Complete diagnosis of cardiovascular disease each consisting of (1) determining the etiology, (2) determining the structural changes, (3) determining the physiological abnormalities, (4) to estimate the remaining functional capacity of the heart. Treatment and prognosis are based on a clear understanding of these 4 factors.
The etiology is determined on the basis of years of patient history, specific changes, laboratory tests, such as: antistreptolizinski 0 titer, serological test for syphilis determination, jodnproteinskog test or serum enzyme test. Abnormalities of cardiac structure and its functions can be determined through careful physical examination, which is necessary to add X-ray and ECG findings. Cardiac catheterization is needed to determine the size santa and to measure pressures in the heart chambers, the aorta and the pulmonary artery. Measurement of dye curves used in certain cases of unexplained desnolevog and levodesnog santa. Angiokardiografija in two directions cineangiografija used to show the anatomy of congenital and acquired anomalies, the extent of valve insufficiency, heart tumors, etc..
Nonspecific phenomenon
The most common symptoms of heart disease are: dyspnea, fatigue, chest pain and palpitations.However, as no matter which of the above symptoms can be found in diseases that are not related to the heart, the proper interpretation of symptoms depends on the systematic examination and diagnostic studies.
Dyspnea
Dyspnea caused by heart disease is usually associated with increased heart and other structural and physiological disorders.
The most common type of dyspnea caused by heart disease is dyspnea fatigue with shortness of breath that occurs even at moderate fatigue as you can break vacation.
Ortopnoa dyspnea in the supine position, which eliminates the sitting position. It exists only in an advanced stage of a heart failure.
Paroxysmal nocturnal dyspnea suddenly awakens patients from sleep and forced him to sit on the bed or stand up. This may be one of the first symptoms of left ventricular relaxation or very pronounced mitral stenosis.
Dyspnea fatigue luck in other circumstances not related to heart disease. Thus, for example, can occur in people with weak physical condition, in obesity, debility, in old age, chronic lung patients, anemia and obstruction of the airways. Ortopnea can occur in very obese patients with ascites, regardless of the cause, of gastrointestinal disorders that cause abdominal distension and in the third month of pregnancy. Paroxysmal nocturnal dyspnea may occur in adults in cases of first attack, bronchial asthma, and cases of obstruction of the airways caused by paratracheal tumors.
State anxiety and cardiac neurosis may also cause dyspnea. Such patients often report that they are unable to breathe well. Psychogenic dyspnea is associated with acute respiratory alkalosis which leads to mental disorders, paresthesias of the limbs or around the mouth, and then to tetany, tremors and fear.
Fatigue
Fatigue, which can be rectified rest is mostly caused by a decrease in heart function. This can be a major difficulty in congenital heart defects, cor pulmonale, or mitral stenosis in which are moreover more complicated and pulmonary hypertension. Asthenia, chronic fatigue and sleepiness that do not improve after rest are usually caused by mental changes as depression, cardiac neuroses and long-term care, or may be a component of "neurocirculatorne asthenia." Organic causes of fatigue include: chronic infections, anemia, endocrine and metabolic changes, chronic poisoning, the use of depressive and sedative drugs, malignancy, collagen disease, and all the debilitating disease.
Chest Pain
Chest pain occurs in sledeeih cardiovascular changes, angina pectoris (this pain is caused by intermittent myocardial ischemia), myocardial infarction; mioperikarditis, in the case of the presence of fluid in the pericardium with cardiac tamponade, aortic dissection or aneurysm of the aorta wall, pulmonary embolism or pulmonary infarction .
Chest pain is one of the most common disorders in which patients complain. It is necessary to carefully examine its quality, location, spread, duration, and factors that accelerate, worsen or odklanjaju pain. It is necessary to make several serial examination and laboratory tests. In addition to recommending and fatigue tests, therapeutic trials, and selective coronary sineangiografija.
