ECG
EKG is a fast, simple and painless method in which the electrical impulses of the heart action and are recorded on paper tape. EKG allows doctors to analyze the source from which the heart rate begins each heartbeat, conducting electrical impulses through the nerve fiber conduction in the heart, the frequency (speed) and heart rate.
Most people suspected of having heart disease are recorded by ECG. This test helps doctors determine the number of heart problems, including heart rhythm disturbances, the insufficient supply of oxygen to the heart and blood, excessive thickening of the heart muscle (hypertrophy), which may be due to elevated cardiac pressures. EKG can also detect when the heart muscle is thin or when it does, it gets replaced with non muscular tissue. This condition may be due to a heart attack (myocardial infarction).
Ergometry (test load carrying)
Test of endurance during physical exercise can greatly doctor indicate the presence and severity of coronary artery disease and other cardiac disorders. Test load carrying (ergometry, stress test), during which the continuous monitoring ECG and blood pressure, can detect problems that are not visible in the standstill. If the coronary arteries are partially blocked, the heart may be getting enough blood at rest but not during physical exertion. Simultaneous examination of lung function can be distinguished limit physical exertion as a consequence of heart disease than those caused by lung diseases, and limit physical exertion that occurs due to the heart and lung disease combined.
During the test subjects were biking or walking on a mobile bar certain speed. Gradually, the load increases. At the same time controls the EKG and blood pressure is measured at certain intervals. In general, subjects performed the test load bearing until their heart rate reached 80% to 90% maximum for their age and gender. If symptoms as shortness of breath or chest pain, or become intolerable appear significant changes in ECG or blood pressure test is terminated earlier.
People who for whatever reason can not perform this test load may be subjected to stress electrocardiogram, which provides data similar to data obtained exercise test, but does not include physical activity. Instead, the injected drug with the aim of increasing the blood supply of normal heart tissue, but this drug reduces the supply of abnormal (diseased) tissue (eg, dipyridamole or adenosine) to mimic the effect of physical load.
Test load tolerance (ergometry) indicates coronary artery disease when
occurrence of certain abnormalities in the ECG when subjects developed angina pectoris or when lower blood pressure.
Neither test is perfect. Sometimes tests show disturbances in people without coronary heart disease (false-positive results), and sometimes the disorder is not found in people who have angina pectoris (false negative results). The people who have no symptoms, especially in younger people, the probability of coronary heart disease is low, despite an abnormal test result. However, the test load is used for screening (screening or search) in apparently healthy populations, for example. program of physical activity before or during the evaluation of life insurance. Many false-positive results can lead to great care and medical expenses. For this reason, many experts do not support the routine performance of ergonomics in people without symptoms.
Holter monitoring (continuous ECG moving)
A heart rhythm disorder, and inadequate blood flow to the heart muscle can occur only for a short or unpredictable. To detect such problems the doctor uses a long-term mobile ECG recorder. In this test subjects wearing a small device on the battery (Holter monitor) that records EKG for 24 hours. While wearing the monitor respondent recorded in calendar time and the type of individual symptoms. Later, the image is placed in a computer that analyzes the heart rate (speed) and rhythm, requires changes in electrical activity that may indicate inadequate blood flow to heart muscle and plays a recording of each heartbeat for 24 hours. Symptoms were recorded in the log are compared with changes in the ECG.
If necessary, the ECG can be sent by telephone to a computer located in a hospital or doctor's office for emergency reading ECG recording immediately after the onset of symptoms. Modern ambulances can be simultaneously recorded ECG and EEG (brain electrical activity measures) to those people who have episodes of fainting (syncope). Such images help to distinguish epileptic seizures from a heart rhythm abnormalities (arrhythmias).
Electrophysiological testing
Electrophysiological testing is used for the assessment of serious arrhythmias, and electrical conductivity. The hospital doctor introduces a small electrode through the veins and sometimes directly through the arteries in the heart chambers to record an ECG within the heart and to accurately determine the whereabouts of the electrical conductive paths.
