U modern people Due to stress, fast pace of life, ecology and other factors, heart and vascular diseases often develop. They may not know about the pathology until a critical situation arises. In this case, it will be difficult for doctors to help and cure the patient, so to maintain heart health it is important to carry out preventive diagnostics, and we’ll tell you how to check your heart in this article.
Symptoms of heart failure
Many people do not go to the doctor when heart problems appear, since the symptoms are often vague and can be confused with other diseases, for example, the lungs or stomach. Even if the problem is obvious, and the patient understands that something is wrong with the heart, he often goes to the pharmacy to buy drugs that can relieve the symptoms, but the disease itself is not treated and progresses.
The main symptoms of heart disease, which require medical help and a thorough examination, are as follows:
- Shortness of breath and lack of air. We are talking about shortness of breath without physical exertion.
- Lack of air at night. In a lying position, the symptom intensifies, and when the body is in an upright position, it disappears, which indicates heart failure.
- Edema. This symptom occurs when various reasons, but if there is a pathology of the heart, then initially the legs swell in the evening, gradually the swelling spreads higher, up to the abdominal area.
- Pain and feeling of tightness in the chest. The symptom appears after and during exercise, but after 5-10 minutes the pain goes away. It disappears if you put nitroglycerin under your tongue. The symptom appears when the patency of the vessels is impaired and they cannot normally cope with the blood supply to the myocardium.
- Heartache. If your heart hurts, there is a stabbing, piercing sensation. When turning or bending, true pain in the heart does not intensify.
- Headache, nausea, tinnitus. Symptoms appear when arterial hypertension. The problem occurs in people over 50 years of age.
- Heart rhythm failure. If your heart begins to beat irregularly and unevenly, it is better to consult a doctor for diagnosis and proper treatment.
Important! In addition to heart rhythm problems, you should consult a doctor if your resting heart rate is more than 90 or less than 60 beats per minute.
Primary diagnosis
The cardiovascular system leads in the number of diseases. A common problem is vascular atherosclerosis. It develops slowly. throughout life. Therefore, doctors advise undergoing diagnostics once a year. If the disease is detected on early stages, the treatment will be fast and effective.
Methods for studying the heart in medical practice are divided into two types:
- objective;
- instrumental.
During the initial examination in the hospital, doctors use an objective examination of cardio-vascular system. After the examination, the doctor makes a presumptive diagnosis, then uses instrumental diagnostics.
Objective methods for examining the heart include:
- Palpation. The test is carried out by placing the hand on the patient's chest, so that the hand is in contact with the ribs, after which the fingers are felt around the heart area. This method helps to hear the heart rhythm, the force of the beats, the height and their location. Due to this, it is possible to identify some pathologies, for example, stenosis, aorta, tachycardia.
Palpation - Percussion of the heart. This method of studying the cardiovascular system makes it possible to approximately determine the size of the organ and its position in chest by tapping. Due to this it is possible to put preliminary diagnosis.
Percussion - Auscultation of the heart. This is done using a stethoscope. This method consists of listening and allows you to assess the nature of the heart murmur and the deviation of the sound picture from the norm. The procedure must be carried out in complete silence.
Auscultation - Measurement blood pressure. IN in this case Any type of tonometer is used that measures blood pressure to determine hypertension or hypotension.
The described methods of studying the cardiovascular system are carried out only during the initial examination; if the doctor finds certain deviations from the norm, he prescribes additional methods to check the activity of the heart, in this case it is used full examination with special equipment.
Electrocardiography
This diagnostic method allows you to record and then study the electrical impulses that the heart muscle produces during operation. If the heart is without pathologies, then electrical excitation passes through different parts of the heart with a certain sequence. If there is a failure in the excitability of the heart muscle, this indicates pathologies and possible diseases.
When the myocardium contracts and relaxes, all data is recorded and written in the form of teeth, after which the doctor receives a curve or graph.
ECG curve The data is recorded by a special device called an electrocardiograph. This diagnostic method allows you to evaluate the frequency and uniformity of the heart rhythm, various electrical processes occurring in the organ. An ECG is performed to detect arrhythmia, ischemia, and heart attack.
Important! Shifts in the ECG curve occur not only due to improper functioning of the heart. The reason may be diseases not related to this organ: pneumonia, pleurisy, obesity, etc.
Electrocardiography may be included in comprehensive examination heart along with other methods.
In addition to taking a cardiogram at rest, other ECG techniques are used:
- Holter monitoring;
- bicycle ergometry.
In the first case, the study continues for a day. Equipment and sensors are connected to the patient, after which round-the-clock recording of indicators of changes in excitability begins. Often, this method is used for severe patients, or if the problem appears periodically, for example, with short-term arrhythmia.
In the second case, an ECG is taken before and after stress on the body. This method allows us to identify the patient’s susceptibility to physical activity. Bicycle ergometry is often used for ischemia, namely exertional angina.
Phonocardiography and echocardiography
Phonocardiography allows you to record all sounds and murmurs of the heart. Recording is performed through a phonocardiograph, which is usually an additional device to an electrocardiograph. This method of instrumental diagnosis allows you to evaluate the symptoms of diseases by sound.
Phonocardiography Echocardiography is performed using ultrasound. Today there are several methods for conducting echocardiography:
- One-dimensional echocardiography allows you to obtain a projection of the organ in the plane. The heart is examined using this method to determine the thickness of the walls and the size of the cavities. Additionally, the functioning of the valves and the condition of the organ during and after contraction are assessed.
- Two-dimensional echocardiography provides a three-dimensional image of the organ being examined, so the method is considered more informative.
- Doppler echocardiography – diagnostics of blood flow inside the heart, used to assess hemodynamics, identify valve and septal defects, and the presence of shunts.
