Lao Zhang has always felt tightness in his chest recently. For this reason, he went to the hospital for several examinations. The doctor asked him to do an electrocardiogram, but the results were all normal. After a week or so, the situation still did not change. He consulted the doctor again, and the doctor told him that he could consider doing a 24-hour electrocardiogram or exercise electrocardiogram to understand the condition of his heart, and if necessary, he could also consider a cardiac ultrasound examination.

The doctor’s suggestion made Lao Zhang a little at a loss. Why do so many heart examinations need to be done? Why do you only need an ECG during a physical examination? If you want a complete understanding of heart problems, are these tests required? When to do other heart tests?

The physical examination will do an electrocardiogram, what can be checked? Under what circumstances should an exercise ECG be done?

An electrocardiogram mainly measures the electrical activity of the heart. Because ECG equipment is simple and easy to obtain, and there is no radiation during the examination, problems can be found in a short time, so it is often used in physical examinations to detect whether there is atrial or ventricular enlargement, conduction abnormalities, and arrhythmias (such as early contractions, Problems such as conduction block, atrial fibrillation) are also one of the necessary items for public physical examination; in addition, if myocardial infarction or hypoxia has occurred, the corresponding changes can also be seen from the electrocardiogram, and even clinical Diagnosis of heart problems, but when the problem cannot be found by examination and auscultation, it can also be further understood from the electrocardiogram. It can be said that the ECG can understand the basic situation of the heart, and can also check many heart diseases, but the ECG has limitations. examination to understand the disease.

Generally speaking, when a patient complains of heart disease symptoms such as mild palpitations, dizziness, chest pain, asthma, and fatigue, in order to understand the relationship between symptoms and organs, it is recommended to perform a stress test, which is to put a certain amount of pressure on the heart. , it is easier to find the problem, because the heart is more likely to show abnormality under stress, that is, exercise ECG, for further determination; in addition, it can also be used to observe the hypoxic changes of the heart during exercise. Usually, the exercise ECG can detect abnormalities before the patient has chest tightness, so it has a warning effect.

In the past, exercise ECG was used to check coronary heart disease, but now it has been gradually replaced by other examinations. At present, exercise ECG mainly examines blood pressure changes, endurance, cardiopulmonary function and arrhythmia induced by exercise.

What can a heart ultrasound check for?

Cardiac ultrasound uses ultrasound to see the structure of the heart, but it can also check the speed of blood flow in the heart and the contraction of various parts of the heart muscle. Observe the beating of the heart.

Furthermore, ultrasound has the highest number of scans per second of all imaging, and the most vivid images seen. And because the muscles and blood flow can be seen at the same time, the size of the heart can be judged according to the ultrasound, how much blood can be sent out with each contraction, and the function of the heart valves, which means that the function and structure of the heart can be immediately known.

At present, echocardiography is mainly done by color echocardiography, which has richer images and better diagnosis of diseases.

Under what circumstances is it recommended to do a coronary CT scan?

Cardiac coronary computed tomography (that is, cardiac CT), because a contrast agent must be used for observation, and there are certain radiation concerns, usually a detailed consultation and preliminary examination and evaluation such as electrocardiogram are performed. Check the pros and cons before choosing. In addition, the contrast agent may put a burden on the patient’s kidneys and may cause certain damage. Therefore, if the patient has kidney problems, it is also necessary to evaluate the pros and cons; The risk brought by the disease, if the information obtained from the inspection is enough to affect the treatment method, it is meaningful to perform the inspection. If the patient feels that the probability of the disease is not high, then this kind of invasive inspection is meaningless.

Often, cardiac catheterization is performed directly when a doctor suspects a coronary artery problem in the heart that needs to be addressed and the patient is assessed to be in a high-risk group. On the contrary, if the patient’s heart disease symptoms are atypical and the risk is low, and it is expected that no interventional treatment is required, this non-invasive and sufficiently precise cardiac coronary CT examination can be used to confirm that everything is fine. At this time, The value of inspection is higher.

In addition to the stenosis of the blood vessels, the coronary CT of the heart can also see the calcification. Once it is seen from this examination that the patient’s cardiovascular stenosis is not serious, but the calcification is common enough to identify the patient as a person with a high coronary atherosclerosis burden, it will be recommended to pay more attention to health risk management , such as stricter control of the third grade.

When should invasive cardiac catheterization be performed?

Invasive cardiac catheterization is recommended once the patient’s cardiac symptoms are typical, likely, and high-risk, or when the condition is found to be poor on electrocardiogram or ultrasound images, or if there are changes in hypoxia.

It is generally believed that if no abnormality is found after an ECG or exercise ECG has been done, and the daily activity is high and the symptoms are not typical, it can be controlled by drugs alone, unless the improvement is not achieved under the control of drugs, and it can be seen clinically that the symptoms have been Cardiac catheterization is only recommended when progressing to high risk.

For people at high risk of cardiovascular disease, what complete cardiac examination should be done and the recommended timing of examination?

Strictly speaking, the information of the health check is only for each time point, but it is impossible to predict when the critical point of danger will be reached; moreover, the early intervention of heart disease will not have a good effect. Control risk factors such as high blood pressure, blood sugar, and cholesterol, which are mandatory items in a complete heart examination.

In the case of high-risk groups, if the risk factors for the disease are not actively addressed, they are always at risk. In addition to regularly measuring blood pressure and heart rate, these people must actively adjust their daily routines, control risk factors, and exercise regularly to reduce the risk of disease;

If you are not a very high-risk group, but maintain good living habits and continue to exercise regularly, you can actually observe symptoms. If the frequency of typical attacks gradually increases, you should consider receiving a complete cardiac examination at this time.

From another point of view, the group of people who usually need to do a complete heart examination regularly is when the patient already has valve problems, has complications caused by other disease processes such as pulmonary hypertension, or has ever had coronary artery disease. Obstruction, in order to prevent recurrence, must be regularly and regularly followed up to observe its changes. Various disease courses, relative observation targets and the most appropriate examination methods, can be discussed with the patient’s cardiologist.