Diagnostics of diseases of the cardiovascular system, analyzes and instrumental methods

Modern diagnostics of the cardiovascular system is based on instrumental and laboratory research methods.

Thanks to objective data, the doctor accurately determines the diagnosis. Determines if an operation is needed. Prescribes long-term treatment.

Instrumental diagnostic methods

The cardiovascular system is responsible for the blood supply to all human organs. The heart is a pump that transports food to the body. If this organ is disrupted, acute and chronic vascular pathology develops.

Important! Patients who have consulted a doctor on time undergo an examination, which allows them to avoid – heart attack, stroke.

After collecting anamnesis and examination, the patient is sent for blood tests. At the same time the necessary functional research methods are carried out. The scope of the activities carried out depends on the clinical picture and the alleged diagnosis.

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Electrocardiogram

If you suspect a heart disease, the patient must undergo a cardiogram. The technique detects disturbances in the rhythm and heart rate. The doctor determines the type of arrhythmia, without which it is impossible to prescribe the correct drugs. The tape also displays nutritional disorders of the heart muscle – hypoxia of myocardial areas.

According to the ECG (electrocardiogram), the doctor diagnoses a heart attack, which allows you to immediately prescribe treatment, saving a person’s life. An ECG indicates a decrease in potassium in the body. It is hypokalemia that is a common cause of arrhythmias. By abnormalities of the ECG, hypertension is recognized.

Echocardiogram

Ultrasound examination reveals abnormalities in the pumping function of the heart. Echocardiography or ultrasound allows you to see the structure of muscle tissue – wall thickness, cavity size, changes in valves. In other words, it determines the contractility of the myocardium.

Thanks to the study, the doctor identifies an aortic aneurysm, tumor, hypertension, heart defects. The method allows you to determine the zone of infarction, thrombosis.

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Holter monitoring

The examination makes it possible to observe the function of the heart for several days – up to 3 days. The method is used to detect paroxysms of tachycardia, arrhythmias. EKG records episodes of ischemia during sleep and wakefulness.

The essence of Holter monitoring is a constant recording of heart impulses at night and daytime. During the exam, the sensors are attached to the chest. The device is worn on a strap attached to a belt or shoulder. Throughout the study, the patient keeps a diary of actions, records the time of onset of pain. The doctor compares the changes in the ECG with the person’s condition – rest or physical activity. Attention! With the help of Holter monitoring, the doctor can catch changes that cannot be detected on a cardiogram taken at rest, when the patient did not have pain.

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Treadmill Test

The “bicycle” technique gives an idea of ​​the work of the heart during physical activity. While the patient pedals or walks on the treadmill, the machine takes a cardiogram and records blood pressure. As a result, the method determines the performance of the heart. The main purpose of the treadmill test is the difference between exertional angina and heart pains of another origin.

-hour blood pressure monitoring

The state of the cardiovascular system is determined by the level of blood pressure throughout the day. Objective data cannot be obtained in one measurement at a doctor’s office and at home. In some people, hypertension occurs at rest, in others after exercise or excitement. To establish a correct diagnosis, it is necessary to know the pressure level at different times of the day during exercise and at rest.

Before the examination, a cuff connected to a manometer is put on the forearm. The device records the pressure and pulse readings every half hour throughout the day, storing the information in the internal memory. Analysis of the results helps the doctor to determine the cause of hypertension.

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Coronary angiography

Interesting! The X-ray contrast method is the most accurate examination of the coronary arteries. In the diagnosis of coronary heart disease, angiography takes the leading place. The method determines the localization of a thrombus, an atherosclerotic plaque. Allows you to see the localization and degree of vasoconstriction.

After puncturing the femoral artery, a long probe is inserted through the catheter. Through it, a contrast agent enters the vessel. With a blood stream, it spreads to all branches. By absorbing X-rays, the contrast creates a picture of blood vessels on the monitor screen, which the doctor sees. Coronary angiography determines the need for surgery. Allows you to plan the tactics of further treatment.

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Doppler

With the help of ultrasound diagnostics (ultrasound), not only the myocardium and valves, but also the vessels of the heart are examined. One of the modes, color Doppler, allows you to see the movement of blood in the coronary arteries and inside the heart.

Using the duplex scanning method, the doctor determines the speed of blood flow in the ventricular cavity. With valve pathology, regurgitation is visible on the screen – a reverse flow of blood. Doppler ultrasonography reveals diseases of large and narrow vessels, detects the slightest changes in the heart valves.

Note! To carry out such a study, a multifunctional high-class equipment is used, enhanced by the Doppler effect. The advantage of Doppler is the absence of the harmful effects of X-rays.

Aortography

Aortography is a modern accurate method for studying the human vascular system. A comprehensive study of the aorta on an X-ray machine is carried out after filling with a contrast agent. Techniques differ depending on the type of procedure:

  • Cardiac aortography is used for circulatory disorders, abnormalities and tumors.
  • Thoracic aortography. In this way, its branches, diseases of the lungs, mediastinum are diagnosed.
  • Abdominal aortography is used to study the liver, bladder, intestines, uterus, spleen.
  • Renal aortography is used to diagnose cysts, pyelonephritis, and cancer.