Radiography
Methods for studying the heart and blood vessels using X-rays allow us to evaluate the size and shape of the heart, large vessels, and the volume of fluid in the pericardial part. When using this method, a person receives a dose of radiation, so there is no point in using it unnecessarily. It is used when other methods do not provide adequate information about the condition of a person and his organ.
X-rays cannot be used to examine pregnant women. One of the types of radiography is tomography. The latter method is more informative, since the picture is displayed on the monitor screen, simulating the patient’s organ, however, the radiation exposure in this case is higher than with x-rays.
Radionuclide examination and angiocardiography
An isotope study of the heart, namely the radionuclide method, is carried out by introducing radioisotopes into the blood, which make it possible to further evaluate their distribution. This method helps determine the formation of blood clots in blood vessels, as well as myocardial infarction. In this case, the patient also receives radiation.
Angiocardiography involves injecting a radiopaque contrast agent directly into the heart. With its help, doctors can study many parameters of the heart chambers and blood vessels. A procedure is used to determine the feasibility of carrying out surgical intervention on the organ. This method is one of the main ones when examining for blood clots. Angiocardiography is performed by catheterization.
Cardiac thrombosis Important! Only the doctor chooses how to check the blood vessels of the heart, by Dopplerography or angiography. The choice of method is influenced by many parameters, including the purpose of the study.
For each person and specific case, a certain type of diagnosis can be used, although in some situations more than one method may be used, but several at once. It depends on the state of health, the age of the patient and the reason why the heart hurts, that is, the existing pathology.
Home testing methods
You can check your heart function at home, and people over 40 years of age are recommended to do this more often in order to detect deterioration of the condition in time. For home diagnostics, a tonometer is used, which can measure blood pressure and pulse rate.
A tonometer can be used of any type, for which you have enough money. Measurements are taken only in a sitting or lying position, at rest. You can do them on both arms, but only on the elbow. If during measurements the pressure is more or less than 110/70-140/90 and the indicator remains long time, it is recommended to visit a cardiologist.
Cardiology profile - set specific tests blood, allowing you to assess the likelihood of recent damage to myocardial cells and assess risk factors for the development of heart and vascular diseases.
Why do you need to do a cardiac profile?
The cardiac profile allows us to identify early and hidden lesions of the cardiovascular system, the risk of developing atherosclerosis, coronary disease heart and heart failure, assess the likelihood of myocardial infarction.
What are the indications for the cardiac profile?
- vascular atherosclerosis;
- cardiac ischemia;
- high blood pressure;
- heart rhythm disturbances - tachycardia, arrhythmia;
- stroke, heart attack.
What do cardiac profile indicators mean?
Lipid profile(lipid profile) is necessary for diagnosing atherosclerosis and coronary heart disease.
Coagulogram determines an increase in blood viscosity, which indicates increased risk development of complications of hypertension and coronary heart disease - heart attacks and strokes.
ASAT(AST, aspartate aminotransferase) is an intracellular enzyme involved in the metabolism of amino acids in liver tissue, heart muscle and other organs. During myocardial infarction, serum AST activity may increase significantly even before the onset of typical signs heart attack on ECG.
Normal AST values:
- Women - up to 31 U/l
- Men - up to 37 U/l.
Creatine kinase(creatine phosphokinase, CK, CPK) is an enzyme that is a catalyst - an accelerator of the rate of ATP conversion.
KFK-MV found in cardiac muscle cells. When myocardial cells are damaged, an increase in CK-MB activity is detected 4 hours after infarction.
Normal CK-MB values:
- women -< 145 Ед/л
- men -< 171 Ед/л
LDH(Lactate dehydrogenase) is a zinc-containing enzyme that is involved in the final stages of glucose conversion and is found in almost all human organs and tissues. The greatest activity of this enzyme is observed in the cells of the heart muscle, liver, and kidneys. At acute heart attack myocardium, already 8-10 hours after the onset of pain, LDH activity sharply increases.
Normal LDH values:< 247 Ед/л
What preparation is needed for the study?
One day before taking blood, it is necessary to avoid drinking alcohol, and 1 hour before taking blood, smoking should be avoided. It is advisable to take blood samples on an empty stomach in the morning. There should be at least 12 hours between the last meal and the blood draw. Juice, tea, coffee are not allowed. You can drink water. It is necessary to exclude increased psycho-emotional and physical stress.
Diseases of the cardiovascular system in medical practice are the most complex and dangerous, which most often lead to death, regardless of the patient’s age.
That is why it is necessary to constantly monitor the condition of your cardiovascular system and undergo preventive examinations from a cardiologist, especially if there are certain prerequisites for the occurrence of pathologies, for example, heredity, overwork, heavy physical activity, etc.
One of the main symptoms of heart disease is the appearance pain in the area of the heart, which can have different strengths and directions depending on the heart disease and its severity. The second characteristic sign of heart disease is shortness of breath, which occurs from circulatory failure.
The third sign of problems with the heart is a rapid heartbeat, as well as interruptions in the functioning of the heart.
All of the above symptoms are signals to contact a cardiologist, who will diagnose accurate diagnosis will necessarily send the patient to additional examination, which includes taking certain tests.
What tests are done for heart disease:
Comprehensive analysis of heart and vascular diseases “Cardiological Profile”
It is also worth considering that many pathological processes in the cardiovascular system are asymptomatic. Therefore, even if you are not bothered by pain in the heart, shortness of breath, rapid heartbeat or arrhythmia, periodic visits to a cardiologist should be included in the list of mandatory preventive measures that will help maintain your health for many years.
As with any disease various organs and systems, timely diagnosis and well appointed effective treatment heart disease will not only help cure certain diseases, but also prevent serious complications, improve the quality of life, prolong it and even save it.
Cardiological profile: why is it needed?