Sometimes the doctor intentionally cause arrhythmia during testing to determine whether a particular drug can stop the disorder and to assist the operations. If necessary, a doctor will quickly return to normal heart rhythm by giving a brief electric shock (cardioversion). Although the invasive electrophysiological testing search and the patient should be anesthetized, testing is very safe: the risk of death is 1 to 5000.
RTG SEARCH
Anyone with heart disease will be recorded in front of the chest x-ray (posterior-anterior recording) and side (profile image). X-ray image shows the shape and size of the heart, and the outlines of the lungs and blood vessels of the chest. Abnormal shape or size of the heart and abnormalities, such as calcium deposits within the heart tissue, they are easily visible. Radiograph of the chest often reveal processes in the lungs, especially in the pulmonary veins and the presence of fluid around the lungs.
Heart failure or heart valve disorders lead to enlargement of the heart. But the size of the heart may be normal in patients with severe heart disease. In constrictive pericarditis, which surrounds the heart like armor connective (scar) tissue, the heart is not increased, although there is heart failure.
Showing pulmonary blood vessels is often more important than the diagnosis of heart show itself. For example.increase in pulmonary artery near the heart and constriction in their lung tissue, suggesting increased right ventricle.
HEART CT (computerized tomography)
Plain computerized tomography (CT) is often not applied in the diagnosis of heart disease. However, it can detect structural abnormalities of the heart, pericardium, great vessels, lungs and other structures of the chest.This test is used to get images that appear after the computer (computer) processing of X-ray data obtained by passing air through the entire chest wall (cross section), and in this way shows the exact position of the disorder.Newer high-speed computed tomography, called computerised tomography provides three-dimensional view of the heart in motion. This search is used to assess cardiac structure and movement disorders.
Fluoroscopy
Fluoroscopy is a continuous X-ray procedure that the screen displays your heart rate and breathing and releasing air from the lungs. No fluoroscopy, which includes a relatively high dose of radiation, mostly replaced by echo-cardiography and other tests.
Fuoroskopija is still used in heart catheterization and electrophysiologic testing. It may be helpful in the diagnosis of some heavy, for example. valvular heart disease and congenital heart defects.
ECHOCARDIOGRAPHY
Echocardiography is one of the most widely applied technique in the diagnosis of heart disease because it is noninvasive, does not use X-ray beam and provides a great view. Search is a harmless, painless, relatively inexpensive and particularly useful.
Echocardiography uses ultrasound waves emitted by high-frequency probe (transducer) and reflected by the structure of the heart and blood vessels and provide a moving picture. Imagery appears on the video screen and recorded to a VCR or on paper. By changing the position and angle sensors, the heart and large blood vessels can be viewed from different sides in order to obtain accurate images of cardiac structure and function assessed. In order to achieve greater clarity and structure analysis of the back of the heart, the doctor may conduct a probe through the patient's throat into the esophagus to record signals from the back side of the heart, to call transesophageal echocardiography.
Echocardiography can observe cardiac wall motion abnormalities, changes in blood volume displaced at each heart beat, and thickening of the membrane around the heart disease (the pericardium), and the accumulation of fluid between the pericardium and the heart muscle (pericardial effusion).
The main types of ultrasound scans are M-mode, two-dimensional, Doppler and color Doppler. In M-mode, the simplest technique is just one part of air directed at the heart under study. Two-dimensional ultrasound, the most widely used technique, creates a realistic two-dimensional display of the computer-created "lobes".Doppler ultrasound detects movements and turbulence of the blood and can provide color display. Color-Doppler and Doppler echocardiography to determine and display the direction and speed of blood flow in heart chambers and vessels. Picture helps the doctor to see if the heart valves open and close properly, and how much you miss when they are closed and the blood is flowing normally. I can see the abnormal connections between blood vessels or heart chambers and can be ordered structure and function of the vessels and chambers.
