How to check your heart. My heart hurts, what tests should I take? What tests should I take if I have heart disease?

Play an important role in the diagnosis of cardiovascular diseases 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). After tapping, the doctor determines the boundaries of the heart, which are pathological cases change.

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. For appointment proper treatment this is extremely important, 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.

Frequently used instrumental diagnostic methods:

• 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 applied to the 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 chest leads are recorded, from V1 to V9, but V1-V6 are most often determined.

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 using a large number of electrodes, a long-term study 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, they often create favorable conditions for the occurrence of arrhythmia or other heart disorder. 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 ultrasonography, 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 heart lesions, congenital and acquired defects, as well as to assess the functional capabilities 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, ultrasound diagnostics is performed, 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, large mammary glands or excessive hair growth chest. Also, the study is not carried out for chest deformities, infectious diseases skin in this area.

Echocardiography is harmless and painless methods research. 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 radiocontrast 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.

A radiopaque contrast agent is injected into the heart cavity and coronary vessels, 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 refers to invasive methods diagnostics, therefore it is used relatively infrequently. 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 laboratory tests for heart disease:

• Urine examination - the kidneys are sensitive to the condition of cardio-vascular 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 with cardiac failure. Inflammatory processes often affect the endocardium, myocardium and other structures of the heart. In this case, leukocytosis develops and ESR increases.
• Sputum examination - carried out only in cases where there is a suspicion of acute failure left ventricle. 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.

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

Inspection

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

Anamnesis

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

Other Important Aspects

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

A little about a normal heart

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

Echocardiography

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

Benefits of Ultrasound

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

What does vascular examination show?

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

Results

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

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.

Synonyms Russian

Congestive heart failure, heart failure.

Heart failure, congestive heart failure.

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

The main symptoms of chronic heart failure include:

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

General information about the disease

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

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

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

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

Who is at risk?

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

Patients at risk include:

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

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

Laboratory research

• There are most often no changes in the general blood test. In some cases, moderate anemia may be detected.
• The erythrocyte sedimentation rate (ESR) may be elevated, especially when heart failure is 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 excluding diabetes mellitus as a risk factor for heart failure.
• Cholesterol. high and low density lipoproteins. There is a clear relationship between elevated cholesterol levels and the development of atherosclerosis, coronary heart disease, and hypertension. High 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 predominance clinical symptoms Conditionally, three main groups of patients can be distinguished:

1. Patients with complaints of pain in the heart area

2. Patients with high blood pressure

3. Patients with rhythm disturbances, interruptions in heart function

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

The minimum examination should include:

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

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

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

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

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

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

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

Heartache

The most common reasons:

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

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

An important role in the examination is given to ECG changes, including during stress tests and daily monitoring, as well as changes in biochemical blood tests (lipoproteins, triglycerides). If necessary, coronary angiography is performed to establish a final diagnosis and determine further treatment tactics. Treatment can be conservative (medication), endovascular (angioplasty and stent placement in coronary arteries through the shoulder 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.) Special attention deserves endocrine causes of increased blood pressure, especially in women after 45 years.

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

Rhythm disturbances, interruptions in heart function

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

What do clinical blood test indicators indicate?

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

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

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

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

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

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

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

So, A general (clinical) blood test shows:

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

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

A significant increase in the content of red blood cells may indicate erythremia (one of the blood diseases). In addition, an increase in the number of red blood cells (erythocytosis, polycythemia) is observed in acute poisoning, when due to severe vomiting and diarrhea there is a large deficiency of fluid in the body; with acidosis (due to metabolic disorders during exacerbation of certain diseases); 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- These are young forms of red blood cells. Children have more of them, adults have less, because the formation and growth of the body has already been completed. An increase in the number of reticulocytes can be observed in anemia or malaria. A decrease in the number of reticulocytes or their absence is an unfavorable sign in anemia, indicating that the bone marrow has lost the ability to produce red blood cells.

