Diagnosis of heart disease in adults
The main methods of diagnosing heart diseases in adults. Together with cardiologists, we will discuss how to check the heart, what procedures and tests exist for this and where they are performed

Cardiovascular diseases are the main cause of death among the inhabitants of our country. Diseases of the heart and blood vessels are rapidly “getting younger”, so doctors are no longer surprised by heart attacks in people aged 35–40. Meanwhile, modern methods of diagnosing the heart make it possible to identify most diseases at an early stage, when the pathology is well treatable.

We talked to our experts about the most popular heart diagnostic methods. Experts told when to check the heart and what examinations the doctor can prescribe.

Why and when to check the heart

An adult should undergo a preventive examination by a cardiologist at least once every two years. During the examination, the doctor will listen to the heart and, if necessary, prescribe additional tests and examinations. Experts also recommend checking the heart for people who:

  • belong to the risk group: smoke, move little, are overweight, suffer from high blood pressure;
  • are being treated for cardiovascular disease and should monitor the results of therapy;
  • notice alarming symptoms in themselves: pain in the heart, palpitations, shortness of breath and sweating with minimal physical exertion:
  • going to take up running, strength training and other sports that are associated with high stress on the cardiovascular system.

At the first stage of the examination, physical methods are used, for example, palpates the heart area. With their help, the doctor makes a preliminary diagnosis, selects laboratory and hardware methods for diagnosing heart diseases.1.

Methods for diagnosing the heart

Methods for diagnosing heart diseases are divided into laboratory and instrumental. The first includes blood and urine tests. The second group combines studies using medical equipment that allows you to assess the state and function of the heart at rest and during exercise. Diagnosis of heart disease is performed on an outpatient and inpatient basis.

Ultrasound of the heart or echocardiography

With the help of ultrasound study the anatomical features and functions of the heart muscle and valves1. The method is used to diagnose heart defects, ischemic disease and myocarditis – inflammatory diseases of the myocardium2.

ECG of the heart

ECG or electrocardiogram has been and remains the leading method for diagnosing heart disease.. ECG is used as part of a preliminary, preventive and periodic medical examination2. The study allows you to detect acute and chronic heart damage, rhythm and conduction disturbances2.

MRI of the heart

During an MRI session, the state of the magnetic field inside the heart is scanned.1,3. After computer processing of the signals, a series of images of the organ is obtained in different projections in statics and dynamics. With the help of images, you can get an idea about the structure of the heart muscle and the functioning of the valves, the condition of the chambers of the heart and coronary arteries1,3.

CT of the heart

Computed tomography of the heart or CT coronary angiography is used to detect structural abnormalities of the pericardium and major blood vessels. Refers to radiation research methods and requires the introduction of a contrast agent3. CT coronary angiography is prescribed for chest pain, if exercise tests are contraindicated for the patient or gave an unclear result3. Coronary angiography is also performed to find more effective methods for diagnosing and treating heart diseases.

Stress echocardiography

The method is a combination of conventional echocardiography with physical and pharmacological stress or electrical stimulation of the heart.3. In terms of diagnostic accuracy, this method is not inferior to radionuclide stress studies, but at the same time it is cheaper, does not have a radiation effect on the doctor and patient, and is safe for the environment.3. During stress echocardiography, a recumbent bike load is usually used. Elderly patients, with excess weight and problems of the musculoskeletal system, are prescribed an examination with drug tests.

CT angiography of the heart

CT angiography or CTA is a type of CT that is used to obtain three-dimensional images of major arteries, with the exception of the coronary arteries.3. Thanks to CTA, narrowing, aneurysms and ruptures of arteries can be detected, as well as blood clots that have broken off in a vein, migrated with blood flow through the venous network and stuck in small arteries of the lungs.

Coronary angiography

This is a radiopaque method for examining the vessels of the heart. With its help, the condition of the coronary vessels is assessed, the places and extent of the lesion are identified. Coronography is considered the most accurate and reliable way to diagnose coronary heart disease.3. Often, based on the results of the study, a decision is made on the need for angioplasty and stenting.3.