Cardiology profile is a set special analyzes blood, which allows:
Assess risk factors for the development of heart and vascular diseases;
Identify early and hidden lesions of the cardiovascular system;
Identify the risk of developing atherosclerosis, coronary heart disease and heart failure;
Assess the likelihood of myocardial infarction.
Cardiological profile: indications
Indications for prescribing a set of cardiological tests are:
Vascular atherosclerosis;
Cardiac ischemia;
High blood pressure;
Heart rhythm disturbances, including:
Stroke;
Arrhythmia;
Heart attack;
Tachycardia.
What tests are included in the cardiac profile?
Lipidogram;
Coagulogram;
AST (AST, aspartate aminotransferase);
Creatine kinase (creatine phosphokinase, CK, CPK);
Lactate dehydrogenase (LDH).
What do cardiac profile indicators mean?
Lipidogram ( lipid profile) helps diagnose atherosclerosis and coronary heart disease.
Using a coagulogram, the level of blood viscosity is determined. An increased blood viscosity level indicates an increased risk of developing complications of hypertension, coronary heart disease, heart attack or stroke.
An increase in the value of AST, an intracellular enzyme involved in the metabolism of amino acids in liver tissue, heart muscle and other organs, indicates an increased risk of developing a heart attack.
This is also indicated by the enzyme creatine kinase, which catalyzes the rate of ATP conversion. An increase in the activity of CPK-MB, an enzyme found in heart muscle cells, indicates an increased risk of myocardial infarction.
The greatest activity of LDH (Lactate dehydrogenase), a zinc-containing enzyme, is observed in the cells of the heart muscle, liver, and kidneys. LDH activity also increases sharply during acute myocardial infarction.
How should you prepare for a cardiac profile?
A cardiac profile is a comprehensive blood test for the content of certain enzymes. Blood for a cardiac profile is taken in the morning, on an empty stomach.
The day before taking blood, it is necessary to avoid alcohol consumption, as well as psycho-emotional and physical stress.
What tests? general prescribed for heart diseases:
Blood chemistry;
General analysis blood;
General urine analysis;
Coagulogram.
Where can I get a full examination?
Get tested and get competent treatment heart diseases
Complete a full examination and pass necessary tests for heart diseases, and you can also receive competent effective treatment at the medical center " Medical practice" in Novosibirsk.
Our medical center has everything necessary to accurately diagnose one or another heart disease and take all necessary measures to reduce the risk of complications.
Highly qualified specialists, the latest equipment, high-quality reagents, modern methods treatment of diseases of the cardiovascular system - we try to do everything to ensure that our patients are satisfied that they receive quality medical care in one of the largest medical centers Novosibirsk.
In our center
You can undergo all types of medical tests and get advice from a cardiologist of the highest category.
Hemostasiological studies. This set of tests is aimed at studying the blood coagulation system.
A biochemical blood test gives the doctor additional information about the functioning of the heart and blood vessels, since it provides results for a larger number of enzymes.
The Invivo VDP diagnostic center will help identify heart diseases thanks to modern MRI and CT machines
Cardiovascular diseases are widespread among our population, regardless of gender and age. In addition, they very often cause premature death. You can protect yourself by regularly taking the simplest tests. In this article we will look at what kind of examination you need to undergo in a particular case.
Symptoms of heart and vascular diseases
Very often, people do not pay attention to the presence of the symptoms listed below, attributing their occurrence to fatigue and other ailments. Of course, you shouldn’t rush headlong to a cardiologist if you find one of the described symptoms. But consult a doctor if these manifestations are observed throughout long period time and do not pass, still it will not be superfluous.
Pale and weak
Anxiety, fatigue, bad dream may be symptoms of cardiac neurosis. Pallor skin speaks of anemia and vasospasm, and blueness of the limbs, nose, cheeks, ears - the presence of cardiopulmonary failure.
Edema
Kidney problems, which people blame when they experience regular swelling towards the end of the day, are not the only reason for the increase. lower limbs. This is due to a large amount of salty food, which affects both the kidneys and the heart. It becomes unable to pump blood, which subsequently accumulates in the legs and causes heart failure.
Dizziness, nausea, headache
Frequent appearance These symptoms may be the first “bell” of an approaching stroke, and also indicate an increase in blood pressure.
Dyspnea
One of the signs of heart failure and angina pectoris may be shortness of breath and a feeling of lack of air.
Cardiopalmus
If you have not been involved in physical activity and have not experienced emotional uplift, and your heart is “jumping out of your chest,” this sign may indicate a malfunction of the heart: impaired blood supply, heart failure, tachycardia, angina pectoris.
Chest pain
This is one of the surest signs of heart problems. Acute pain in the chest, occurring even at rest, may be a sign of angina, which, in turn, is a precursor to coronary heart disease and myocardial infarction.
What tests are taken to detect heart and vascular diseases?
Oddly enough, to diagnose the state of the cardiovascular system, the doctor prescribes the most common laboratory research: general and biochemical analysis s blood. Based on their results, one can judge the main processes occurring in the body.
Complete blood count (CBC): interpretation of results
It gives an idea of the level of hemoglobin, the number of leukocytes, red blood cells, platelets, erythrocyte indices, erythrocyte sedimentation rate (ESR) and other indicators. By deciphering the results of this seemingly simple analysis, the doctor can detect several disorders in the body at once:
reduced level hemoglobin(normal for men - 130-160 g/l, for women - 120-140 g/l) indicates kidney problems, anemia, internal bleeding may indicate; increase in white blood cell count(the norm is from 4 to 9 x109 cells per liter) suggests the development of an inflammatory process; decrease in red blood cells(norm for men - 4.4-5.0 x1012/l, for women - from 3.8 to 4.5 x1012/l) - a sign of chronic inflammatory processes and oncological diseases, and their increase indicates dehydration of the body; lack of platelets(in men the norm is 200–400 thousand U/μL, in women - 180–320 thousand U/μL) leads to problems with blood clotting, and too much leads to the formation of blood clots; big erythrocyte sedimentation rate(ESR) is a clear sign of an inflammatory process. ESR norm for men - 1-10 mm/h, for women - 2-15 mm/h.