Erythrocyte sedimentation rate (ESR) determines how quickly red blood cells settle in a test tube, separating from the blood plasma. In women, the ESR rate is slightly higher than in men; during pregnancy, the ESR increases. Normally, the ESR value in men does not exceed 10 mm/hour, and in women - 15 mm/hour. 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 muscle mass when taking corticosteroids.

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

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

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

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

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

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

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

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

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

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

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

- acute blood loss;

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

— conditions after removal of the spleen;

- observed during treatment with corticosteroids;

- some rarer diseases.

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

- heavy iron deficiency anemia;

- some bacterial and viral infections;

- liver diseases;

- diseases of the thyroid gland;

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

- systemic lupus erythematosus.

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

The volume of erythrocytes compared to plasma increases with:

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

— congenital defects hearts, accompanied by insufficient oxygen supply to the tissues;

— a person being in high altitude conditions;

- insufficiency of the adrenal cortex.

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

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

Blood formula. The study of the leukocyte formula has important diagnostic value, showing characteristic changes for 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.

At various diseases look at the combination of the following signs: 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; presence or absence degenerative changes in cells.

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 see a cardiologist, especially if there are certain prerequisites for the occurrence of pathologies, for example, heredity, overwork, severe physical exercise 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.

Second characteristic feature 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 - 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 activity of the heart, 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 complications. 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.

To prevent illness and early death, you need to know how to check blood vessels for atherosclerosis. A degenerative disease occurs under the influence of harmful factors and habits. Age-related changes and an unhealthy lifestyle contribute to the deposition of cholesterol. Sclerotic vascular lesions lead the list of causes of death among the world's inhabitants.

During a routine ultrasound examination, the doctor determines the main indicators of the performance of the veins of the lower extremities: the condition of the valve apparatus and the patency of the vein. This data is often sufficient to make a diagnosis of varicose veins.

To determine the extent of the disease and further treatment, ultrasound angioscanning of the veins of the lower extremities with Doppler sonography and color coding of blood flow is usually performed. For this, special devices are used. They determine the degree of venous deficiency based on the amount of blood that flows back from the valves down to the legs.

The main task when examining the veins of the lower extremities is not to miss blood clots. Their danger lies in the fact that if a blood clot breaks off, then large vessels become blocked. Which can lead to a heart attack and even death. Even without tearing off, they pose a very big threat because they can completely stop the flow of blood through the vein.

How to clean vessels

There are special preparations for medicinal cleaning of blood vessels.

1. Statins are the most effective means for cleaning blood vessels. They have a minimum of side effects. In addition to their basic properties, they are characterized by anti-inflammatory functions. The duration of treatment depends on the patient’s age and the degree of vascular contamination.
2. Bile acid sequestrants. They activate their binding in the intestines and further excretion. When using, it is necessary to take into account the possibility of adverse reactions in the form of intestinal problems and the occurrence of gas formation.
3. Fibrates reduce the amount of fat in the body and reduce the amount of cholesterol.
4. Vitamins. Ascorbic acid and B vitamins are considered the most effective.

There are many more diseases associated with vascular damage than it might seem. And the main difficulty in their treatment is diagnosis. Symptoms of vascular damage are extremely varied and, as a rule, are not identified on their own, but are associated with an exacerbation of a chronic condition or the emergence of a new pathology.

Vascular system

This includes blood vessels and the heart. The function of the first is to move blood, the second is to pump it.

The vessels are divided as follows:

• aorta - the main arterial trunk that carries blood from the ventricle;
• arteries are large vessels that supply oxygenated blood to the internal organs;
• arterioles - arteries of medium and small size that supply blood to tissues;
• capillaries - the smallest vessels serving literally every cell;
• venules - small veins that drain blood from tissues;
• veins are large vessels that move blood back to the heart; vein walls are much thinner.

Single injuries to capillaries or larger vessels usually do not have a noticeable effect on health. Much more dangerous is the constant disruption of work, since when the lumen of the vessels decreases, the inflow or outflow of blood decreases. Both phenomena are equally destructive.

