With atherosclerosis, fat accumulation and growth occurs connective tissue in the wall of the arteries. The integrity of the inner lining of the vessels is compromised, their lumen narrows, which leads to an obstruction to the blood supply to organs and tissues. Diagnosis requires consultation with a therapist, cardiologist, other specialists, as well as research lipid spectrum blood, ultrasound of blood vessels, heart, angiography.
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Examination by specialists for atherosclerosis
Most often, an assumption about the presence of atherosclerosis in a patient may arise from a local therapist or family doctor. The process of changes in the walls of blood vessels develops in almost all people after 45 years.
But its manifestations and severity are different. After the doctor ascertains the complaints, he gives a referral for biochemical blood tests to confirm higher level cholesterol, low density lipids and ECG.
Following primary diagnosis As a rule, it is recommended to consult such specialists for a more in-depth examination:
- cardiologist – examines damage to the heart and large arteries;
- vascular surgeon – identifies circulatory disorders in the lower extremities;
- neurologist - determines the degree of blood flow in the vessels of the brain;
- endocrinologist - examines thyroid gland, hormones, etc. (and atherosclerosis is often a sign of diabetes);
- ophthalmologist - examines changes in vision.
What will the doctor reveal during the examination?
To make a diagnosis, the following patient complaints are important:
- headache, dizziness, tinnitus;
- paroxysmal weakness and numbness in the limbs;
- at physical activity there is difficulty breathing, increased heartbeat and chest pain;
- When walking you need to stop because of pain in your legs.
Upon examination, nonspecific signs are revealed:
- xanthomas – yellow spots on the lower eyelids;
- xanthelasma - cholesterol deposits on outer surface elbow joints, calcaneal tendons;
- clouding of the iris in the form of a crescent;
- tortuous, dense temporal and brachial arteries;
- difference in pulse filling in the extremities.
High levels are often found arterial pressure, systolic murmur in the apex of the heart, accentuated 2nd tone above the aorta.
What tests to take for atherosclerosis and their interpretation
The diagnosis of atherosclerosis can take place in several stages. First, the lipid composition of the blood is examined, and then instrumental diagnostics vascular network.
Blood tests, including biochemical
General analysis blood is not very informative; sugar may be elevated, which requires an in-depth study of carbohydrate metabolism.
To determine the risk of cardiovascular pathology, an indicator called the atherogenicity index is used. This is the ratio of the concentration of total blood cholesterol to low-density lipoproteins. If it is below 2.9, then the patient’s probability of developing atherosclerosis is low, the average risk is up to 4.9, and higher values ​​indicate 100% atherosclerotic vascular damage.
Ultrasound of blood vessels, including lower extremities
The patency of the arteries is determined, the disturbance of blood flow, the presence of signs of thrombosis or blockage are assessed atherosclerotic plaque. The method is used for reduced pulsation in the feet, popliteal and femoral artery, as well as differences in pulse filling in the lower extremities. Indirect symptom– slow healing of wounds at the site of impaired blood supply.
X-ray examination
Allows you to identify signs of heart atherosclerosis ( coronary arteries), aorta, pulmonary artery:
- the size of the heart is increased, mainly due to the left ventricle;
- There may be symptoms - bulging of the area, most often on the left;
- elongation of the aorta, pathological bend, increased shadow contrast, areas;
- when the pulmonary artery is damaged, the pulmonary pattern is enhanced, and there are aneurysmal changes in the branches.
On x-ray(direct projection): penetrating atherosclerotic aortic ulcer with false aneurysm (shown by arrow). Cardiogram (ECG)
At coronary disease heart, as the main manifestation of atherosclerosis, symptoms on an ECG during a routine study are not very specific, especially with initial stages:, arrhythmia, conduction disorders. Therefore more full information can be obtained from load tests.
Stress testing for atherosclerosis
Several options for physical activity are used to determine its tolerance:
- climbing onto a step platform (Master's test);
- – riding a special bicycle;
- – walking on a treadmill.
Bicycle ergometry In case of joint diseases or thrombophlebitis, as well as general detraining, they are replaced with pharmacological tests with Isadrin or Ergometrine.
These studies are considered positive (the diagnosis is confirmed) if the patient experiences chest pain of a typical nature for angina pectoris, a greater than normal increase in heart rate, a decrease in pressure by 25% or less, a change in the location of the ST segment in relation to the isoline.
Ankle-brachial index
The pressure on the shoulder is measured in a standard way in the supine position, and then the cuff is installed 5 cm above the ankle. is calculated by dividing the systolic pressure indicators - ankle by brachial. The norm at rest is from 1 to 1.3.