Biochemical blood test: what do deviations from the norm indicate?
Thanks to it, the doctor receives additional information about the functioning of the heart and blood vessels, since it provides results for a larger number of enzymes.
ALT (alanine aminotransferase) And AST (aspartate aminotransferase) They are always tested in pairs so that the doctor can see and separate the damage to the heart and liver. Their increase, in most cases, indicates problems with muscle cells heart, the occurrence of myocardial infarction. ALT norm in women - up to 31 U/l, in men - up to 41 U/l. The AST norm in women is also up to 31 U/l), and in men - up to 35-41 U/l.
LDH - lactate dehydrogenase(for women the norm is 125-210 U/l, for men - 125-225 U/l) and CK-creatine phosphokinase and especially its MB-fraction (MB-CPK) increase during acute myocardial infarction. The laboratory norm for CPK is 10-110 IU, and CPK-MB isoenzymes are 4-6% of total CPK. Myoglobin increases in the blood as a result of breakdown muscle tissue heart or skeleton. The norm for men is 19 – 92 µg/l (average – 49 ± 17 µg/l), for women – 12 – 76 µg/l (average – 35 ± 14 µg/l). Electrolytes (K+, Na+, Cl-, Ca2+ ions) also tell a lot: an increase in potassium content in the blood serum (normal 3.6 - 5.2 mmol/l) leads to a violation heart rate, possible development ventricular excitation and fibrillation; low level K+ can cause a decrease in myocardial reflexes; insufficient content of Na+ ions (normal 135 – 145 mmol/l) and an increase in chlorides (normal 100 – 106 mmol/l) are fraught with the development of cardiovascular failure. Cholesterol, contained in the blood in large quantities, serves as a risk for the development of atherosclerosis and coronary heart disease. On average, the norm for total cholesterol is considered to be from 3.61 to 5.21 mmol/liter, the level of “bad” cholesterol (LDL) should be in the range from 2.250 to 4.820 mmol/liter, and high-density cholesterol (HDL) - from 0.71 to 1.71 mmol/liter. C-reactive protein appears in the body when inflammatory process or tissue necrosis that has already occurred, since in the blood serum healthy person it is contained in minimum values. The norm for children and adults is the same - less than 5 mg/l.
Coagulogram
The results of this analysis, which is sometimes prescribed in addition to the main ones, give the doctor an idea of the process of blood clotting, its viscosity, the possibility of blood clots or, conversely, bleeding. The table below shows the main indicators of this analysis.
Note that during pregnancy, the results of a coagulogram differ from the norms presented above.
A referral for a CBC, a biochemical blood test and a coagulogram is prescribed by the attending physician, and the results of the study can be obtained within 1-2 days, depending on the equipment of the laboratory.
How to protect yourself from heart and vascular diseases?
Getting rid of excess weight, which significantly increases the risk of developing diseases of the cardiovascular system, comes first. For normal blood circulation and to prevent the formation of blood clots, it is necessary to expose your body to physical activity every day. This does not mean going to the gym every day; initially, walking will suffice, increasing the distance every few days.
Following a diet reduces cholesterol levels in the blood and thereby has a positive effect on the condition of blood vessels. Fresh vegetables, berries and fruits, which contain antioxidants beneficial to our body, cleanse and strengthen the walls of blood vessels. For example, acids contained in fatty fish, walnuts and almonds fight vascular thrombosis.
Quitting the use of alcohol and tobacco will certainly be beneficial not only to the heart and blood vessels, but will also have a beneficial effect on the health of all body systems.
Knowledge base: Chronic heart failure
Chronic heart failure
Chronic heart failure (CHF) is a disease in which the heart is unable to pump enough blood to supply the body with oxygen. It can occur as a result of many diseases of the cardiovascular system, among which the most common are coronary heart disease, hypertension, rheumatoid heart defects, and endocarditis. A weakened heart muscle is unable to pump blood, releasing less and less of it into the vessels.
Heart failure develops slowly and initial stages appears only during physical activity. Characteristic symptoms at rest indicate a severe stage of the disease. As CHF progresses, it significantly worsens the patient’s condition, leading to decreased performance and disability. The result can be chronic liver and kidney failure, blood clots, and strokes.
Timely diagnosis and treatment can slow down the development of the disease and prevent dangerous complications. Important role In stabilizing the condition, the correct lifestyle is given: weight loss, low-salt diet, limiting physical and emotional stress.
Synonyms Russian
Congestive heart failure, heart failure.
Heart failure, congestive heart failure.
Clinical manifestations of heart failure depend on its duration and severity and are quite varied. The development of the disease is slow and takes several years. If left untreated, the patient's condition may worsen.
The main symptoms of chronic heart failure include:
shortness of breath on exertion, when going into horizontal position, and then at rest; dizziness, fatigue and weakness; lack of appetite and nausea; swelling of the legs; accumulation of fluid in abdominal cavity(ascites); weight gain due to edema; fast or irregular heartbeat; dry cough with pinkish sputum; decreased attention and intelligence.
General information about the disease
By contracting, the heart ensures continuous circulation of blood through the vessels. Along with blood, oxygen and nutrients are supplied to all organs and tissues, and the end products of metabolism, including liquid, are removed. This is achieved by alternating two phases: contraction of the heart muscle (called systole) and its relaxation (diastole). Depending on which phase of cardiac activity disrupts its functioning, we speak of systolic or diastolic heart failure.
