Cardiovascular Investigations

Introduction

Cardiovascular investigations are essential for diagnosing and managing heart diseases. These investigations help assess heart function, detect abnormalities, and guide treatment decisions. This lecture will cover the most common tests used in cardiology.

1. Electrocardiogram (ECG/EKG)

What is it?

An ECG records the electrical activity of the heart and can detect: - Arrhythmias (irregular heartbeat) - Previous heart attacks - Heart enlargement

How is it performed?

Electrodes are placed on the skin to record heart signals.

2. Echocardiogram

What is it?

An echocardiogram uses ultrasound to create images of the heart, helping assess: - Heart structure and function - Valve abnormalities - Blood flow issues

Types of Echocardiograms:

  • Transthoracic echocardiogram (TTE) – Non-invasive, performed from the chest.
  • Transesophageal echocardiogram (TEE) – More detailed, performed via the esophagus.

3. Stress Testing

What is it?

A stress test evaluates how the heart responds to physical exertion or medication. It is useful for detecting coronary artery disease (CAD).

Types:

  • Treadmill stress test – The patient exercises while ECG monitors heart function.
  • Stress echocardiography – Uses ultrasound after exercise.
  • Nuclear stress test – Uses radioactive material to examine blood flow.

4. Cardiac Catheterization & Coronary Angiography

What is it?

This invasive test involves inserting a catheter into the heart to visualize the coronary arteries using contrast dye.

Why is it done?

  • Detects blockages in coronary arteries
  • Measures heart chamber pressures
  • Helps plan interventions like stenting

5. Cardiac MRI & CT Scan

What is it?

Advanced imaging techniques provide detailed heart and blood vessel images. - Cardiac MRI – Assesses heart structure, function, and tissues. - CT Coronary Angiography – Detects coronary artery narrowing non-invasively.

Conclusion

These investigations are crucial for diagnosing and managing cardiovascular diseases effectively. The choice of tests depends on patient symptoms and specific medical conditions.

Source recommendations

1. American Heart Association Guidelines on Cardiovascular Testing

  1. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
  2. https://professional.heart.org/en/guidelines-and-statements
  3. https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/heart-health-screenings
  4. https://www.ahajournals.org/doi/10.1161/cir.0000000000000678
  5. https://professional.heart.org/en/guidelines-statements

2. European Society of Cardiology Guidelines on Cardiovascular Imaging

  1. https://www.escardio.org/Sub-specialty-communities/European-Association-of-Cardiovascular-Imaging-(EACVI)
  2. https://academic.oup.com/ehjcimaging
  3. https://www.escardio.org/Guidelines/Scientific-Documents/Recommendations-and-position-papers
  4. https://academic.oup.com/ehjcimaging/article/16/9/919/2399830
  5. https://www.escardio.org/Guidelines/Recommended-Reading/Cardiovascular-Imaging

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