired defects, as well as to assess the functionality of the myocardium. It is considered the method of choice when examining people with complaints of weakness, dizziness, heart pain, loss of consciousness, and rapid heartbeat.
A number of modified heart examinations have been created based on ultrasound:
- Doppler echocardiography - the ultrasound monitor shows intracardiac blood flow, which allows you to see heart defects, pathological shunts and chords, and assess the hemodynamics of the heart.
- One-dimensional echocardiography allows you to see the heart in one plane. Quite a rough diagnosis, which is used to obtain the size of an organ and the thickness of its walls. Data are also obtained on the functioning of the valve apparatus and the contractility of the heart.
- Two-dimensional echocardiography is a more informative study compared to the previous one. This is achieved by obtaining a three-dimensional image of the heart and its structures.
- Stress ECHO is one of the options for stress tests. Combines ultrasound and bicycle ergometry techniques. First carried out ultrasound diagnostics, and after “riding” the patient on a bicycle, an ultrasound is performed. As a result, coronary artery disease and obstruction of the coronary vessels are determined, and the effectiveness of therapy is assessed.
Ultrasound is not prescribed in cases of chronic smoking, bronchial asthma, in the presence of large mammary glands or excessive chest hair. Also, the study is not carried out for chest deformities, infectious diseases skin in this area.
EchoCG is a harmless and painless research method. It is performed quite quickly and, if necessary, is repeated the required number of times.
Video Echocardiography, ultrasound of the heart, research methodology
Angiocardiography
The method refers to x-ray examinations, during which a radiopaque contrast agent is used. With the help of the study, it is possible to study the chambers of the heart, as well as nearby veins and arteries.
Into the cavity of the heart and coronary vessels A radiopaque contrast agent is injected, for which a special catheter is used. It is supplied to the heart and blood vessels through the femoral or subclavian artery. When a contrast agent is injected, the structural parts of the heart become visible and a series of images are taken to evaluate them. Before the procedure, be sure to take a sedative and antihistamine.
The study is often carried out before heart surgery in order to clarify the necessary physiological parameters of the myocardium. The method is also quite effective in diagnosing heart defects and disruption of the structure of nearby large vessels. Since the widespread use of echocardiography, angiocardiography has become less common. But in some cases, this method is indispensable, since it allows you to more accurately determine the anatomical structures of the heart.
Angiocardiography is an invasive diagnostic method and is therefore relatively infrequently used. Still, if necessary, it helps to obtain more accurate data than with echocardiography.
Video Angiography and stenting of cardiac vessels
Lab tests
Often prescribed in the presence or high risk of identifying concomitant pathology. Also, with some heart lesions, certain substances are released into the blood, which are detected using special laboratory tests.
Common lab tests for heart diseases:
- Urine examination - the kidneys are sensitive to the state of the cardiovascular system. For swelling, after an attack paroxysmal tachycardia, septic endocarditis the quality and quantity of urine changes. Basically, the disorders are expressed in a decrease in the specific gravity of urine, the determination of hyaline casts, red blood cells, and protein in the urine.
- A blood test is quite informative in diagnosing cardiovascular diseases. In particular, often with heart defects the number of red blood cells increases. This change is associated with oxygen starvation due to cardiac insufficiency. Inflammatory processes often affect the endocardium, myocardium and other structures of the heart. In this case, leukocytosis develops and ESR increases.
- Sputum examination is carried out only in cases where there is a suspicion of acute left ventricular failure. With this pathology, there is congestion in the lungs, resulting in the formation of bloody-foamy sputum. In some cases, it may be colorless, which is often noted with severe pulmonary congestion. Microscopic analysis of sputum allows you to identify “cardiac cells”, the presence of which is characteristic of myocardial infarction and heart failure.
During each examination, it is necessary to carefully follow the requirements of the doctor conducting the diagnosis. This will help you get faster and better results. It will also subsequently prevent the development of complications, so joint cooperation between the doctor and the patient will help achieve the desired result.
A person's heart is the size of his fist. For some it is more, for others it is less, but despite this, every day any heart passes through hundreds of liters of blood, directing it to all internal organs, to all parts of the body. The work of the heart is directly related to our life, so it is very important to periodically examine it and, if necessary, treat it. Chest pain, burning sensation, tingling, shortness of breath, too rapid heartbeat - all this indicates a malfunction of the heart and is an undeniable reason for examination.
A high-quality, accurate and comprehensive examination of the heart can only be carried out in a medical institution. To conduct such an examination, you need to contact a cardiologist. When you see a doctor, clearly and comprehensively describe to him the sensations that are bothering you - this will help save some time and speed up the determination of the correct diagnosis.
Coronary angiography is the most complex and expensive examination of the heart, which is prescribed only in emergency cases. During the examination, the patient is injected with a contrast agent, which fills the lumens of the arteries and displays damaged areas. This procedure is only performed on hospitalized patients prior to heart surgery. If you are unable to visit medical institution