Systolic heart failure is a consequence of weakness of the heart muscle and is characterized by insufficient ejection of blood from the chambers of the heart. Its most common causes are coronary heart disease and dilated myocardiopathy. More often observed in men. Diastolic heart failure occurs when the heart muscle loses its ability to stretch. As a result, much less blood enters the atria. Most common reasons: arterial hypertension, hypertrophic myocardiopathy and stenotic pericarditis.
The human heart can be roughly divided into right and left halves. Pumping blood into the lungs and saturating it with oxygen is ensured by the work of the right parts of the heart, and the left ones are responsible for delivering blood to the tissues. Depending on which departments fail to cope with their task, they speak of right ventricular or left ventricular heart failure. When the functioning of the left sections is impaired, shortness of breath and cough come to the fore. Right-sided failure manifests itself as systemic edema.
To select the necessary medications, it is very important to determine the mechanism of heart failure and its type.
Who is at risk?
The presence of at least one of the following risk factors is sufficient for the development of chronic heart failure. The combination of two or more factors significantly increases the likelihood of disease.
Patients at risk include:
high blood pressure; coronary heart disease; myocardial infarction in the past; heart rhythm disturbances; diabetes mellitus; congenital heart disease; frequent viral diseases throughout life; chronic renal failure; alcohol addiction.
The diagnosis of chronic heart failure is made based on the history of the disease, characteristic symptoms and results of laboratory and other studies.
Laboratory research
There are most often no changes in the general blood test. In some cases, moderate anemia may be detected. The erythrocyte sedimentation rate (ESR) may be elevated, especially when heart failure is the result of rheumatic heart disease or infective endocarditis. A general urinalysis is important to diagnose renal complications and exclude the renal origin of edema. One of possible manifestations chronic heart failure - high levels of protein in the urine. Total protein and protein fractions in the blood may be reduced due to their redistribution into the edematous fluid. Blood glucose. Important for exclusion diabetes mellitus as one of the risk factors for heart failure. Cholesterol. high and low density lipoproteins. There is a clear relationship between increased level cholesterol and the development of atherosclerosis, coronary heart disease, hypertension. High level cholesterol and lipoproteins in heart failure may indicate a more severe course of the disease. Sodium and potassium in the blood. In chronic heart failure, their level in the blood serum can change significantly due to edema. Monitoring blood composition is especially important when prescribing diuretics. Brain sodium
Cardiac examination
Often, a person who first feels any complaints from the cardiovascular system, upon initial outpatient treatment, immediately receives treatment, bypassing a full cardiological and related examination, which should include both instrumental and laboratory diagnostic methods.
Depending on the predominance clinical symptoms Conditionally, three main groups of patients can be distinguished:
1. Patients with complaints of pain in the heart area
2. Patients with high blood pressure
3. Patients with rhythm disturbances, interruptions in heart function
Various combinations of clinical symptoms are also possible (rhythm disturbances and heart pain against the background of high blood pressure).
The minimum examination should include:
Examination by a cardiologist with a detailed collection of complaints and physical examination (auscultation, percussion) ECG (ECG in 12 leads, ECG on a long tape, cardiotopography, ECTG-60, ECG with isometric stress) Ultrasound ( ultrasonography) heart, dopplerography of blood vessels, transesophageal ultrasound (often necessary for rhythm disturbances to exclude the presence of blood clots in the cavities of the heart), ultrasound of the kidneys, adrenal glands, thyroid gland 24-hour monitoring of blood pressure and ECG (Holter monitoring) Stress tests (velergometry, treadmill test, informational and pharmacological tests) Consultations of related specialists (endocrinologist, gynecologist, ophthalmologist, gastroenterologist, neurologist, nephrologist, etc.) Laboratory tests: biochemical blood test ( glucose, electrolytes, lipid spectrum, cholesterol and other cardiac enzymes), determination of the level of certain hormones (thyroid gland, brain natriuretic peptide).
Heartache
The most common reasons:
Coronary heart disease (CHD) Heart valve defects Neurocirculatory dystonia (NCD)
A special role must be given differential diagnosis pain due to diseases of the spine (osteochondrosis).
An important role in the survey is played by ECG changes, including during stress tests and daily monitoring, as well as changes in biochemical blood tests (lipoproteins, triglycerides). If necessary, coronary angiography is performed to establish a final diagnosis and determine further tactics treatment. Treatment can be conservative (medication), endovascular (angioplasty and stent placement in coronary arteries through the brachial or femoral artery), surgical (coronary artery bypass grafting with artificial circulation or on a beating heart).
If spinal osteochondrosis is suspected, a consultation with a neurologist is required, who will determine the volume necessary research(CT, MRI, etc.)
High blood pressure
First of all, it is necessary to exclude the symptomatic nature of arterial hypertension (hypertension caused by diseases of specific organs). Such hypertension includes hypertension due to diseases of the kidneys and their vessels, tumors of the kidneys and adrenal glands, brain tumors, vascular diseases (coarctation of the aorta, other vascular pathology.) Special attention deserves endocrine causes of increased blood pressure, especially in women after 45 years.
If the cause of hypertension cannot be found (and this happens in approximately 95% of cases), such hypertension is considered idiopathic, or essential (is an independent disease), and requires treatment with special drugs. It is very important to understand that this disease requires systematic, often lifelong treatment. A very common mistake is the practice of taking antihypertensive drugs only to reduce high blood pressure, rather than taking them continuously and regularly. (See Guide to Lowering Blood Pressure.)