Indications for testing

There are no characteristic signs of vascular damage. Arteries and veins are connected to various organs, and if 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:

1. Abnormal blood pressure.
2. Increased intracranial pressure.
3. Any traumatic brain injury.
4. Migraines and headaches, the cause of which is unknown.
5. Brain tumors.
6. Preparing for heart surgery.
7. Any signs of ischemia.
8. Varicose veins.
9. Swelling and heaviness of the limbs, chilliness, convulsions.
10. Risk factors: smoking, overweight, diabetes, etc.

Appointment of a specialist

Only a specialist can tell you how to check the blood vessels of the brain. First of all, with this kind of ailment, people turn to a neurologist. Its area is the vessels of the nervous system and brain. He is the one who refers you for examination of the arteries of the head and neck.

The cardiologist prescribes a check of the heart vessels in order to separate diseases of the heart and blood vessels, the symptoms of which are very similar.

The examination of veins and arteries is prescribed by an angiologist or angiosurgeon, who is in charge of blood and lymphatic vessels.

Examination of the vessels of the whole body is performed quite rarely, however, it gives the most complete picture.

Examination of the vessels of the head

The condition of the vessels of the head and neck is checked most often. Firstly, the symptoms of the disorder in this case are most pronounced, and secondly, they are the most painful. A person with pressing but mild chest pain ignores it for a long time in the hope that this phenomenon is temporary. Severe headaches and dizziness force the patient to seek advice much more quickly.

A neck examination is usually prescribed together with a check of the cerebral vessels, since they form a single system. Damage to the arteries of the neck is characterized by the same symptoms.

Magnetic resonance imaging

The most informative and modern research method allows you to obtain a complete picture of the functional and anatomical features of blood circulation.

The method is based on irradiating the patient with radio signals in a magnetic field. The tomograph records signals of varying power depending on the medium - moving or stationary, as well as on the speed of blood flow. As a result, the specialist receives layer-by-layer images of the brain and, accordingly, the arteries and veins of the skull and neck in a three-dimensional image. In this way, any pathologies of large and small vessels are detected.

The completeness of the picture depends to some extent on the power of the tomograph.

Rheoencephalography

MRI examination is, of course, the highest quality way to check the vessels of the head and neck, but also the most expensive. Instead of tomography, rheoencephalography may be prescribed.

The essence of the method comes down to recording the electrical conductivity of the blood flow. The signal from the latter differs from the signals of other tissues due to pulsation. With the help of a rheograph, information is obtained about the blood volume of the vessels of the neck and head, the speed of blood flow, the condition of the walls, and so on.

The procedure is much less convenient and takes more time. The working mechanism of the device is electrode plates, which during the research process must be applied to the areas of the head being studied.

Dopplerography

Or. It is an ultrasound examination of the head and neck using a specialized sensor. The procedure is completely painless, simple and allows you to get instant results.

This method is universal and has no contraindications. And therefore it is used to check the blood vessels of the whole body. It is carried out very simply: the patient is placed on the couch, the sensor is applied to the area being studied, and an image appears on the monitor. It is also prescribed to the youngest patients - children 4-5 years old, provided that the latter can lie motionless for 15-20 minutes.

The method is perfect for studying large and small blood flows throughout the body, but the quality of testing capillaries depends on the power of the equipment.

Electroencephalography

The device detects and records fluctuations in brain potentials. In this case, only the arteries and veins of the head are examined. The method is less informative; it helps to obtain information about disruption of normal blood flow and nerve conduction. However, for epilepsy, speech disorders and the like, electroencephalography is indispensable.

CT scan

The method uses x-rays. With its help, information is obtained about the physical condition of the walls, but the blood flow is not assessed. In this way, the presence or absence of tumors, vascular pathologies are determined, the condition of the walls is assessed - narrowing, expansion, the presence of a lesion, and so on.

CT is prescribed both for examining the vessels of the head and neck and the whole body.