ABI measurement When the coefficient changes, the following pathology can be suspected:
- less than 0.4 – severe arterial blockage, risk trophic ulcers and gangrene;
- from 0.41 to 0.9 – moderate or mild degree circulatory disorders, angiographic examination is necessary;
- from 0.9 to 1 – upper limit normal, pain may occur during physical activity;
- more than 1.3 – the vessel wall is dense, rigid, a symptom of diabetes or kidney failure.
Dopplerography
Using Doppler, the speed of blood flow in the vessels of the neck, brain and lower limbs. Most often, a duplex or triplex study is prescribed, in which scanning is performed using ultrasound and visualization on the screen of blood supply disorders and the location of atherosclerotic plaques.
Ultrasound of neck vessels: external stenosis carotid artery due to atherosclerosis Vascular contrast
By filling the vascular network with a contrast agent, narrowing of the lumen, obliteration (blockage), the affected area and the state of regional blood flow, and the development of bypass pathways - collaterals can be detected.
The following types of diagnostics are used:
- aortography,
- angiography peripheral vessels,
- coronary angiography.
Tomographic research methods
With this technique, a contrast agent is injected intravenously, and then an image of the vascular arterial network is obtained using a tomograph. Using the device, disturbances in the structure, location and functioning of large and peripheral vessels are detected. To diagnose atherosclerosis the following is used:
- MRI of extremity vessels;
- CT scan of the aorta;
- peripheral tomographic arteriography;
- multislice CT of the aorta, coronary vessels, renal and extremity arteries.
MRI of vessels of the lower extremities These methods are among the most informative; they are used to determine the volume surgical intervention and in complex diagnostic cases.
To identify atherosclerosis, the patient’s complaints and examination data are taken into account, but in order to confirm the diagnosis, an analysis must be performed lipid composition blood, as well as ultrasound and angiographic examination of the arterial network. The most informative are tomographic methods.
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Approximately 40–60% of all people in the world die from heart and vascular diseases. Against this background, it is simply impossible to dispute the importance of cardiology as a field practical medicine.
Who is a cardiologist?
Many have heard that “cardio” means heart in Greek. People understood the importance of this organ for humans back in ancient times. Nowadays, the area of ​​knowledge of a cardiologist is wider - it is not only the heart, but also blood vessels.
Cardiovascular diseases are a huge problem for humanity. Problems of this kind can be the consequences of diabetes, obesity, or be congenital. And if earlier the heart usually began to “become naughty” in people of retirement and/or old age, now many diagnoses have become “younger”. And now people sometimes die from heart attacks very young.
Modern cardiology allows you to cure or at least alleviate a lot of diseases of cardio-vascular system. And yet the rate of sudden or immediate death from cardiac arrest remains high. The reason is people’s lack of attention to their health.
In what cases do you consult a cardiologist?
The obvious answer is when the heart hurts. However cardiovascular diseases do not always cause pain. Human can:
- experience difficulty climbing stairs or covering even relatively short distances;
- sweating excessively and for no reason;
- feel dizzy, suddenly nauseous, lose balance;
- feel your heart enlarged, beating too hard.
The initial stage of many heart and vascular diseases is asymptomatic. This is why therapists recommend it annually, even if there are no complaints.
Other risk groups are people with increased blood pressure(hypertension), diabetes mellitus, rheumatoid diseases. And if real chest pain begins, even if it is not severe, you should contact a cardiologist as soon as possible.
How to prepare for your appointment
The most important thing is to collect specific complaints. It is best to remember exactly when any warning signs, in what situation (for example, during physical or emotional stress). It is also important to tell when and how relief came: did you have to lie down or did it all go away on its own?
Perhaps there are any additional medical documents? For example, you became ill on a business trip, and the local ambulance specialists did a cardiogram? The results of such and similar surveys can be very useful.
It is also advisable to know whether any of your closest relatives have or have had cardiovascular diseases. Very strong here hereditary factors.
How does an appointment, consultation, examination with a doctor go?
The cardiologist gets his first opinion about the patient’s condition from simple tests: measuring pulse, blood pressure, and listening. In this way, the doctor finds out what to pay attention to. Then various examinations are prescribed: cardiograms, ultrasound, radiography of the heart, blood tests.
Such studies usually make it possible to determine the diagnosis. Sometimes the doctor prescribes additional referrals, for example, for vascular catheterization. This method is invasive, that is, penetrating.