However, some other diseases that are not related to the change of heart followed by chest pain and hard to distinguish from heart disease. These include: (1) disease or arthritis and discus in the upper or lower cervicalnim thoracic spine parties, (2) heart neurosis, (3) neurocirculatory asthenia and other emotional changes, (4) sliding hiatal hernia, acute or chronic cholecvstitis, Acute pancreatit, kardiospazam, peptic ulcus, esophageal pain, (5) changes that cause localized pain in the chest wall, pectoral strain or inflammation of the intercostal muscles and ligaments, postmiokardialnog infarction syndrome, (6) spontaneous pneumothorax, (7) pleurisy, diseases spinal hordes, mediastinal tumor, malignant changes in the ribs and vertebrae; (8) mediastinal emphysema.
Palpitations
The sudden loss of consciousness and irregular action of the heart are the most common complaints of cardiac patients. In most cases, palpitations arises because of fear or concern arises because of pre-existing heart disease or because of long-term emotional changes as eg. because neurocirculatory asthenia. Organic causes are anemia, thyrotoxicosis, debility and paroxysmal tachycardia.
Usually describes two types of palpitations: Sinus tachycardia, fast and hard hitting that can begin gradually or suddenly, but still slows down gradually appears on exertion or during arousal. Premature ventricular systole cause the heart to specific sensations such as eg. "Skipping shock" or "deadlock and strike again."
Patients with paroxysmal tachycardia describe the real feeling of rapid, regular palpitations or "flutter".This sensation begins suddenly, lasts a few minutes or hours, and stops suddenly. In younger patients, there are no other symptoms, except in cases when an attack is extended. In elderly patients, paroxysmal arrhythmias can lead to angina pectoris, congestive heart function, or syncope. Paroxysmal atrial fibrillation occurs as a rapid and irregular action that starts and stops abruptly. Patients usually do not complain about the occurrence of chronic atrial fibrillation and flutter on, except in cases when after efforts accelerated action and excitement of Commerce.
For the purpose of diagnosis it is necessary to take an ECG during episodes of palpitations. However, other clinical factors used in making the diagnosis. It is necessary to observe the clinical action of the heart, heart rate and rhythm, the effects of fatigue and pressure on the carotid artery. Add to this the age of the patient and possibly other diseases. If we take into account all of the above elements of the diagnosis can be set up without ECG.
The etiology is determined on the basis of years of patient history, specific changes, laboratory tests, such as: antistreptolizinski 0 titer, serological test for syphilis determination, jodnproteinskog test or serum enzyme test. Abnormalities of cardiac structure and its functions can be determined through careful physical examination, which is necessary to add X-ray and ECG findings. Cardiac catheterization is needed to determine the size santa and to measure pressures in the heart chambers, the aorta and the pulmonary artery. Measurement of dye curves used in certain cases of unexplained desnolevog and levodesnog santa. Angiokardiografija in two directions cineangiografija used to show the anatomy of congenital and acquired anomalies, the extent of valve insufficiency, heart tumors, etc..
Nonspecific phenomenon
The most common symptoms of heart disease are: dyspnea, fatigue, chest pain and palpitations.However, as no matter which of the above symptoms can be found in diseases that are not related to the heart, the proper interpretation of symptoms depends on the systematic examination and diagnostic studies.
Dyspnea
Dyspnea caused by heart disease is usually associated with increased heart and other structural and physiological disorders.
The most common type of dyspnea caused by heart disease is dyspnea fatigue with shortness of breath that occurs even at moderate fatigue as you can break vacation.
Ortopnoa dyspnea in the supine position, which eliminates the sitting position. It exists only in an advanced stage of a heart failure.
Paroxysmal nocturnal dyspnea suddenly awakens patients from sleep and forced him to sit on the bed or stand up. This may be one of the first symptoms of left ventricular relaxation or very pronounced mitral stenosis.
Dyspnea fatigue luck in other circumstances not related to heart disease. Thus, for example, can occur in people with weak physical condition, in obesity, debility, in old age, chronic lung patients, anemia and obstruction of the airways. Ortopnea can occur in very obese patients with ascites, regardless of the cause, of gastrointestinal disorders that cause abdominal distension and in the third month of pregnancy. Paroxysmal nocturnal dyspnea may occur in adults in cases of first attack, bronchial asthma, and cases of obstruction of the airways caused by paratracheal tumors.