Ultrasonography

The method was developed for examining the vessels of the neck, namely the carotid and intervertebral arteries, as well as the posterior and anterior cerebellar arteries. They are responsible for adequately supplying the brain with oxygen, and therefore disruption in their work affects its functions.

The working element of the device is an ultrasonic scanner. The lying patient is examined with a scanner, and an image of the artery is obtained on the monitor.

Examination of heart vessels

• Today, the most popular method is Doppler ultrasound. The aorta and venous trunk are large vessels, and ultrasound scanning allows us to assess their condition with great accuracy. Doppler ultrasound is completely safe for the heart and allows you to get instant results.
• CT scan- an equally popular method and very informative. In this study of the heart, the injection of a contrast agent - iodine, for example, is often used. Using CT, you can assess the condition of the artery walls, detect tumors and other abnormalities.
• Coronary angiography refers to surgical methods and is performed in extreme cases when the patient is on the operating table. A contrast agent is injected directly into the artery, and a scanning device - an angiograph - records the result. The undoubted advantage of the method is the ability to immediately compensate for the narrowing of the heart vessel.

Extremity examination

As a rule, examination of the vessels of the legs is prescribed, since the arteries and veins of the upper extremities are less susceptible to disease.

Dopplerography and ultrasonography are used to assess the condition of blood vessels - this procedure is almost always prescribed together with a heart examination, as well as phlebography and phlebomanometry

• Phlebography - radiography against the background of the injection of a contrast agent, provides information about the physical condition of the veins.
• Phlebomanometry- measurement of venous pressure under various physical activities.

Of all the methods, it remains the most informative, since the method allows you to detect damaged venous valves and localize the source of the disease.

Complete vascular check

MR angiography is used to check all main and peripheral vessels. The examination is carried out using a magnetic resonance imaging scanner without the injection of a contrast agent. The power of the device's magnetic field is at least 1 Tesla.

MR angiography allows you to obtain data on both the physical state of arteries and veins - expansion or narrowing of the walls, the appearance of atheromatous plaques, the formation of an aneurysm, and the functional state - the level of elasticity of the wall, inflammation, and so on.

The study is long-term. As a rule, it is carried out in sessions of up to 15 minutes, the number of procedures is up to 6. In some cases, a session can take up to 60 minutes. MR angiography is only available in specialized clinics.

Checking blood vessels is an important part of diagnosis for a very large number of disorders. Sometimes, such a procedure becomes the last diagnostic method. There are quite a lot of indications for this, and if a specialist prescribes a test, you should not ignore the recommendation.

In case of damage and bleeding from burst vessels in the head, damage to the intervertebral discs and cartilage, sleep disturbances and coordination of movements, frequent headaches, loss of orientation in space, irritability, you should think about your health and, first of all, consult a therapist who will refer you to the right specialist . If he determines that the problem lies in the circulatory system, he will refer you to doctors such as a neurologist or neuropathologist (which is basically the same thing), as well as to an angio-surgeon. They will tell you how to check the blood vessels for the presence of blood clots.

The vascular system is an important part of the human body; blood comes and goes through it with the necessary oxygen and nutrients to the cells, thus ensuring the vital functions of the whole organism. For many millions of years it has not changed in any way either in form or function.

Blood also flows through arteries from the heart to arterioles and capillaries, which supply liquid tissue to all the cells of a certain area. And back through the venules and veins into the heart.

Specialists

Many people do not consider it necessary to run to the doctor for help due to some discomfort, for example, dizziness, swelling of the legs in the evening, which goes away overnight, or the appearance of stars on the legs. Either there is no time, then there is no desire. As a result, patients are admitted to the medical department with severe pathology.

With such symptoms, a neurologist and a surgeon are obliged to check the circulatory system, and very often it is its disorders that are detected: atherosclerosis, phlebitis, thrombosis, arterial tortuosity, elephantiasis, varicose veins, hemorrhoids and many others.

If a disease is suspected, specialists must prescribe a comprehensive examination, with the help of which they will accurately determine the pathology and it will be possible to prescribe treatment for the blood vessels.

