Examinations of the Heart

Apr 7, 2012 , Translated by Kristina Knazko

vysetreni-srdce.jpg - kopie
vysetreni-srdce.jpg - kopie
Examinations of the heart are among the most important examinations in medicine. They help to not only unveil existing heart conditions, but also prevent heart diseases. Examinations of the heart include physical examinations performed regularly by a physician, instrumental non-invasive and invasive examinations, as well as biochemical examinations that confirm the presence of specific substances in the blood.

Examinations of the Heart

The heart is a vital, hollow, muscular organ, whose main function is to pump blood so that is can easily reach all tissues of the human body. Together with the blood vessels, it makes up the circulatory system; the functioning of which is dependent on the flawless performance of individual parts. Heart diseases are very common nowadays and therefore it is essential to detect and treat them as soon as possible. Even in this case, the best solution to prevent similar problems is to lead a healthy, balanced lifestyle.

Physical Examinations of the Heart

Physical examinations of the heart are part of the basic chest examination. They includes the visual, palpable, audible and tapping tests.

  • Visually, the shape of the chest is evaluated. Possible asymmetry, presence of scars or jugular veins could indicate heart problems, especially if elevated.
  • Palpation can identify an apical heart beat which is caused by the enlargement of the heart. Though sometimes it is not possible to palpate an apical heartbeat.
  • Tapping on the chest can evaluate the size of the heart by determining its borders. These can be determined much easier with other methods, thus tapping is no longer commonly performed.
  • The most important of these tests is auditory. This requires a stethoscope, which acts as a sound amplifier. The physician places the end on the stethoscope on various areas on the front of the chest, where a heart murmur can be detected. A heart murmur could be a sign of a heart defect, usually in the valves. To evaluate the heart's activity, a pulse must be taken. This is done by placing a few fingers on the wrist over the arteries.

Examining the Heart with Devices

Other important examinations of the heart include the use of special devices. Depending on whether the examination penetrates the body or not, examination methods are separated into invasive and non-invasive methods.

Non-Invasive Methods

Non-invasive methods are those that do not penetrate the body.

  • The basic method of examining the heart is an electrocardiograph (EKG). Thanks to the EKG, the electrical potential on the surface of the chest, produced by the heart, can be monitored with electrodes. Changes in electrical potential are recorded by means of curves and waves on paper. Thus we can determine whether the electrical activity of the heart is abnormal, these changes, as well as their location. If the EKG recoding is abnormal, further testing is often required.
  • It is also very common to perform an echocardiograph (ECHO), which shows the heart with the help of an ultrasound. This helps monitor the heart's activity, its size and its individual sections, wall thickening and direction of blood flow.
  • Bicycle ergometer, or EKG stress test is an examination of the change in electrical potential during physical stress, which is achieved by pedaling a specially modified bicycle. During the examination, the stress is gradually increased and in the presence of narrowed coronary arteries, pain and chest discomfort may arise, suggesting angina pectoris. This examination can also determine an abnormal heart rhythm.
  • Magnetic resonance imaging (MRI) of the heart is one of the newest methods and is not used very often. With the help of a contrasting agent, scars on the myocardium (the muscle layer of the heart) can be displayed, the heart's activity and blood flow can be assessed and anomalies can be detected.

Invasive Methods

In the case of suspected obstruction or significant narrowing of a coronary artery, a coronary angiography can be performed. This is where a contrasting agent is injected into the blood stream, which an x-ray or CT of the coronary arteries can clearly display. The contrasting agent is injected into the coronary arteries using a catheter, which is typically inserted into the arteries in the groin.

Biochemical Examination of the Heart

During a heart attack, chemical methods are also very important as they can determine the level of certain substances in the blood that are indicative of damage to the heart muscle. Usually the troponin level is measured. Troponin is usually located inside cells, but during damage to their surface, troponin can get into the blood. Other parameters that need to be monitored are CK-MB, myoglobin and ANP. Troponin and CK-MB are primarily elevated during a myocardial infarction. Also, a high level of myoglobin indicates acute myocardial infarction.

Treating the Heart and Prevention

Due to the above mentioned diagnostic methods, the successful treatment of heart diseases has increased in the last few years, which cause significant problems in developed countries. The patient needs to be responsible with regards to treatment, however many are unable to achieve this. Lifestyle and eating habits need to be monitored and not everyone is able to modify these, despite there not being any dramatic modifications required. With damage to the heart, however, lifestyle changes are essential should the patient want to avoid further problems in the future.

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