Stress echocardiography
Cardiac stress determination or stress echo is done to investigate underlying coronary artery disease. It helps determine blood flow and the pumping rate of the heart. The preliminary tests performed before stress echocardiography include the assessment of ventricular function, wall motion thickness and aortic root. These tests indicate cardiac conditions along with ischemic heart disease and other cardiac conditions. Stress echocardiography is recommended over pharmacological assessment, because of its advantage in describing the cardiac performance during the test through images. Pictures are taken of your heart before and after exercise to check the efficiency of the heart.
Stress echocardiography is carried out on a treadmill or by a bicycle in a supine position. A work load of 25W is given initially with subsequent rise in intensity. Stress echocardiography also determines the aerobic capacity. The use of bicycle exercise has an advantage as it gives the Doppler information of the test. This provides information about the blood flood through the heart's pumping chambers and valves. Stress echocardiography has been extensively used in the risk evaluation for coronary artery disease even in patients who are asymptomatic. The usual protocol followed for the test is fasting for at least three hours before the test is performed.
Before commencing the stress test, your blood pressure and electrocardiogram (EKG) is also done. The stress echo is taken during the rest phase, stress phase and a repeat when the heart is still beating fast. Pregnant women are not advised to undergo this test. You will be connected to an ECG monitor to record the heart activity through small electrodes. Stress echocardiography is beneficial for physicians to determine the treatment options for asymptomatic conditions pertaining to coronary artery disease. It also aids the detection of angina or chest pain in the patients and also conditions like cardiomegaly and myocardial infarction.
SPECT
SPECT or Single Photon Emission Computed Tomography is a diagnostic tool that that uses gamma camera to collect gamma rays that are emitted from the patient. Radioactive isotope is adminstered to the patient either as injection or inhalation or ingested liquid. SPECT imaging helps acquire multiple images from multiple angles. The gamma camera is rotated around the patient. Dual-headed cameras can help in accelerating the test. Often triple-headed cameras are also used. SPECT is particularly useful in imaging of tumors, bones, thyroid and infections. Cardial imaging and brain imaging provide critical information about localized functions. MPI (Myocardial perfusion imaging) is an important cardiac stress test. SPECT images allow diagnosis of ischemic heart disease. This test is comparable to stress echocardiography. SPECT imaging of the brain aids in distinguishing Alzheimer's disease from other vascular dementias. Nearly 30 or more images are taken of the specific body area that is being viewed. SPECT scanning is time consuming.
Cardiologist
Cardiologists are physicians who diagnose and treat ailments related to the cardiovascular system that comprises of the heart, arteries, and veins. Pediatric cardiologist is a physician who focuses on diagnosing and treating heart problems in infants, children and young adults. Cardiologists specialize in treatment of angina (chest pain), heart attack, heart failure, high blood pressure and irregular heart beats. A cardiologist has to complete medical school and undergo residency in internal medicine for a period of three years. Further three years of specialization in the field of cardiology is required. For pediatric cardiologists a specialization in pediatrics is required prior to cardiology specialization. Cardiologists are specialists who provide complete heart care; they can determine the working condition of a person's heart by means of different tests. The responsibilities of the cardiologist include:
- The primary function of a cardiologist is to check on how well a person's heart is working.
- They determine this by asking for various tests like the treadmill test (exercise electrocardiogram), and through procedures like angioplasty, cardiac catheterization etc.
- They offer treatments for the diagnosed heart diseases through interventional cardiology like angioplasty, where a mechanical device is used to set right the problem in the heart.
- They use electrophysiology that helps in treating the electrical functioning of the heart.
- They also have the additional responsibility of keeping control over the factors that determine the health of the heart such as blood pressure and cholesterol levels. These levels in the blood of a person are kept under control thus keeping the heart comfortably functioning.
Modern techniques used in the field of cardiology
With the advancement in the field of medicine, cardiologists have the access to the latest technologies like:
Auscultation: A stethoscope is used to identify and detect heart abnormalities and murmur in the heart.
Echocardiography: Ultrasonic waves are used to visualize the heart.
Electrocardiography: EKG instruments are used to monitor the electrical activity of the heart.
Holter monitor: Records the EKG for 24 hours and more non-stop.
Modern blood tests: Determining the levels of HDL, LDL, triglycerides, homocysteine, and C-reactive protein helps in easy identification of heart problems.
Stress testing: Determines the levels of stress and cardiac function of the heart.
Coronary catheterization: Functioning of the heart is determined by inserting catheter into the heart.
Bibliography / Reference
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