Diagnostics

Most diagnostic methods include various methods that graphically display the picture of the vessel on the monitor screen of a specialized device. These include MRI, REG, DPG, ECG and others.

The study is divided into checking blood vessels:

1. Brain;
2. General for the presence of thrombosis.

In order to check the blood vessels of the brain, use:

Magnetic resonance imaging. Makes it possible to analyze the condition of brain vessels, integrity, ongoing processes, to see whether there are cholesterol formations or blood clots. These devices have different resolutions, which are determined by such a unit of measurement as tesla (T). For example, with a power of four hundredths of a Tesla, the equipment will be weak, and accordingly the picture displayed on the screen will not be of high quality. The doctor may miss some details. With a power of one and a half tesla, the picture will be clearer, and therefore the result will be more correct. Sometimes, the method is supplemented by staining blood elements with special dyes, if the patient is not allergic to them. This procedure will allow you to quickly determine the presence of a blocked element or growths on the walls of blood vessels.

Rheoencephalography. It is also called cerebral tomography. A rheograph is used to identify brain diseases. The places where the electrodes will be attached are lubricated with alcohol, they can be evenly positioned, or localized in the injured area. These metal plates are attached to the current source and are also lubricated with a contact substance. Electrical conductivity shows the movements of blood flow, which can be used to understand the filling of a vessel with blood, its tone and the structure of the walls. The method makes it possible to distinguish blood flow in veins and arteries, which is very important.

To check the neck vessels for blood clots use:

Dopplerography. It is painless and is performed without special preparation of the patient, only basic hygiene standards must be observed. The patient is placed on the couch and the required area (neck, head) is lubricated with gel. Using a special device, a specialist scans the human body. At the same time, an image is shown on the monitor. Based on it, the doctor makes a conclusion about the disease. The quality of the half-hour procedure and its result depend on the device itself, and on the training and experience of the specialist, how accurately he can establish the diagnosis. This method is also suitable for examining the head area.

Ultrasonography. It is carried out in the same way on both the head and cervical vessels. The carotid artery is the most suitable because it is closer to the surface and is easier to find. By examining it, you can understand the state of the entire arterial system. Determine the presence of thrombosis, fibronodules, plaques. During the examination, the patient is placed on his back, his head is tilted back, and he is turned slightly away from himself. Next, the doctor moves a special device along the neck, then under the jaw and behind the ear. Then the head is turned over and the process is repeated. After examining the paired arteries, the patient is placed on his side to examine the vessel in the spine. There are color devices, they will provide a more accurate picture of the condition of the vein.

There are several indications for the use of this method of diagnosing cardiovascular diseases:

• Dizziness;
• Previous strokes;
• Increased pressure;
• Strong throbbing in the neck;
• Pain in the head;
• Severe impairment of vision and memory.

An examination of the brain and neck for the presence of blood clots in the vessels is carried out in cases of severe blood deficiency, capillary rupture, VSD, concussion, high blood pressure, tinnitus, pain in the head, and loss of orientation in space.

To check the heart vessels for blood clots, use:

• Electrocardiogram;
• Echocardiography;
• Ultrasonography;
• Rheovasography;
• Examination of blood vessels for elasticity.

Before these methods, a specialist listens to the heart, measures pulse and pressure. This makes it possible to understand big picture about his work.

In addition, a blood test may be performed to determine the content of sugar, minerals and other components. Fits standard method duplex scanning, which was already described above.

Other automated diagnostic methods include:

CT scan. It is carried out if Doppler ultrasound does not give a complete result. Quite an old method, appeared at the end of the twentieth century. Currently updated with new technologies. The apparatus with which the study is carried out is a table with a ring-shaped shell connected to a computer scanner. The patient is placed on the table. When you turn on the device, the shell begins to rotate. The monitor displays a three-dimensional image of the desired area. Recognizes vasoconstriction. CT is applicable in a regular clinic. If the image is not accurate enough, contrast agents, such as iodine, are added to the blood. The method is used not only for the heart vessels, but also for the chest, abdominal areas, legs and arms. With its help, you can examine not only the desired part of the body, but also the tissues surrounding it. For example, when examining the heart, it is important to know whether a tumor has formed and what is the condition of the largest azygos vessel.

