What tests are used to correctly diagnose cardiovascular diseases – the most common cause of death in Poles?

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Poles most often die from diseases of the cardiovascular system. However, many of them can be treated, provided they are diagnosed.

Blood pressure measurement

– Every man who turns 20 should measure his blood pressure at least once a year – says Dr. Beata Kłosiewicz-Wąsek, director of the Allenort Cardiology Center in Warsaw. – People with hypertension are often unaware of their disease. Meanwhile, it requires treatment because it may lead to complications such as a heart attack or stroke – she adds. The cardiologist explains that the most reliable are pressure measurements performed with a pressure recorder. It is a special device that measures blood pressure every now and then within 24 hours and stores it in the device’s memory. The patient should lead a normal lifestyle while wearing the recorder. After receiving the device, the doctor analyzes the measurements and can accurately assess the advancement of the disease, the risks resulting from it, or assess the effectiveness of the treatment.

Preventive blood test

Once a year, and at least every three years, it is also worth taking blood tests, i.e. assessing the lipid profile, sugar level, uric acid and homocysteine ​​levels. – These tests help in the early diagnosis of hypercholesterolemia, diabetes and hyperuricemia, which are risk factors for cardiovascular diseases, and we are able to treat them effectively – explains Dr. Beata Kłosiewicz-Wąsek.

BMI — Body Mass Index

Obesity is an increasingly common problem in Poland. Self-assessment should be made by determining BMI (body mass index) and WHR (waist to hip ratio). BMI is a factor calculated by dividing your body weight in kilograms by the square of your height in meters and should be less than 25. Above 25 we are overweight, and above 30 we are obese. BMI calculators are available on all overweight websites.

We measure the WHR by dividing the waist circumference by the hip circumference. When the WHR turns out to be greater than or equal to 0,8 (women) or 1,0 (men), we are dealing with abdominal obesity, which is the most threatening form of obesity to our health.

Heart EKG (electrocardiogram)

A more detailed examination of the heart is the electrocardiogram (ECG), which is a test of the electrical activity of the heart. Special electrodes attached to the patient’s body record electrical impulses. The examination can reveal not only heart ischemia or its infarction, but also diagnose cardiac arrhythmias, some congenital diseases, the consequences of arterial hypertension, etc. It can be performed in a family doctor’s office. It only takes a few minutes. It takes longer for the doctor to interpret the result. After such an analysis, the patient receives charts and a description. – In some patients, e.g. with suspected arrhythmia or after collapsing, we perform 24-hour Holter electrocardiographic monitoring, which will give us ECG recording in various situations, e.g. during sleep or during exercise – says Dr. Beata Kłosiewicz-Wąsek. The cost of a commercial test, depending on the type of recorder, ranges from PLN 100 to PLN 200.

The echo of the heart

The test that assesses the structure of the heart and the correctness of blood flow is the so-called echo of the heart. It allows to detect, among others congenital and acquired heart defects, visualization of the effects of coronary artery disease and arterial hypertension and the degree of their severity. – Simply put, it is an ultrasound of the heart combined with a Doppler examination, which shows the blood flow in the heart – explains Dr. Beata Kłosiewicz-Wąsek. It takes about 30 minutes. The patient receives the result immediately. The examination costs from PLN 100 to PLN 150.

Treadmill exercise test

The test that determines the patient’s efficiency is the so-called exercise test. – Normal ECGs may show resting heart ischemia. Most often, however, in coronary artery disease, exercise-induced ischemia occurs, i.e. when oxygen consumption increases and the constricted coronary vessels are unable to supply sufficient oxygenated blood. Hence the need to perform an ischemia provoking test. – The stress test can also diagnose exercise-induced arrhythmia, and also shows whether the adaptation of the pulse and pressure is adequate to the load – explains Dr. Beata Kłosiewicz-Wąsek. This test is done on a treadmill or stationary bike. The patient runs or pedals under a gradually increasing load, and special devices measure the parameters of his heart. Cardiology effort is measured in metabolic units MET or watts. A moderately fit 30-40-year-old should be able to exercise around 10-11 METs. If the result of an exercise test is in doubt, the patient should undergo in-depth diagnosis. Remember that this test is potentially dangerous and should be referred by a doctor. Only he can do them too. Commercially made, it costs from PLN 100 to PLN 150.

Computed tomography and magnetic resonance imaging of the heart

Cardiac imaging examinations include computed tomography and magnetic resonance imaging of the heart or coronary vessels. Tomography requires administration as an intravenous injection of radiological contrast that shades the vessels and cavities of the heart. On this basis, the doctor will see abnormalities in the structure of the heart or constrictions in the coronary vessels. Magnetic resonance imaging is especially useful for assessing the structure of the heart muscle. Both tests take more than 20-40 minutes. They cost about PLN 1000-1500 depending on the scope of the study.

Angiography and coronary angiography

There are a number of other non-invasive or invasive tests that can more accurately diagnose cardiovascular disease. One of the frequently performed invasive examinations is the so-called angiography, which is the study of blood flow through blood vessels. Angiography reveals narrowing of the arteries and blood vessels or their complete obstruction. A variation of this is coronary angiography, which shows changes in the coronary arteries that supply blood to the heart. A thin wire-thick catheter is inserted into the artery in the groin or wrist with the help of a needle, through which radiological contrast is introduced into the coronary vessel. Then the doctor looks at the vessels in the film. The contrast filling the vessels shows exactly the places narrowed by the atherosclerotic process and allows the assessment of the severity of the disease. In the course of such an examination, a decision may be made on the treatment method, e.g. on angioplasty, i.e. the expansion of the narrowed area with a balloon and possible stenting, or the necessity to implant coronary aortic bypass (so-called bypass), i.e. additional vessels bypassing the diseased area.

Prophylactic for cardiovascular diseases is, among others Hawthorn flower available at Medonet Market.

Text: Halina Pilonis

_{The material was created in cooperation with the Allenort Cardiology Center in Warsaw}