Rhythm disturbances, interruptions in heart function
Electrocardiogram (ECG) data play a key role in diagnosis. To find out the causes of arrhythmia, it is necessary to exclude organic reasons(damage to the valvular apparatus of the heart) - for this, an ultrasound of the heart is performed - and coronary heart disease. Some arrhythmias may be congenital. A common cause of arrhythmia may be dysfunction of the thyroid gland, which requires a full endocrinological examination (consultation with an endocrinologist, determination of hormone levels in the blood). When establishing the cause and determining the nature of the rhythm disturbance, an electrophysiological study (EPS) of the heart may be necessary.
What do clinical blood test indicators indicate?
It is hardly possible to find a person who has not done a clinical (or general) blood test at least once in his life. This is one of the most commonly used tests for diagnosing various diseases; such a study, performed professionally, can tell the doctor a lot about the patient’s health status.
Most often, people, independently receiving the results of a clinical blood test in the laboratory or listening to their interpretation from a doctor, do not understand what this or that indicator means and how it relates to their condition. Of course, the patient should not “replace” the doctor and try to diagnose himself, etc., based on the results obtained. The purpose of this article is to familiarize a wide range of readers with the main indicators of a general blood test, so that the terminology used by doctors when communicating with patients is not a “closed secret,” and the doctor and patient would better understand each other.
For a general blood test, blood is taken from a finger (or from a vein) in the morning on an empty stomach. The night before, it is recommended to refrain from fatty foods, as this may affect your white blood cell count. Stress can also distort the blood picture - even a quarrel with someone on the way to the clinic.
To take the analysis, disposable sterile instruments are used. The laboratory technician who draws blood must work either in disposable gloves or rubber gloves, which are disinfected with disinfectant solutions after each blood draw, and which he changes as necessary.
Traditionally, blood is taken from the fourth finger of the left hand, which is thoroughly wiped with cotton wool and alcohol, after which an injection is made with a special needle into the flesh of the finger to a depth of 2-3 mm. The first drop of blood is removed with cotton wool soaked in ether. First, blood is drawn to determine hemoglobin and ESR, then to determine the number of erythrocytes and leukocytes, after which blood smears are made using slides and the structure of cells is studied under a microscope.
In addition, you need to take into account that each laboratory has its own “standards” for a general (clinical) blood test, so it is better to ask your doctor all your questions.
A general blood test helps a doctor of any specialty. Based on the results of a blood test (hemogram), the doctor can competently assess the condition of the body, make a preliminary diagnosis and promptly prescribe appropriate treatment.
So, A general (clinical) blood test shows:
the number of red blood cells, erythrocyte sedimentation rate (ESR), hemoglobin content, white blood cell count, leukocyte formula and other indicators, each of which we will dwell on in detail.
Red blood cells also known as red blood cells. In humans, 1 mm³ of blood contains 4.5-5 million red blood cells. Red blood cells contain hemoglobin and carry oxygen and carbon dioxide. An increase in the number of red blood cells is a sign of diseases such as leukemia, chronic lung diseases, and congenital heart defects. Anemia (decreased number of red blood cells) can be caused by stress, increased physical activity, and fasting. If you cannot immediately determine the cause of the decrease in the number of red blood cells, then it is better to go to a hematologist and undergo additional examination.
A significant increase in the content of red blood cells may indicate erythremia (one of the blood diseases). In addition, an increase in the number of red blood cells (erythocytosis, polycythemia) is observed with acute poisoning when due to severe vomiting and diarrhea there is a large deficiency of fluid in the body; with acidosis (due to metabolic disorders during exacerbation of certain diseases); when losing fluid for various reasons (heat, illness, heavy physical activity); with long-term cardiovascular or pulmonary diseases, when the body is not sufficiently supplied with oxygen and increases the number of red blood cells in an attempt to still deliver oxygen to the tissues; or when a person is in the highlands, when he no longer has enough oxygen.
Color index- its normal value for people of any age is 0.85-1.15. The blood color index is an indicator of the degree of saturation of red blood cells with hemoglobin and reflects the relationship between the number of red blood cells and hemoglobin in the blood. When its values differ from the norm, this generally indicates the presence of anemia. In this case, anemia is divided into:
Hypochromic - color index less than 0.85;
Hyperchromic - color index greater than 1.15.
However, anemia can also be normochromic - when color index remains within normal limits.
Reticulocytes- these are young forms of red blood cells. Children have more of them, adults have less, because the formation and growth of the body has already been completed. An increase in the number of reticulocytes can be observed in anemia or malaria. A decrease in the number of reticulocytes or their absence is an unfavorable sign in anemia, indicating that the bone marrow has lost the ability to produce red blood cells.
Erythrocyte sedimentation rate (ESR) determines how quickly red blood cells settle in a test tube, separating from the blood plasma. In women, the ESR rate is slightly higher than in men; during pregnancy, the ESR increases. Normally, the ESR value in men does not exceed 10 mm/hour, and in women - 15 mm/hour. ESR indicator may vary depending on various factors, including due to various diseases.
An increase in ESR in a blood test is one of the indicators that makes the doctor assume that the patient has an acute or chronic inflammatory process (pneumonia, osteomyelitis, tuberculosis, syphilis), as well as increase in ESR typical for poisoning, myocardial infarction, trauma, bone fractures, anemia, kidney disease, cancer. It is observed both after operations and as a result of taking certain medicines. A decrease in ESR occurs during fasting, with a decrease muscle mass when taking corticosteroids.
Hemoglobin- a complex iron-containing protein found in red blood cells - erythrocytes - of animals and humans, capable of reversibly binding to oxygen, ensuring its transfer to tissues. Normal content hemoglobin in human blood is considered: for men 130-170 g/l, for women 120-150 g/l; in children - 120-140 g/l.
