Different heart conditions require different tests.
Cardiac physical examination has attracted more and more attention, what items should be checked for routine physical examination? To learn about the special tests for the heart, you must first understand what is wrong with the heart before you can do a special test for the heart disease. In general, the heart can be divided into three parts: the cardiac conduction system, the cardiovascular system, and the cardiac muscular system.
The heart is composed of atrium, ventricles, and various valves, and the atributes are separated by mitral and tricuspid valves, and the ventricles are separated by aortic valves and pulmonary arteries respectively. The heart muscle is responsible for contraction, relaxation, and blood circulation within the heart.
According to the classification of heart function, it is as follows.
The cardiac conduction system is composed of special myocardial fibers, which can generate and conduct impulses, so that the atrial muscle and ventricular muscle can contract and relax in a coordinated and regular manner, so as to maintain the normal rhythm of the heart.
The blood vessels of the heart, the arteries of the heart are the left and right coronary arteries that originate from the ascending aorta, and the blood circulation that supplies the heart itself is called the coronary circulation.
The hollow muscular organ is mainly composed of myocardium, with four chambers: left atrium, left ventricle, right atrium, and right ventricle. There are valves between the atria and the ventricles, which allow blood to flow only from the atria to the ventricles, acting as one-way valves, so that blood can only flow from one direction to the other and not backwards.
The cardiac conduction system is responsible for directing the heart to beat and conduct signals, and they are composed of a group of special cells, which can produce electrical signals and conduct along a specific pathway, so that the heart can contract and relax regularly according to the program, and move regularly according to a certain frequency and interval.
The rhythm of a normal heart should be sinus rhythm. Anything that is not sinus rhythm is an abnormal beat, and what we call arrhythmia is a problem with the electrical conduction system of the heart. Weakening or enhancement of electrical signals, prolongation or blockade of conduction, or even cessation of transmission of electrical signals, resulting in irregular heartbeats, arrest, or advance, interspersion, or delay.
The cardiovascular system is responsible for supplying blood to the heart, providing essential oxygen and nutrients.
The nutrition of the heart is carried out by the coronary arteries**, and the right coronary artery is mainly distributed in the right atrium, right ventricle, and posterior ventricular septum, and also in the posterior wall of the left ventricle. The left coronary artery is divided into two branches, one anterior descending and one circumflex, which are located in the left atrium, left ventricle, and anterior ventricular septum, and also in front of the right ventricle.
Different cardiac examinations examine different tissue structures of the heart.
The most commonly used conventional electrocardiogram, also known as ordinary electrocardiogram, records the bioelectrical activity of the heart, helps diagnose arrhythmias, assists in judging myocardial ischemia, myocardial infarction and location, indicates heart enlargement and hypertrophy, evaluates the impact of drug or electrolyte abnormalities on the heart, and evaluates the working condition of the pacemaker.
When there is chest tightness, chest pain, palpitations, and palpitations, routine ECG can reflect myocardial ischemia, various premature beats, arrhythmias, atrioventricular block, etc.
However, an ordinary ECG can only reflect the electrical activity of the heart during the examination, and if the patient does not have the disease, the ECG may be normal and does not mean that there is no problem with the heart, such as paroxysmal atrial fibrillation. Moreover, there is symmetrical cancellation of the ECG vector, and myocardial ischemia in special parts cannot be found, resulting in omission.
Holter ECG: Records changes in the heart's electrical rays over a 24-hour period or even longer.
Compared with a regular ECG, a 24-hour Holter ECG records the ECG signals at all times of the day, which can improve the detection rate of paroxypathic arrhythmias, especially transient arrhythmias and transient myocardial ischemic attacks.
It can also clarify the type, nature, and severity of arrhythmias, analyze the causes of paroxysmal syncope, vertigo, and palpitations, evaluate the prognosis of patients with heart disease, and evaluate the efficacy of drugs.
Treadmill exercise test: also known as exercise stress test, is used as an adjunct to the diagnosis of coronary heart disease.
For patients whose ECG is uncertain and who are unwilling to undergo coronary angiography, the presence of myocardial ischemia should be further determined; Asymptomatic, occult myocardial ischemia is found.
To evaluate cardiac function and exercise tolerance in patients with coronary heart disease, in order to guide the patient's exercise mode and intensity, it can also be used as a basis for training.
Coronary CTA: primary screening for coronary artery disease.
Coronary CT angiography (CTA) is a method of scanning the coronary arteries with multidetector spiral CT after intravenous injection of a contrast agent to understand coronary artery lesions.
Coronary CTA can reconstruct coronary images to determine whether patients have coronary artery sclerosis and stenosis, and is suitable for primary screening of coronary heart disease and postoperative review of coronary stents. Compared with coronary angiography, it has the advantage of being non-invasive, safe, and easy for patients to accept.
Coronary angiography: the "gold standard" for diagnosing coronary heart disease
Coronary angiography is the "gold standard" (widely recognized as the most reliable and accurate method or standard) for diagnosing coronary heart disease.
Coronary angiography is used to evaluate the rowing, number, and malformation of coronary arteries; To evaluate the presence, severity and extent of coronary artery lesions; To evaluate changes in coronary artery function, including coronary artery spasticity and the presence or absence of collateral circulation; At the same time, the evaluation of left heart function can be taken into account; Intervention according to the degree and extent of coronary artery disease**; To assess the effects of coronary artery bypass grafting and intervention**.
Indicated in patients with typical symptoms of ischemic angina, with chest pain but atypical symptoms, and with positive ECG or imaging.
Cardiac ultrasound - to observe the changes in heart shape and heart function.
It mainly examines whether there is any abnormality in the morphology of the heart and whether the heart function is normal, which is of great value for discovering congenital heart disease, heart size, and valve disease.
Cardiac ultrasound is used to understand the degree of valvular disease, whether there is regurgitation, the thickness of the myocardium, the size of the heart chambers, the movement of the myocardium, and the measurement of cardiac function.
Cardiac ultrasound can be repeatedly examined, dynamically observed and compared, which has certain clinical significance for judging the progression and prognosis of the disease.
In short, to determine which part of the heart is wrong, whether it is a single problem or other parts of the problem, the doctor will preliminarily determine whether the problem is the electrocardiogram, cardiovascular system or myocardial system according to the patient's symptoms, gender, age, past medical history and risk factors, and then select the appropriate examination to confirm the diagnosis. Of course, the disease is complex, people still have seven emotions and six desires, the natural wind, cold, summer, dampness and dryness can also cause disease, and the heart is also a part of the human body, which affects the whole body, in order to avoid missing the diagnosis, sometimes all the examination items have to be carried out again, in order to understand the heart problem in an all-round way.