The author of this article: Wang Xing, Deputy Chief Physician of the Cardiovascular Department of the No. 983 Hospital of the Joint Logistics Support Force

With so many types of cardiac examinations, when the heart is uncomfortable, which ones can be more accurate? It is necessary to understand that the heart is made up of several parts.

The heart consists of three major parts

Heart = circuit + water circuit + atrioventricular wall.

The heart is actually like a house, with circuits, waterways, houses, basements, and walls. That is to say, the heart basically consists of the above three parts, including the electrocardiographic system, which is the beating of the heart; the cardiovascular system, which is the blood supply of the heart itself; the atrioventricular cavity of the heart and the myocardium, which is the structure and function of the heart.

These three departments can be said independently, and they can also be sick independently. But only if these 3 parts are intact, the heart can work properly, otherwise there will be a heart attack. And if there is a problem in one department, there may be problems in other departments, which may eventually lead to cardiac insufficiency, heart failure, and even cardiac arrest.

1. Circuit disease, aka arrhythmia

< p>The circuit of the heart refers to the beating of the heart, and arrhythmia refers to the abnormal heartbeat. Too fast, too slow, and wild beating are all arrhythmias.

A healthy heart should beat in sinus rhythm, and everything else that is not in sinus rhythm is abnormal, or it can be said is heart disease. Such as atrial rhythm, ventricular rhythm, supraventricular rhythm, etc.

The heartbeat should generally be between 50-100 beats at rest, and of course between 50-80. If the heartbeat is less than 50 beats per minute or more than 100 beats per minute during rest, it is abnormal, called bradycardia or tachycardia.

2. Waterway disease, also known as cardiovascular disease

The waterway of the heart is actually the blood supply of the heart itself, that is, coronary heart disease, angina pectoris, myocardial infarction, heart stent, heart bypass, etc. are all diseases of the heart waterway.

Aging and a range of factors can lead to plaque buildup in blood vessels. When there is plaque in the arteries of the heart, it is called coronary atherosclerosis. When the plaque is more than 50% narrowed, it is called coronary atherosclerotic heart disease, or coronary heart disease for short. When the plaque stenosis exceeds 70%, it may lead to angina pectoris; when the plaque ruptures and forms a thrombus, it will block the blood vessel, which is called myocardial infarction; very serious plaque, which cannot be controlled by drugs, may require stents or bypasses.

3. Atrioventricular walls, i.e. structural heart disease

The structure of the heart, including left atrium, right atrium, left ventricle, right ventricle, myocardium, atrial septum, ventricular septum, mitral valve, tricuspid valve, aortic valve, pulmonary valve, etc. .

that is, the house and basement of a house; and the walls between houses, the walls between basements; the connection between the left atrium and the left ventricle; The door between the right atrium and the right ventricle is called the mitral valve, and the door between the right atrium and the right ventricle is called the tricuspid valve.

Structural problems of the heart, one of which is congenital, called congenital heart disease, such as atrial septal defect, which is the wall between the atria A hole is broken; a ventricular septal defect is a hole in the wall between the ventricles.

There is another type of acquired disease, which is also divided into two types. Doors and windows, that is, valves, will have problems. The other is due to changes in the structure of the heart caused by other diseases or other heart diseases. For example, rheumatic heart disease is a heart valve problem caused by rheumatism. Heart disease; drinking alcohol can cause changes in the structure of the heart, called alcoholic cardiomyopathy; almost all heart diseases are not treated in a timely manner, which will eventually affect the size of the heart, cause the atrioventricular cavity to enlarge, and eventually lead to cardiac insufficiency, leading to heart failure, Shorten lifespan.

10 different heart examinations with different purposes

Because there are many types of heart disease, the three main ones are There are many specific heart diseases below, so there is no one test that can detect all heart diseases. Therefore, the examination items of the heart have their own characteristics and different purposes:

1. Electrocardiogram:

Check if the rhythm is sinus rhythm, or another rhythm, such as atrial, atrial tachycardia, atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, Room early, room early, etc. Check your heart rate, which is how many times your heart beats per minute.

At the same time, P wave, ST segment, T wave, PR interval, QT segment, etc. can be seen, so as to judge or infer arrhythmia, cardiac size, myocardial ischemia, etc.

2. Echocardiography:

Check whether the left and right atria and left and right ventricles of the heart are normal, check whether the heart muscle is normal, check whether the mitral valve, tricuspid valve, aortic valve, and pulmonary valve are normal, and check whether the heart function is normal.

3. Holter:

It is also a 24-hour electrocardiogram, which can record every heartbeat in 24 hours. The purpose is to record the heartbeat more comprehensively, especially for the diagnosis of arrhythmia.

4. Plate test:

That is, doing an electrocardiogram on a treadmill, recording the electrocardiogram while running, to see if there is any ST segment change, so as to determine whether there is coronary heart disease.

5. Coronary CTA:

< span> An enhanced CT, mainly to see if there is plaque and stenosis in the blood vessels of the heart, to diagnose coronary heart disease.

6. Coronary angiography:

< span>It is currently considered to be the gold standard for diagnosing coronary heart disease, so cardiac angiography is mainly to check whether there is coronary heart disease, rather than the most accurate examination for checking the heart.

7. Cardionuclide:

< span> is a method to determine whether there is ischemia in the myocardium, and it is a good choice for asymptomatic myocardial ischemia.

8. Electrophysiological examination:

< span>Arrhythmia is suspected, but it is not caught by electrocardiogram and dynamic electrocardiogram. Electrophysiological examination is required if necessary, which is also a method for catheter to enter the body.

9, troponin, cardiac enzymes:

< p>When myocardial infarction or myocarditis is suspected, a blood test is required to see if it is elevated and to determine whether there is damage to the myocardium.

10, BNP:

In patients with suspected heart failure, or patients with existing heart failure, blood BNP can be used to help determine the degree of heart failure.

Therefore, there is no so-called best examination, only the most suitable examination. Sometimes a 30-yuan ECG + the patient’s symptoms can diagnose acute myocardial infarction. So it’s not that cheap inspections are inaccurate.

Cardiovascular doctors will preliminarily judge whether it is a circuit problem, a waterway problem, or a structural problem based on the patient’s symptoms, and then select the appropriate examination .

For example: palpitation, palpitations, fast heartbeat, slow heartbeat, disordered heartbeat, dark eyes, syncope, etc., arrhythmia will be considered, then It is recommended to do an electrocardiogram or a Holter monitor.

For example: chest pain, chest tightness, suffocation, pain in the precordial area and other angina symptoms, cardiovascular stenosis will be considered, then it is recommended to do an electrocardiogram or a further tablet Tests, or coronary CT or coronary angiography to directly observe whether there is plaque inside the blood vessels.

For example: chest tightness and suffocation, shortness of breath when walking, children often squatting while walking, purple lips, edema of lower limbs, loss of appetite, etc. Then if you suspect that it is cardiac insufficiency or heart failure, it is recommended to do a cardiac ultrasound to see if it is a valve disease, a cardiomyopathy, or an enlarged heart.

In short, there are many kinds of heart disease, and there are also many kinds of heart examinations. There is no best one, only the one that suits you is the best!

Editor: Ren Xuan

Reviewer: Yang Xiao Ming