Indications for research:

  • aortic stenosis,
  • aneurysm,
  • tumor of the mediastinum,
  • clinical symptoms of vasoconstriction of various organs.

The procedure is performed on an empty stomach. The night before, the patient cleans the intestines with an enema. Before the session, doctors check to see if there is an allergy to the contrast agent. Then local anesthesia is done.

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Research methodology

During the procedure, a puncture is made in the passable femoral, radial, or axillary artery. A conductor is inserted inside it, through which a catheter is inserted. After removing the guide wire, the catheter is advanced into the aorta under the control of X-ray television. Upon reaching the vessel, a contrast agent is injected – diode, cardiotrast, hypac. Immediately after that, a series of pictures are taken, which are stored in the computer’s internal memory. Information can be transferred to flash drives.

During the session, the person feels warm. Some patients feel discomfort or nausea. After the procedure, a sterile bandage is applied to the puncture site.

What analyzes are done for pathology of the heart and blood vessels

At the stage of diagnosing diseases, blood and urine tests are mandatory. In terms of information content, laboratory tests are superior to echocardiography, and are inferior only to magnetic resonance imaging.

In the cardiology department, all incoming patients undergo a general urine test and a blood test with a leukocyte formula. They are studies for a preliminary assessment of the patient’s condition. To establish the final diagnosis, special laboratory tests are carried out:

  • determination of blood serum enzymes,
  • biochemical analysis of urine,
  • acid-base state,
  • coagulogram – blood coagulation system,
  • cholesterol research.

Enzymes are found in many tissues of the body – liver, muscles. They are active in acute conditions. At the same time, their level rises.

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Serum enzymes

Enzyme analysis consists of several indicators:

  • Creatine phosphokinase (CPK) is a substance that accelerates the conversion of ATP. In healthy women, its level is less than 145 U/L, in men – no more than 171 U/L. With a heart attack, CPK rises after 4 hours.
  • AST (aspartate aminotransferase) is involved in the metabolism of amino acids in the myocardium. With a heart attack, AST rises earlier than the characteristic curve on the cardiogram. Normally, the indicator in men is not more than 37 mmol/l, in women – 31 mmol/l.
  • LDH (lactate dehydrogenase) is involved in the glucose conversion reaction. Normally, the enzyme level does not exceed 247 U/L. A persistent increase in LDH means the development of myocardial infarction. The indicator begins to grow 8 hours after coronary artery thrombosis.

Important! A blood test for enzymes is a marker of cardiovascular disease. Tests are sensitive in case of infarction or prolonged myocardial ischemia. Therefore, if an acute coronary disease is suspected, an enzyme test of serum is always determined.

Blood is taken from a vein during the first hours after the onset of pain in the heart. With angina pectoris or heart attack, the level of enzymes is the basis for emergency measures.

Coagulogram

The analysis is done to determine the viscosity of the blood. With an increase in the indicator, the risk of heart attack and stroke increases. The course of hypertension is complicated. A standard analysis consists of several indicators. Decoding is done by a specialist who analyzes all the information in the complex.

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Lipid exchange

Diagnosis of atherosclerosis includes the study of lipid metabolism. Blood for cholesterol, triglycerides is checked for coronary heart disease, obesity, myocardial infarction. In overweight people with menopause, the risk of developing early vascular sclerosis increases. Elevated cholesterol is also detected in hypertensive patients and people with arrhythmias. Therefore, lipid metabolism is necessarily determined for these persons.

Cholesterol enters the body with food, but some is formed in the liver. An increase in the level warns of the risk of developing atherosclerosis. Normally, the average total cholesterol level varies between 3,2 and 5,6 mmol/L. In old age, it rises to 7,1.

Interesting! In the US, where people are addicted to cholesterol-free diets, the number of cases of Alzheimer’s disease has increased. Studies have shown that it is the lowering of cholesterol that is the cause of this disease in the elderly.

The level of HDL – “good” and LDL – “bad” cholesterol is investigated at the stage of diagnostics of the cardiovascular system. Three glycerides are also part of lipid metabolism. The normal content in blood plasma is from 0,41 to 1,8 mmol/l.

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Analysis of urine

With ischemic heart disease and chronic heart failure, protein is determined in the urine. In addition, the analysis detects hyaline casts. With concomitant diabetes mellitus, the smell of acetone of the secreted liquid appears.

For diseases of the heart and blood vessels at the first stage, available research methods are used – an electrocardiogram and ultrasound. Laboratory tests are necessary at the stage of diagnosis and treatment monitoring. Contrast angiography is crucial for the prognosis of the disease. This method indicates whether an operation is needed, determines the scope of treatment measures.

Electrocardiogram Diagnostics of the heart, blood vessels and respiratory function Causes of diseases of the cardiovascular system

Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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