Blood hemoglobin is involved in the transport of oxygen and carbon dioxide and maintains pH balance. Therefore, determining hemoglobin is one of the most important tasks of a general blood test. Low hemoglobin (anemia) can be the result of large blood loss; a decrease in hemoglobin occurs when there is a lack of iron, a necessary material for the construction of hemoglobin. Also low hemoglobin (anemia) is a consequence of blood diseases and many chronic diseases
, not related to them. A hemoglobin level higher than normal can be an indicator of many blood diseases, and a complete blood count will also show an increase in red blood cells. Increased hemoglobin typical for people with birth defects heart, pulmonary heart failure. An increase in hemoglobin may be caused by physiological reasons
– in pilots after flights, climbers, after significant physical activity, the hemoglobin level is higher than normal. Leukocytes - These are the protectors of our body from foreign components. The blood of an adult contains an average of 4-9x10 9 leukocytes/l
. White blood cells fight viruses and bacteria and cleanse the blood of dying cells. There are several types of leukocytes (monocytes, lymphocytes, etc.). The leukocyte formula allows you to calculate the content of these forms of leukocytes in the blood. If leukocytes are found in increased numbers in a blood test, this may indicate the presence of viral, fungal or(pneumonia, tonsillitis, sepsis, meningitis, appendicitis, abscess, polyarthritis, pyelonephritis, peritonitis), and also be a sign of poisoning of the body (gout). Previous burns and injuries, bleeding, postoperative condition of the body, myocardial, lung, kidney or spleen infarction, acute and chronic anemia, malignant tumors all these “troubles” are accompanied by an increase in the number of blood leukocytes.
In women, a slight increase in leukocytes in the blood is also observed in the period before menstruation, in the second half of pregnancy and during childbirth.
A decrease in the number of white blood cells, which can be shown by a blood test, may be evidence of viral and bacterial infections (flu, typhoid fever, viral hepatitis, sepsis, measles, malaria, rubella, parotitis, AIDS), rheumatoid arthritis, renal failure, radiation sickness, some forms of leukemia, diseases bone marrow, anaphylactic shock, exhaustion, anemia. A decrease in the number of leukocytes can also be observed while taking certain medications (analgesics, anti-inflammatory drugs).
Platelets- these cells are also called blood plates. They are the smallest blood cells. The main role of platelets is participation in blood clotting processes. IN blood vessels platelets can be located near the walls and in the bloodstream. IN calm state platelets are disc-shaped. If necessary, they become like a sphere and form special outgrowths (pseudopodia). With their help, blood platelets can stick to each other or stick to a damaged vascular wall.
A decrease in the number of platelets is observed in women during menstruation and during normal pregnancy, and an increase occurs after physical activity. Also, the number of platelets in the blood has seasonal and daily fluctuations. Typically, platelet monitoring is prescribed when taking certain medications, when a person has burst capillaries for no reason, has frequent nosebleeds, or when being examined for various diseases.
An increase in the number of platelets in the blood (so-called thrombocytosis) occurs when:
Inflammatory processes (acute rheumatism, tuberculosis, ulcerative colitis);
Acute blood loss;
Hemolytic anemia (when red blood cells are destroyed);
Conditions after removal of the spleen;
It is observed during treatment with corticosteroids;
Some rarer diseases.
A decrease in the number of platelets (thrombocytopenia) is observed in a number of hereditary diseases, but appears much more often in acquired diseases. The number of platelets decreases when:
Severe iron deficiency anemia;
Some bacterial and viral infections;
Liver diseases;
Diseases of the thyroid gland;
The use of a number of medications (vinblastine, chloramphenicol, sulfonamides, etc.);
Systemic lupus erythematosus.
Hematocrit- this is the proportion (as a percentage) of the total blood volume that is made up of red blood cells. Normally, this figure is 40-48% for men, 36-42% for women.
The volume of erythrocytes compared to plasma increases with:
Dehydration (dehydration), which occurs with toxicosis, diarrhea, vomiting;
Congenital heart defects, accompanied by insufficient oxygen supply to the tissues;
A person being in high altitude conditions;
Insufficiency of the adrenal cortex.
The volume of red blood cells relative to plasma decreases with blood thinning (hydremia) or with anemia.
Hydremia can be physiological if a person immediately drinks a lot of liquid. After significant blood loss, compensatory hydremia occurs when blood volume is restored. Pathological hydremia develops when there is a violation water-salt metabolism and occurs with glomerulonephritis, acute and chronic renal failure, with heart failure during the period of swelling.
Blood formula. The study of the leukocyte formula is important diagnostic value, showing characteristic changes for a number of diseases. But these data should always be assessed together with other indicators of the blood system and the general condition of the patient.
At various diseases look at the combination of the following signs: total number of leukocytes; the presence of a nuclear shift of neutrophils (the so-called “shift according to the formula to the left”, that is, the appearance of young, immature forms of neutrophils in the blood); percentage individual leukocytes; the presence or absence of degenerative changes in cells.
Cardiovascular diseases are widespread among our population, regardless of gender and age. In addition, they very often cause premature death. You can protect yourself by regularly taking the simplest tests. In this article we will look at what kind of examination you need to undergo in a particular case.
Symptoms of heart and vascular diseases
Very often, people do not pay attention to the presence of the symptoms listed below, attributing their occurrence to fatigue and other ailments. Of course, you shouldn’t rush headlong to a cardiologist if you find one of the described symptoms. But it would not be a bad idea to consult a doctor if these manifestations are observed over a long period of time and do not go away.
Pale and weak
Anxiety, fatigue, poor sleep can be symptoms of cardiac neurosis. Pale skin indicates anemia and vasospasm, and blue discoloration of the limbs, nose, cheeks, and ears indicates the presence of cardiopulmonary failure.
Edema
Kidney problems, which people blame for regular swelling at the end of the day, are not the only reason for enlarged lower limbs. This is due to a large amount of salty food, which affects both the kidneys and the heart. It becomes unable to pump blood, which subsequently accumulates in the legs and causes heart failure.