Coronary angiography. This method of diagnosing blood vessels is used very rarely in intensive care conditions. With the help of a special coloring substance injected into the blood through a puncture in the skin, you can see on a computer the processes occurring in the blood vessels and heart. The method allows you not only to understand the cause of the problem, but also to solve it. For example, inserting a catheter will help widen narrowed areas of the artery.

For blood clots

In order to check the vessels for the presence of thrombosis in the lower extremities, the doctor conducts a visual examination of the patient. The presence of stars on the legs, swelling, heaviness (according to the patient) indicates the presence of the disease. For a more accurate determination, deep-lying large vessels should be examined. The methods described above are perfect for this - duplex and ultrasound diagnostics. But besides them, there are others that make it possible to determine the degree of blood patency. For example, the Delta Perthes test involves taping the patient’s lower limb and observing. The bandaged person walks for about ten minutes, after which the tourniquet is removed. After this, with normal patency, the superficial veins collapse within one minute, otherwise, they remain inflated for some time.

Phlebography. It is carried out in the same way as many methods with the introduction of a coloring agent. After its introduction, X-rays are taken from different sides, which complicates and lengthens the process. The patient is given tasks: not to breathe, to breathe, to change body position.

Functional dynamic phlebomanometry. This method of checking blood vessels for the presence of blood clots is more accurate than the first one, since it is carried out during different physical activities. But still, to detect the problem, additional ultrasound and Doppler diagnostics are necessary.

Thus, ultrasound diagnostics using Doppler sonography is best suited for checking the vessels of the head, neck, and heart.

There is an opinion that these methods are harmful to health and can destroy cellular elements, but their use for quite a long time has not proven this, so it is generally accepted that such diagnostics do not harm the human body. Therefore, when making an urgent diagnosis, it is better to listen to the recommendations of the attending physician and not refuse them. After all, an accurate determination of the cause of the ailment will in any case help solve it faster.

Difficult and not always efficient. Angiography of the vessels of the lower extremities is a hardware examination of the vessels of the legs, which will help to more accurately make a diagnosis. As you know, vascular disorders rarely manifest themselves on their own. A disruption in blood flow causes characteristic symptoms in the organ to which the veins and arteries are connected. Let's consider what are the indications for the need to check veins and arteries, what types of examination of the vessels of the lower extremities exist and what are their differences.

In what cases is examination of the blood vessels of the legs carried out?

Vascular disorders are a fairly common occurrence. Swelling of the limbs, tingling, aching, numbness, pain are signs of incipient blood flow pathologies. Of course, such symptoms require careful verification using both x-rays (angiography and CT angiography), magnetic waves (venous MRI), and Doppler ultrasound examination.

The examinations are designed to check the extent of damage to the veins and arteries in the legs in the following diseases.

1. Atherosclerosis of the arteries. Various research methods reveal how narrowed the vessels are and whether they are blocked by plaques.
2. , it is also called obliterating endarteritis. Inflammation of the spasmodic walls of small capillaries and arteries of the legs. They examine how deformed the walls of the vessels in the foot are, and whether blood clots have formed in them.
3. Such vascular pathologies in which protrusion of the arterial wall occurs: diverticulitis, dissecting aneurysm. Using hardware diagnostics, they look for the location and extent of the vessel wall dissection.
4. Venous damage: thrombophlebitis, thrombosis. The study helps to identify the location of the blood clot and its size.
5. Injuries of the lower extremities. The examination is carried out to determine whether compression of the vessels has occurred.
6. Trophic ulcers and necrotic changes in the feet or legs.
7. Instrumental diagnostics are also carried out to monitor the effectiveness of treatment before surgery or prescribing medications and after surgery or therapy.