- using a simple tonometer, monitor your blood pressure (measure every day and record the readings of the device);
- don’t let yourself sit in one place, be sure to move, and fresh air;
- combine fish, meat, cereals, vegetables and fruits, whole grain bread in your diet, limit simple fats and sweets;
- do not smoke, eliminate alcohol as much as possible or completely;
- From time to time, get your blood tested and check your sugar and cholesterol levels.
Diseases of the cardiovascular system are widespread and rank first in the world in mortality. Modern methods diagnosing pathologies such as acute and chronic myocardial damage and arterial hypertension, as well as correctly selected treatment, can significantly prolong the patient’s life.
A specialist cardiologist whose activities affect not only the process of diagnosing heart and vascular diseases, but also prescribing adequate therapy and preventive measures.
A patient suffering from heart pain should not take the occurrence of such a serious symptom lightly. In this case, you should seek help from a cardiologist without delay. The specialist will select suitable treatment and will help you solve the problem. It is possible that a course will come to the aid of the patient manual therapy and will save him from heartache, or will it be necessary surgical intervention. It all depends on the diagnosis.
Often we don’t even think about what difficult conditions we create for our heart:
- Frequent stress;
- Tobacco smoking;
- Alcohol consumption;
- Poor nutrition;
- Lack of physical activity;
- Excess body weight.
All this negatively affects the work of this important organ.
The heart must function in conditions of human activity, providing him with long life. Therefore, it is very important to treat your body with care, listen to it, ensuring work without failures.
In case of heart disease, contacting a cardiologist is very important, because sometimes a visit to the clinic can save a life.
The main signs of cardiac disease include:
- Pain localized in the heart and behind the sternum. They usually radiate to the left side or arm;
- Shortness of breath accompanying physical activity;
- Arrhythmia;
- Cardiopalmus;
- Swelling of the legs;
- High blood pressure.
All of the above symptoms are a serious reason to suspect disorders of the cardiovascular system, the treatment of which requires considerable effort, both on the part of the patient and on the part of the cardiologist.
What tests should you take before visiting a cardiologist?
Having made an appointment with a specialist, patients often ask the question: “What tests should I take with me to my appointment with a cardiologist?”
Below is a list of studies to facilitate history taking and diagnosis:
This is a study that allows you to record electrocardiogram and blood pressure readings for 24 hours in natural human living conditions. This method Heart rate monitoring not only records the indicator per day, but also provides the opportunity to detect disturbances provoked by physical activity or emotional stress during changes in blood pressure. Also, the recorder device makes it possible to study the activity of the heart and pressure indicators during night rest, identify coronary disease, establish fainting states and ensure the effectiveness of the therapy used. Moreover, the study demonstrates a connection between arterial hypertension and angina pectoris.
This diagnostic method does not require serious preparation. However, before visiting a specialist who is fixing the drug, you should not neglect water procedures, since in the next 24 hours you will have to give up the opportunity to take a shower.
The patient should not forget that the registrar is different high sensitivity to electromagnetic radiation.
When choosing clothes, you should prefer a loose fit and natural fabrics.
The device consists of a recording box worn over the shoulder and electrodes attached to the patient's body. During the examination, the person records information about his or her occupation. physical activity, indicating time intervals and footnotes about well-being. Upon completion of the observation, the diary is handed over along with the device to the staff of the medical institution.
The readings taken are deciphered using a special computer program. The result is given to the patient after 2-3 days;
Electrocardiography
This is a diagnostic method that allows you to record information about the activity of the heart, the principle of which is to record electrical potentials that arise during the operation of the organ in the form of a graph on the monitor or on paper.
An ECG is a low-cost, non-invasive test that contains information about the functioning of the heart. Electrocardiography is recorded from the surface of the patient’s body (his arms, legs and chest). Data recording is carried out for 5-10 minutes, using a dozen electrodes or suction cups and cuffs.
ECG is a powerful diagnostic tool that allows you to assess the regularity of heart contractions, their frequency, and consider the source of the rhythm;
A cardiac examination is a safe, informative way to obtain information about the condition of the heart and blood vessels. This diagnostic method is widely used in cardiology; it is safe and does not cause discomfort for the patient.
Echocardiography - performed using ultrasound equipment, large vessels and the heart are examined, blood flow is assessed, and tissue structure is studied.
The research procedure does not provide negative influence on humans and does not involve the use of X-ray or radioactive radiation, and therefore has no contraindications or side effects.