Myocardial perfusion scintigraphy

The method allows you to assess the level of blood supply to the heart muscle. Used to diagnose coronary artery disease and myocardial infarction and to evaluate the results of angioplasty and stenting2,3. Requires intravenous administration of radiopharmaceuticals. The drugs accumulate in healthy tissues of the heart muscle, and then the radiation from them is captured by the sensors of the diagnostic device3.

Screening for coronary calcium using MSCT

One of the most effective methods of early diagnosis. Allows you to detect atherosclerotic plaques and the degree of their prevalence in the vessels during the period when the patient feels completely healthy. With the help of MSCT, the progression of the disease and the effectiveness of therapy in patients with coronary artery disease are monitored. Multispiral computed tomography does not require the introduction of a contrast agent and special preparation.

Assays

For the diagnosis of heart diseases, general blood and urine tests, a biochemical blood test with a study of electrolytes and lipid profile, glucose, creatinine and liver enzymes are prescribed.2. If myocardial infarction is suspected, the blood concentration of cardiospecific enzymes, primarily creatine phosphokinase and L-lactate-NAD-oxidoreductase, is determined. If necessary, an assessment of thyroid hormones and indicators of inflammation is prescribed.

Preparing an Adult for Heart Diagnosis

Blood and urine tests are taken on an empty stomach. Before donating the biomaterial, you must refrain from food, alcohol and physical activity for 12 hours. You can’t take blood tests if you did a CT scan or put a dropper before that.

Most hardware studies – electrocardiography, echocardiography, MRI – do not require special training. Before carrying out stress tests and provocative tests, the patient should refuse to take certain drugs, in particular, beta-blockers, antianginal drugs, calcium antagonists. Features of preparation are determined by the doctor individually for each patient.

Where to check the heart

The heart is checked in diagnostic centers, public and private clinics. In many large cities, there are specialized cardiological centers where they diagnose and treat patients with cardiovascular diseases.

Popular questions and answers

Pain and discomfort in the left half of the chest is periodically or constantly experienced by more than 50% of adults. Therefore, the problem of timely diagnosis and treatment of cardiovascular diseases worries many. Experts answer popular questions from readers: cardiologist Elena Stark and cardiologist, PhD Olga Aparina.

Where is the heart?
The heart is located in the chest cavity and is located asymmetrically: two-thirds of this organ is to the left of the midline, and one-third is to the right. From below, the diaphragm adjoins the heart, and from above, large vessels – the aorta, pulmonary artery and its branches.
Which doctor checks the heart?
Therapists, cardiologists and cardiac surgeons deal with the treatment of diseases of the heart and the cardiovascular system, when it comes to surgical intervention. Diagnostic procedures are performed by doctors of functional diagnostics, including specialists in ultrasound and radiation diagnostics.
How to check if the heart or any other organ hurts?
Chest pain does not mean heart problems. Similar symptoms may be associated with neurological disorders, diseases of the spine and digestive system. It is possible to distinguish heart pain from some other on several grounds. Most often, heart pain is accompanied by pressure in the chest, pain in the shoulder, arm and neck. Signs of a serious heart condition can include shortness of breath, cold sweats, nausea, low blood pressure, and a weak pulse. With these symptoms, you need to urgently seek medical help.
  1. Clinical and laboratory diagnostic methods in cardiology. Strutynsky A. V. https://static.my-shop.ru/product/pdf/292/2912846.pdf
  2. Functional diagnostic methods in cardiology. Journal “Military Medicine” No. 1 for 2018. http://rep.bsmu.by/bitstream/handle/BSMU/18609/26.pdf?sequence=1&isAllowed=y
  3. Modern functional methods for studying the cardiovascular system in the diagnosis, assessment of severity and prognosis of patients with coronary heart disease. A. A. Myasnikov Institute of Clinical Cardiology. V. P. Lupanov. https://cardiovascular.elpub.ru/jour/article/viewFile/1948/1604

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