Despite the fact that the indications for examining the veins and arteries of the legs are the same, the techniques used are different. It is important that any of the proposed types of examination will help detect damage in the veins or arteries of the legs.

CT or MRI of veins, angiography, Doppler ultrasound do not replace each other, but complement and clarify the research results.

Principle of angiography

Methods for assessing vascular disorders are divided into two types: invasive (with penetration into the patient’s body) and non-invasive. The first group includes the most accurate and informative research method - angiography. What is the principle of the study?

This method uses x-ray photography of the studied vessels into which a radiopaque substance has been injected. Angiography can examine arterial disorders (in this case the method is called arteriography) and the condition of the veins (phlebography). The examination is carried out in a hospital or medical centers equipped with an X-ray angiography room.

The research proceeds as follows. First, the leg area is anesthetized, an incision is made, and a thin tube, an introducer, is inserted into the vessel being examined. The catheter through which the contrast agent is supplied is connected to the introducer. The doctor injects an iodine-based substance into the vein or artery of the leg being studied. Then they make a series x-rays during the distribution of the substance through the veins or arteries.

The manipulation is quite long, about an hour. After the examination, a tight bandage is applied to the incision site. Bed rest for 6–10 hours is recommended to prevent blood clots.

To quickly remove iodine from the body, it is recommended to drink at least one and a half liters of water.

Indications and contraindications

Preparation for the procedure begins two weeks before it takes place. Alcohol is excluded, blood-thinning medications are suspended, general and biochemical blood tests, a coagulogram, and tests for infections (HIV, syphilis, hepatitis B and C) are taken. The day before the examination, an allergy test is performed to determine the tolerance of the radiocontrast agent. The intestines are cleansed the day before, since you will not be able to get up after the angiography. Half an hour before the test, the doctor gives intravenous injections of antihistamines and sedatives. The examination is carried out on an empty stomach, since when contrast is applied to the veins, sensations of heat and nausea are possible.

Contraindications to the procedure are:

• allergies to iodine or anesthetic drugs;
• pregnancy – due to negative effects x-ray radiation to the fruit;
• lactation period, because the contrast agent passes into breast milk in small doses;
• inflammation of the veins - due to the risk of blood clot rupture;
• low blood clotting - due to heavy bleeding after the procedure;
• increased blood clotting - due to the risk of blood clots;
• mental illness - angiography causes stress in most patients, and a person with a mental disorder will not be able to adequately respond to the doctor’s instructions and report his well-being.

Angiography is a relatively safe method. But in practice, there are cases of a serious allergic reaction to the contrast agent and injury to blood vessels. Less aggressive are angiography using computed tomography (CT) and magnetic resonance imaging (MRI).

Angiography is used more often as a simultaneous surgical treatment of blood vessels.

CT angiography and MRI angiography

Angiography can be performed using different devices. A more modern and gentle method is angiography with examination of blood vessels using a computed tomography (CT) scanner. Externally, the procedure resembles conventional angiography, only the contrast agent is administered not through a catheter, but with a syringe into a vein. The patient also lies on the tomograph table, he is fixed, connected to monitors and placed together with the table inside the scanning machine. A computer tomograph processes x-ray sections and displays a clear anatomy of the vessels of the legs in a three-dimensional image.

Another principle for studying the vessels of the lower extremities is used in MRI angiography. A person is placed in a magnetic resonance chamber and irradiated with radio waves in a magnetic field. The procedure is safe and painless, but has a number of contraindications, which include pregnancy, metal implants in the body, claustrophobia, and excessive body weight (over 135 kg).

If you compare the two methods, you get the following picture.

CT examination and MRI diagnostics do not require hospitalization. On the day of the procedure, the patient returns to active life. No special patient preparation is required before the MRI procedure.

MRI angiography is an alternative to vascular examination with a computed tomograph. However, diagnosticians note less clear tracking of aneurysms in the vessels during MRI examination.