- Ultrasound of the heart and blood vessels is performed within 30-40 minutes and does not require preparatory measures;
Blood chemistry
This research does not require serious material costs. The diagnostic method is an accessible and quick examination that allows you to identify disturbances in the functioning of the body.
The patient's blood is taken to evaluate many indicators. In laboratory conditions, the material is studied. The amount and concentration are recorded chemical substances. When there are disturbances in the functioning of the body, the composition of the blood undergoes changes.
The biomaterial is taken on an empty stomach, in the morning. Venous blood is required for the study. Three days later, the result is given to the patient.
Attention! It must be taken into account that the standards biochemical analysis for male and female representatives may differ and also depend on the age category;
UAC
The analysis helps the doctor obtain information about the number of leukocytes, platelets, red blood cells in the blood, erythrocyte sedimentation rate, erythrocyte indices, and other indicators.
According to available data, a cardiologist can identify the presence of problems such as:
- Low hemoglobin level, which indicates impaired kidney function, anemia, internal bleeding;
- Decreased red blood cells, which is a symptom chronic inflammation or cancer;
- Lack of red blood cells, which causes problems with blood clotting;
- A high level of leukocytes, indicating existing inflammation;
- A high erythrocyte sedimentation rate is a sign of an inflammatory process.
The patient is given a conclusion on the results of the analysis 1-2 days after the material is collected. Blood is donated on an empty stomach early in the morning. On the eve of the visit to the laboratory, you should avoid physical and emotional stress and drinking alcoholic beverages;
OAM
If the cardiovascular system malfunctions, the patient’s urine undergoes some changes. For example, heart failure affects the density and color of the biomaterial, and hypertension can cause the formation of sediment.
To obtain reliable information about the state of the body, morning urine (first urination) should be collected. It is released into the toilet for a few seconds, after which the material is collected in a sterile container. The study requires 50 to 100 milliliters of liquid.
Treatment of cardiovascular diseases can be carried out both in a hospital and in outpatient setting. Therapy is carried out using the most modern techniques:
- Pharmacogenetics;
- Drug treatment;
- Cardiac surgery;
- Extracarporal hemocorrection.
A cardiac profile is a set of specific blood tests that allows you to assess the likelihood of recent damage to myocardial cells and evaluate risk factors for the development of heart and vascular diseases.
Why do you need to do a cardiac profile?
A cardiological profile allows you to identify early and hidden lesions of the cardiovascular system, the risk of developing atherosclerosis, coronary heart disease and heart failure, and 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 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 Đ•Đ´/Đ»
- men -< 171 Đ•Đ´/Đ»
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 Đ•Đ´/Đ»
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.
For various heart diseases, a number of specific blood tests are performed. Based on the results of such studies, one can judge the state of a person’s cardiovascular system and the degree of heart disease. What are these specific tests, and how to take them correctly?
Specific blood test - cardiac profile
Cardiological profile name a number of specific blood tests that allow you to assess the likelihood of damage to myocardial cells and assess risk factors for cardiovascular diseases.
Thanks to the cardiological profile, it is possible to identify lesions of the heart and blood vessels early stages, prevent the development of coronary heart disease, atherosclerosis, and also assess the likelihood of myocardial infarction.
Indications for a specific blood test - cardiological profile
- atherosclerosis
- cardiac ischemia
- high blood pressure
- tachycardia, arrhythmia, bradycardia
- have had a stroke or heart attack
What indicators are included in the cardiac profile?
Lipidogram (or lipid profile) necessary for the prevention of atherosclerosis and coronary heart disease.
AST (aspartate aminotransferase, AST)- a cellular enzyme that takes part in the metabolism of amino acids in organs and tissues. An indicator of myocardial infarction is an increase in AST activity in the serum. Normal AST values ​​for women are no more than 31 U/l, for men no more than 37 U/l.
Creatine kinase (creatine phosphokinase, CK, CPK)- this is also an enzyme that functions as a catalyst (accelerator) for the conversion of ATP.
KFK-MV part of cardiac muscle cells. Normal values ​​for women are no more than 145 U/l, for men no more than 171 U/l.
LDH (lactate dehydrogenase)- a zinc-containing enzyme involved in glucose conversion processes and is present in almost all human tissues and organs. Normal value LDH - less than 247 U/l.
How to take a specific blood test correctly?
The day before the blood test, avoid drinking alcohol, and smoking is prohibited 1 hour before the test. Blood is taken on an empty stomach in the morning. You are only allowed to drink water. It is also recommended to exclude physical and nervous tension, stress.
The analysis is completed within 24 hours.
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