About methods of research in cardiology and a bit about treatment of coronary artery disease

About methods of research in cardiology and a bit about treatment of coronary artery disease
What is important to understand?No methods of research or analyzes that answer the question: "How's the case at all, everything is in order»

Each method can answer the question addressed precisely this method.The question should ask the doctor, which the question arose.If something bothers you - talk to the doctor, do not take any research on your own - it is a pity, and time and money.

Often, the patient said: "Let's remove cardiogram, something I sometimes pricks the heart."He thinks that if the ECG is in order, and there are no problems.Erroneous and sometimes a dangerous one!Even with severe angina ECG shot is a pain attack, it may be absolutely normal.A soothing the patient is not examined further, it does not receive the necessary treatment.

And what better ECG or ECHOCARDIOGRAPHY (echocardiography)?

frequently asked questions.Nothing "is better"!These methods respond to different questions and are not interchangeable.For example, only an ECG help the doctor to understand what kind of arrh

ythmia when there is cardiac arrhythmias.And echocardiography only show irregular heartbeat.Yes, and then not always.

When paroxysmal (not permanent) conventional ECG rhythm disturbances can not give the information, because it is registered under a minute.For such cases, the method invented Holter monitoring.

Little cardiograph (slightly bigger than a matchbox) is connected to the patient for a day (sometimes for three days), and the patient lives his normal life: walks, runs, runs.Recording then automatically visible, and the doctor gets information about many important things that escape the attention of the normal ECG.

And echocardiography?An indispensable method for the diagnosis of heart disease, some are not frequent, thank God, but dangerous diseases from the group cardiopathy, to assess the condition of the heart muscle and the effectiveness of certain drugs in the treatment of heart failure.However, echocardiography is not applicable for the diagnosis of angina, this method does not provide information on the coronary blood flow.So the doctor recommended: "You have chest pain (or rhythm disturbances), let's ECHO" totally unsubstantiated.

And ECG at rest, as mentioned above, does not give a clear diagnosis.For such cases, so-called stress tests.

and cardiogram and echocardiography can be made under load, on bicycle or treadmill.Here both methods yield very important information: ECG showing signs of ischemia, and echocardiography - a violation of local contractility of the heart.This is serious!Then we are waiting for coronary angiography.

But do not be so scared right!

It's study done in many clinics, it usually takes no more than 30 minutes and it is already "on stream".How to do it?Through an artery in the thigh or arm to the heart of a thin catheter is advanced.Then, into the vascular system of the heart is administered contrast - solution, which is visible on x-ray.At this point, remove the "X-ray film."

immediately see what kind of vessels of the heart and to what extent are narrowed by atherosclerotic plaque, namely the narrowing (stenosis) cause angina or a heart attack.

Why know?

Indeed, the diagnosis of coronary heart disease (CHD), such as angina, previous research has already been installed.Assign medications a doctor can and without coronary angiography.Such treatment is the old fashioned way, probably, improve health and reduce chest pain.But the disease is still something!Sooner or later the deterioration or complications.

If you want to become a healthy person should be treated by modern - do stenting.

It also has quite a common procedure, nothing special.The ability of the stent is achieved during coronary angiography.Through the same catheter in a vessel of the heart, right in the place of stenosis, spend another catheter with a balloon and a stent at the end.

stent - a metal mesh in the folded state.The balloon is inflated with air and expand the lumen of the vessel to its normal size, while smoothing the stent.Then the balloon is removed, the stent in the expanded state remains fixed.

All: expanded and strengthened vessel, the blood flow in it normal.So, and no symptoms of angina - heart is getting enough blood.

If you hit several vessels, give 2 or more stents, as necessary.In the world, millions of people have already undergone this process (we will not call it an operation) and consider themselves healthy.In Moscow and in the Russian cardiological centers of large cities, this procedure is performed for a long time and well mastered.

Unfortunately, not all patients with coronary artery disease and angina may perform stenting.Sometimes (about 20% of cases) during coronary angiography doctor sees stenosis located so uncomfortable that stenting is technically feasible.Or constriction in the cardiac vessels are so pronounced that even catheter does not pass through them.In these cases, the patient cardiologists recommend surgery - coronary artery bypass grafting.

This is the real heart surgery.The gist of it is this: from the aorta to the heart vessel stenosis after places sutured Shunt - a workaround for blood.

Cut vessel graft taken from a vein or leg or artery from the arm.Thus, the blood enters the mainstream vessels of the heart, bypassing the site of stenosis.And everything is all right, the man is practically healthy, exercise capacity as before, to the disease.

If necessary, set and 5-6 shunts in different vessels.Operation time-consuming, can last 6-8 hours.However, doing it for a long time, the methodology established, and in many cardiac centers in Russia it has successfully mastered.One and a half - two months after the surgery - and you practically healthy.The sutures, however, in bad weather can ponyt.

What conclusions can we draw from all this?

If you have pains in the chest, especially if they occur during exercise, walking - refer to a good cardiologist, do not pull.Attentive conversation with the doctor - 80% of the diagnosis.The doctor will refer you to the necessary research for you.

If the diagnosis of CHD is confirmed, if your pain attacks effectively connected with angina - agree on coronary angiography.

But, we repeat, do it only makes sense, if you are set on further steps to health.Just like that - it makes no sense.

If the results of coronary stenting or surgery offer - agree!The risks of complications of these operations can not be compared with the risk of disease complications.Otherwise, who would do these operations ?!And better to be healthy than sick!

I wish you health and good luck!

Chief Physician of Cardiology Advisory Center

«KARDIOTEL» Ph.D.YMOstrogorsky

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