State anxiety and cardiac neurosis may also cause dyspnea. Such patients often report that they are unable to breathe well. Psychogenic dyspnea is associated with acute respiratory alkalosis which leads to mental disorders, paresthesias of the limbs or around the mouth, and then to tetany, tremors and fear.
Fatigue
Fatigue, which can be rectified rest is mostly caused by a decrease in heart function. This can be a major difficulty in congenital heart defects, cor pulmonale, or mitral stenosis in which are moreover more complicated and pulmonary hypertension. Asthenia, chronic fatigue and sleepiness that do not improve after rest are usually caused by mental changes as depression, cardiac neuroses and long-term care, or may be a component of "neurocirculatorne asthenia." Organic causes of fatigue include: chronic infections, anemia, endocrine and metabolic changes, chronic poisoning, the use of depressive and sedative drugs, malignancy, collagen disease, and all the debilitating disease.
Chest Pain
Chest pain occurs in sledeeih cardiovascular changes, angina pectoris (this pain is caused by intermittent myocardial ischemia), myocardial infarction; mioperikarditis, in the case of the presence of fluid in the pericardium with cardiac tamponade, aortic dissection or aneurysm of the aorta wall, pulmonary embolism or pulmonary infarction .
Chest pain is one of the most common disorders in which patients complain. It is necessary to carefully examine its quality, location, spread, duration, and factors that accelerate, worsen or odklanjaju pain. It is necessary to make several serial examination and laboratory tests. In addition to recommending and fatigue tests, therapeutic trials, and selective coronary sineangiografija.
However, some other diseases that are not related to the change of heart followed by chest pain and hard to distinguish from heart disease. These include: (1) disease or arthritis and discus in the upper or lower cervicalnim thoracic spine parties, (2) heart neurosis, (3) neurocirculatory asthenia and other emotional changes, (4) sliding hiatal hernia, acute or chronic cholecvstitis, Acute pancreatit, kardiospazam, peptic ulcus, esophageal pain, (5) changes that cause localized pain in the chest wall, pectoral strain or inflammation of the intercostal muscles and ligaments, postmiokardialnog infarction syndrome, (6) spontaneous pneumothorax, (7) pleurisy, diseases spinal hordes, mediastinal tumor, malignant changes in the ribs and vertebrae; (8) mediastinal emphysema.
Palpitations
The sudden loss of consciousness and irregular action of the heart are the most common complaints of cardiac patients. In most cases, palpitations arises because of fear or concern arises because of pre-existing heart disease or because of long-term emotional changes as eg. because neurocirculatory asthenia. Organic causes are anemia, thyrotoxicosis, debility and paroxysmal tachycardia.
Usually describes two types of palpitations: Sinus tachycardia, fast and hard hitting that can begin gradually or suddenly, but still slows down gradually appears on exertion or during arousal. Premature ventricular systole cause the heart to specific sensations such as eg. "Skipping shock" or "deadlock and strike again."
Patients with paroxysmal tachycardia describe the real feeling of rapid, regular palpitations or "flutter".This sensation begins suddenly, lasts a few minutes or hours, and stops suddenly. In younger patients, there are no other symptoms, except in cases when an attack is extended. In elderly patients, paroxysmal arrhythmias can lead to angina pectoris, congestive heart function, or syncope. Paroxysmal atrial fibrillation occurs as a rapid and irregular action that starts and stops abruptly. Patients usually do not complain about the occurrence of chronic atrial fibrillation and flutter on, except in cases when after efforts accelerated action and excitement of Commerce.
For the purpose of diagnosis it is necessary to take an ECG during episodes of palpitations. However, other clinical factors used in making the diagnosis. It is necessary to observe the clinical action of the heart, heart rate and rhythm, the effects of fatigue and pressure on the carotid artery. Add to this the age of the patient and possibly other diseases. If we take into account all of the above elements of the diagnosis can be set up without ECG.
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