In the admission consultation and diagnostic medical offices of MC “Doverie” the following examinations are conducted: primary prevention (assessment of cardiovascular risk level for healthy individuals), and secondary prevention (for patients with cardiovascular diseases).
Key elements of diagnostic and healing activities:
- physical studies of heart and vessels;
- preparation of differential diagnostic plan
- specifying the need for additional diagnostic non-invasive and/or invasive methods and interpretation of results obtained;
- periodic estimate of global individual cardiovascular risk level
- specifying individual medication and/or invasive (interventional) treatment aiming at prolonging the patient’s life and/or maintaining the good quality of patient’s life
The electrocardiogram (ECG) is a record of heart’s electrical activity. Each heart contraction is a result of electric pulse which is formed in special cells in the upper right heart section. This is painless and non-invasive method used for establishing:
- Disturbances of heart rate (cardiac arrhythmia)
- Ischemic heart disease (narrowing or blockage of coronary arteries)
- Myocardial infarction (heart attack) in emergency conditions
- Myocardial infarction experienced in the past
- Cardiac defects
- Disturbances of cardiac valves functions
ECG should be made once a year by the general practitioner as a prevention procedure, at each consultation with cardiologist, as well as if there are doubts that any of above listed states may be available. No special preparation is needed. But it will be good to avoid drinking cold water and drinks, as well as making physical exercises just before ECG. The cold liquids are likely to change the electric potential thus misleading us, and the physical exercises accelerate the heart rate.
In echocardiography (EchoCG) ultrasound waves are used in order to construct the heart images. In such way the physician may assess the structure and function of heart (how it beats and pumps blood) carefully and in detail examining the cardiac muscle, valves and heart cavity. The examination may be appointed if the physician has doubts that there are problems with the heart valves or cavities, or disturbances in its pumping function.
Our specialists’ cardiologists make several versions of EchoCG depending on the information to be acquired:
- Transthoracic EchoCG – this is the standard non-invasive EchoCG. Contact gel is used on the chest and the abdomen upper part together with device called transducer or EchoCG probe by which the reflections (echo) of ultrasound waves by heart are recorded. The Doppler studies are part of the standard EchoCG. It is used to record the speed and direction of blood flow though the heart and blood vessels.
- Transoesophageal EchoCG – this is more rarely required for some specific states. In this EchoCG the flexible tube containing the transducer is inserted through the mouth and throat in the oesophagus. From there, very detailed heart images can.
- Stress EchoCG – some cardiac problems especially those affecting the coronary arteries supplying the heart muscle with oxygen, are exhibited only under physical effort. In Stress EchoCG the ultrasound heart images are obtained prior and immediately after the physical effort (on treadmill or exercise bike). If it is not possible fro you to have physical load, a medication can be used creating conditions for the heart that simulate physical effort.
· Holter ECG
The Holter monitor is a small portable device that can make continuous recording of heart electrical activity (electrocardiogram – ECG) and is referred to as Holter ECG. When the standard electrocardiogram cannot ensure the information required for the presence or absence of cardiac muscle disturbances, the physician may appoint Holter ECG. The purpose to conduct such is to establish disturbances in heart rate at longer monitoring as the standard electrocardiogram covers only a period of several seconds.
Usually Holter ECG is carried for 24 hours (more rarely for 48 hours) and after that the doctor analyses the heart electric activity for this period. The device is placed and removed in the medical exam room and in the remaining time when the patient is carrying it, such patent may do its usual activities. It not required entering the hospital in order to perform Holter ECG.
· Holter Blood Pressure (BP)
Holter BP is similar to Holter ECG but instead of heart electric activity it records the blood pressure. Quite often in the examination room the values measured for the BP do not correctly correspond to the actual ones. Such state is called “white coat hypertension” and is due to the uneasiness of patient to visit physician and BP to be measured. Such uneasiness results in increase of BP and this is why the values measured in the examination room may be higher than the actual ones.
The doctor may appoint Holter BP in the following cases:
- If there are doubts that the white coat hypertension is present
- If there are doubts for hidden hypertension – this is a state opposite to white coat hypertension for which BP is normal in the examination room but increased values are measured at home
- To make more accurate assessment whether the therapy for increased BP is efficient
- When the patient’s BP is varying considerably
- When there doubts for BP decrease in some periods of the day
- When there are increased BP values for pregnant women
- When there are big differences in BP values measured in the examination room and at home
- If necessary, the BP values at night will be assessed - this is important for certain diseases related to higher BP during the night