DIAGNOSIS IN CARDIOVASCULAR DISEASES – About Health US

This makes the cardiovascular system the most important system in a living organism. However, in the course of recent years, the percentage of cardiovascular diseases is rapidly growing. According to the World Health Organization, cardiovascular diseases are the leading cause of death worldwide. It is estimated that, in 2008 alone, 17.3 million people died from cardiovascular diseases, representing 30% of all the deaths in the world. Among them, 7.3 million people died of coronary heart disease and 6.2 million deaths were due to stroke.

If several decades ago, problems with the cardiovascular system mostly occurred in elderly people and pensioners, nowadays heart diseases are often found in people of middle age, teens and even young children. The list of diseases associated with this system is very large, but the most common and dangerous of them, such as arrhythmias, atrial fibrillation, endocarditis, coronary heart disease, aortic stenosis, arterial hypertension, angina pectoris, can be easily diagnosed in their early stages and may be successfully treated. Modern medicine offers a wide range of methods of diagnosis, analysis and treatment of cardiovascular diseases. For this, it is necessary to visit the cardiologist in the event of any slightest suspicion, to undergo periodic examinations, including the electrocardiogram, the full lipidogram, when needed — coronary angiography, functional cardiac tests or other cardiac examinations that listed below.

The main symptoms which allow the preliminary diagnosis or the suspicion of a cardiovascular disease are:

  • Pain and discomfort in the chest
  • Palpitations
  • Dyspnea
  • Edema
  • Changes in the color of the skin (pallor, cyanosis)
  • Headaches and dizziness

Inflammatory processes (myocarditis, pericarditis, endocarditis) and myocardial infarction are accompanied by fever, sometimes chills.

Heart problems may also be indicated by poor sleep, sticky sweat, anxiety, nausea and chest discomfort when lying on the left side, a feeling of weakness and fatigue of the body.

Everyone should be aware of the necessity for early diagnosis, because it is no secret that the earlier the disease is detected, the easier and with the least risk to the patient’s life it may be treated.

Modern cardiology uses all the most advanced diagnostic and treatment methods. If in the past a doctor could do with just inspection, auscultation of the heart with the stethoscope and with an electrocardiogram, over the last decade highly sophisticated and effective methods of diagnosis have appeared in cardiology.

We all know what an ultrasound is. It is used in medicine for years. Echocardiography is a method of ultrasound directed to the study of morphological and functional changes in the heart and its valve apparatus. It is based on capturing the reflected ultrasonic signals from the structures of the heart. This method allows to determine the state of the soft tissues, the thickness of the heart walls, the valvular condition, the volume of the heart cavities, the contractile activity of the myocardium, to see heart work in real-time regimen and to estimate the blood flow characteristics in the atria and ventricles.

Modern ultrasound machines may not only see the structure of the heart, but also, very importantly, may also assess the state of the blood flow in its vessels. This was made possible by Doppler ultrasound. On its screen the doctor can see any abnormal ejection of blood into the cavities of the heart, can estimate the rate of the blood flow in the coronary arteries, the condition of the heart walls and of its valves.

Before the application of Doppler ultrasound, the main and oldest diagnostic method of coronary artery disease was the electrocardiography (ECG). This method is completely safe (as well as echocardiography), simple and cheap. ECG allows the doctor to see how the heart muscle responds to a particular load. For example, in coronary heart disease at the time of an angina attack, relevant ECG changes can be seen on the tape. ECG also allows monitoring the state of the heart. This is the so-called Holter ECG monitoring, when the patient is given a portable device for 24 hours or more, recording on a tape the ECG changes, which allows the doctor to assess the heart function during the day.

The X-ray method as a method for heart disease diagnosis is already outlived and quite irrelevant nowadays. However, X-rays are a component of other, very important and serious coronary heart disease diagnostic methods. They are currently used in invasive diagnostic techniques, i.e. in those in which tools or special substances are introduced into the patient’s body.

One of the most popular and frequently applied invasive methods is coronary angiography. This method associated with the X-ray of the heart is able to identify any narrowing of the coronary vessels lumen. However, in order to allow X-rays to spot the blood vessels among other tissue mass of the chest, a long thin plastic tube is supplied through the femoral artery in the inguinal area, to the heart’s coronary arteries. Next, a special contrast material is introduced through the heart’s arteries, and in this way their narrowings can be seen. Thus, this method allows to see exactly what kind of artery is narrowed and to what extent — something that may not be visualized with echocardiography, much less with ECG.

Functional tests (cardiac stress tests) greatly enhance the diagnostic capabilities of other diagnostic methods in cardiology. They allow the determination of hidden electrocardiographic abnormalities that for various reasons could not be recorded in a normal electrocardiographic examination (latent coronary insufficiency, transient arrhythmias).The most common functional stress tests are the exercise challenge test (bicycle ergometer, treadmill), the test with beta-adrenergic blockers and the test with dipyridamole.

Exercise challenge tests are diagnostic methods for the detection of electrocardiographically recorded latent (hidden) coronary heart disease and for determining individual exercise tolerance by using an increasing speed of exercise performed on a bicycle ergometer or a treadmill under ECG investigation. When physical stress tests cannot be performed (because of various reasons), the patient may be subjected to stress tests with pharmacological agents (such as beta-adrenergic blockers or dipyridamole).

Myocardial perfusion scintigraphy is used to assess myocardial perfusion using thallium and technetium isotopes. Perfusion scintigraphy is used to confirm the diagnosis of coronary heart disease, as well as to specify the localization of myocardial ischemia (areas with insufficient blood flow from the arteries).

Computer tomography (CT) of the heart is a study, which creates an image of the heart, using the technology of CT, with or without the administration of intravenous contrast, to visualize the anatomy of the heart, coronary circulation, and of large vessels (including the aorta, pulmonary veins and arteries).

Magnetic resonance imaging (MRI) of the heart allows a detailed assessment of the structural features of the heart’s chambers and blood vessels, of the intracardiac hemodynamics, and of the heart’s functional performance, and is used to measure the velocity of the blood flow in large vessels. The greatest practical importance of cardiac MRI is for patients with congenital heart disease, aortic aneurysms, aortic coarctation, tumors of the heart, cardiomyopathies, especially hypertrophic cardiomyopathy, unexplained pulmonary hypertension, right heart pathologies. In addition, MRI of the heart can also serve as a second-line diagnostic method in case of unclear results revealed by other studies (especially echocardiography).

Several laboratory studies can also be of diagnostic importance in cardiovascular diseases, such as: the general blood analysis (with the detection of red/white blood cells and platelets), the blood’s biochemical analysis (with the determination of the potassium and calcium necessary for the heart’s contractile activity), including the lipidogram, the urinalysis, the heart’s biomarkers, such as troponin, creatine kinase (CK-MB), lactate dehydrogenase (LDH) and others.

The cardiovascular system is a support without which our life would collapse. That is why it is important to stop the progression of cardiovascular diseases in their earliest stages.

The diagnosis of cardiovascular diseases is the first step for the determination of the treatment plan for the any cardiac problems. Nowadays, the great opportunities of medicine worldwide give us the chance to identify abnormalities in the heart and in its vascular state at an early stage, to prevent the development of cardiovascular diseases and to provide timely medical assistance.

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