MRI (magnetic resonance)
Magnetic resonance imaging (MRI) is a diagnostic test that uses a strong magnetic field in order to make detailed view of the heart and chest. This is extremely expensive and modern imaging methods is still under development in the diagnosis of heart disease.
The subject is placed in a large electromagnet that causes vibrations of atomic nuclei in the body and gives characteristic signals, which are converted to two-and three-dimensional imaging of cardiac structures. Contrast media (radiologically visible assets) are not usually required. Sometimes, however, give intravenous paramagnetic contrast agents to help reveal areas of poor blood flow to the heart muscle.
The lack of MRI is that it is to create the imagery needed more time (search takes longer time) than with computed tomography (CT). For motion pictures of the heart obtained by MRI are less clear than those obtained by CT. In addition, some people get claustrophobic during the MRI recording because they have to lie quietly in a narrow space of a large machine.
Radionuclide EXPAND
In view radionuclide is the minimum amount of radioactively labeled substance (indicator) is injected into a vein, and the exposure to radiation during the execution of this search is less than most conventional x-ray examinations. The indicator can quickly spread through the blood throughout the body, and gets to the heart.Then using a gamma camera detects the presence of indicators. The image is displayed and stored on floppy or CD for subsequent analysis.
Different types of cameras to record the radiation can only display one image or can generate a series of computer-enhanced images (picture a cross-section), a technique that is known as computed tomography single photon emission (SPECT stands engl.). The computer can also create three-dimensional image.
Radionuclide imaging is useful in diagnosing partial to people who have chest pain of unknown origin. For those who have a narrowing of the coronary arteries is used to reveal a narrowing effect on the blood supply and heart function. Radionuclide display is also used to assess whether there are improvements in myocardial blood supply after the installation of bypass surgery (by-pass) or similar procedures, and to determine the prognosis after a heart attack (myocardial infarction).
The flow of blood through the heart muscle is usually examined thallium-201 injection into a vein and recording during the test load. The amount of thallium-201 is absorbed in the cells of the heart muscle depends on blood flow. At the highest load of the heart muscle with poor blood supply (ischemia) showed less radioactivity - and provides a weaker picture than the adjacent muscle tissue with normal supply. People who are unable to exercise may be given intravenous injections of the drug dipyridamole or adenosine to mimic the effect of physical stress on blood flow. These drugs are diverted from the bloodstream stricture (abnormal) in normal blood vessels.
Once a student breaks a few hours, this is another record. The doctor can then see in which areas of the heart there was a recovery of blood flow (reversibly reduced flow), which is usually the result of narrowing of the coronary arteries, and in which areas they have developed irreversible (irreversible) scars on the heart muscles, which are usually the result of previous heart attack .
If the suspicion of an acute heart attack (myocardial infarction) is used as an indicator of technetium 99-m instead of thallium-201. Unlike thallium, which accumulates primarily in normal tissues, technetium accumulates primarily in the damaged tissue. However, since technetium also accumulates in bones, the ribs in some degree obscure view of the heart.
Recording of technetium is used for the diagnosis of heart attack (myocardial infarction). Damaged area of heart technetium is absorbed, so this test can detect heart attack within a week of starting 12 to 24 hours after onset.
PET (positron emission tomography)
With positron emission tomography (PET) nutritional ingredient that is essential for the functioning of the heart cells are marked with a substance that releases radioactive particles called positrons, and then injected into a vein. For several minutes, when selected nutritional ingredient reaches the heart of being tested, searches of the area and reveals the highest activity. Heart frequency is accelerating, and blood pressure is slightly lower.Rarely appear mild reactions such as nausea, vomiting and coughing. Serious reactions as shock, convulsions, kidney problems and heart failure (cardiac arrest) are very rare.
Allergic reactions ranging from skin rashes to rare and life-threatening condition called anaphylactic shock.Cardiac arrhythmia may occur when the catheter touches the heart wall. The team performing the procedure is equipped and trained for the emergency treatment of any adverse events.
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