Dizziness, nausea, headache
The frequent occurrence of these symptoms may be the first “bell” of an approaching stroke, and also indicates an increase in blood pressure.
Dyspnea
One of the signs of heart failure and angina pectoris may be shortness of breath and a feeling of lack of air.
Cardiopalmus
If you have not been involved in physical activity and have not experienced emotional uplift, and your heart is “jumping out of your chest,” this sign may indicate a malfunction of the heart: impaired blood supply, heart failure, tachycardia, angina pectoris.
Chest pain
This is one of the surest signs of heart problems. Acute chest pain that occurs even at rest may be a sign of angina, which, in turn, is a precursor to coronary heart disease and myocardial infarction.
What tests are taken to detect heart and vascular diseases?
Oddly enough, to diagnose the state of the cardiovascular system, the doctor prescribes the most common laboratory tests: general and biochemical blood tests. Based on their results, one can judge the main processes occurring in the body.
Complete blood count (CBC): interpretation of results
It gives an idea of the level of hemoglobin, the number of leukocytes, red blood cells, platelets, erythrocyte indices, erythrocyte sedimentation rate (ESR) and other indicators. By deciphering the results of this seemingly simple analysis, the doctor can detect several disorders in the body at once:
- decreased hemoglobin level(normal for men - 130-160 g/l, for women - 120-140 g/l) indicates kidney problems, anemia, internal bleeding may indicate;
- increase in white blood cell count(the norm is from 4 to 9 x109 cells per liter) suggests the development of an inflammatory process;
- decrease in red blood cells(the norm for men is 4.4-5.0 x1012/l, for women - from 3.8 to 4.5 x1012/l) - a sign of chronic inflammatory processes and cancer, and their increase indicates dehydration of the body;
- lack of platelets(in men the norm is 200–400 thousand U/μL, in women - 180–320 thousand U/μL) leads to problems with blood clotting, and too much leads to the formation of blood clots;
- big erythrocyte sedimentation rate(ESR) is a clear sign of an inflammatory process. The ESR norm for men is 1-10 mm/h, for women – 2-15 mm/h.
Biochemical blood test: what do deviations from the norm indicate?
Thanks to it, the doctor receives additional information about the functioning of the heart and blood vessels, since it provides results for a larger number of enzymes.
- LDH - lactate dehydrogenase(for women the norm is 125-210 U/l, for men - 125-225 U/l) and CK-creatine phosphokinase and especially its MB-fraction (MB-CPK) increase during acute myocardial infarction. The laboratory norm for CPK is 10-110 IU, and CPK-MB isoenzymes are 4-6% of total CPK.
- Myoglobin increases in the blood as a result of the breakdown of muscle tissue of the heart or skeleton. The norm for men is 19 – 92 µg/l (average – 49 ± 17 µg/l), for women – 12 – 76 µg/l (average – 35 ± 14 µg/l).
- Electrolytes (K+, Na+, Cl-, Ca2+ ions) They also talk about many things: an increase in potassium content in the blood serum (normal 3.6 - 5.2 mmol/l) entails a disturbance in heart rhythm, the possible development of excitation and ventricular fibrillation; low K+ levels can cause decreased myocardial reflexes; insufficient content of Na+ ions (normal 135 – 145 mmol/l) and an increase in chlorides (normal 100 – 106 mmol/l) are fraught with the development of cardiovascular failure.
- Cholesterol, contained in the blood in large quantities, serves as a risk for the development of atherosclerosis and coronary heart disease. On average, the norm for total cholesterol is considered to be from 3.61 to 5.21 mmol/liter, the level of “bad” cholesterol (LDL) should be in the range from 2.250 to 4.820 mmol/liter, and high-density cholesterol (HDL) - from 0.71 to 1.71 mmol/liter.
- C-reactive protein appears in the body during an inflammatory process or tissue necrosis that has already occurred, since it is contained in minimal levels in the blood serum of a healthy person. The norm for children and adults is the same - less than 5 mg/l.
ALT (alanine aminotransferase) And AST (aspartate aminotransferase) They are always tested in pairs so that the doctor can see and separate the damage to the heart and liver. Their increase, in most cases, indicates problems with the muscle cells of the heart and the occurrence of myocardial infarction. ALT norm in women - up to 31 U/l, in men - up to 41 U/l. The AST norm in women is also up to 31 U/l), and in men - up to 35-41 U/l.
Coagulogram
The results of this analysis, which is sometimes prescribed in addition to the main ones, give the doctor an idea of the process of blood clotting, its viscosity, the possibility of blood clots or, conversely, bleeding. The table below shows the main indicators of this analysis.
Note that during pregnancy, the results of a coagulogram differ from the norms presented above.
A referral for a CBC, a biochemical blood test and a coagulogram is prescribed by the attending physician, and the results of the study can be obtained within 1-2 days, depending on the equipment of the laboratory.
How to protect yourself from heart and vascular diseases?
Getting rid of excess weight, which significantly increases the risk of developing diseases of the cardiovascular system, comes first. For normal blood circulation and to prevent the formation of blood clots, it is necessary to expose your body to physical activity every day. This does not mean going to the gym every day; initially, walking will suffice, increasing the distance every few days.
Following a diet reduces cholesterol levels in the blood and thereby has a positive effect on the condition of blood vessels. Fresh vegetables, berries and fruits, which contain antioxidants beneficial to our body, cleanse and strengthen the walls of blood vessels. For example, acids contained in fatty fish, walnuts and almonds fight vascular thrombosis.
Quitting the use of alcohol and tobacco will certainly be beneficial not only to the heart and blood vessels, but will also have a beneficial effect on the health of all body systems.
Tests for heart and vascular diseases: which ones to take, why and where?
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