” I just feel a little chest tightness, why do I need to do an electrocardiogram after an echocardiogram? Are the two different? It is recommended that I do another coronary CT, do so many examinations want to waste my money?”
Why do I always have to do so much to see a doctor? an examination?
Today, I will tell you about the content and purpose of various cardiac examinations. After understanding the necessity, you can understand why the doctor arranges these< /span> checked.
The author of this article: Huang Yandong, Song Jialin, Department of Ultrasound, Shanghai Changzheng HospitalSource: Shanghai Changzheng Hospital
01
Heart Instructions
Heart It is located in the thoracic cavity, at the front and lower part of the mediastinum, adjacent to the lungs on both sides, and is surrounded by the pericardium.
Although this house is not big, it has “two rooms and two floors” (two atria and two ventricles) A small single house with four rooms, complete water pipes, and electrical system, with its operation, the blood of the whole body gathers here and flows to the blood vessels at all levels.
left<600">House Doors and Windows:Mitral, Aortic, Tricuspid, PulmonaryHouse walls: Atrial septum, interventricular septum, free wall myocardial tissue that makes up the chambers of the atrioventricular
content_title” height=”300″ layout=”responsive” sizes=” (min-width: 320px) 320px, 100vw” src=”https://mmbiz.qpic.cn/mmbiz_png/lZub2rm81Ujcbm7ORtxwRMrNicYQnFqgmClPjJAaOgibGu497VCB8nFKnSiaqvGueFQOGVjzrLhA70buxMJdnR5tA/640″ width=”600″> House plumbing:The blood vessels of the heart, including the coronary arteries and their branches and venous vessels at all levels, also known as coronary circulation; Supply the oxygen and nutrients required for myocardial activity, and the veins recycle the products of myocardial metabolism and send them back to the heart
height=”300″ layout=”responsive” sizes=”(min-width: 320px) 320px, 100vw” src=”https://mmbiz.qpic.cn/mmbiz_png/lZub2rm81Ujcbm7ORtxwRMrNicYQnFqgmPNaR8HI4ibAmBia8bicBAzEIytRia67iaqYkBBJgbr8iawibQsdV5WE000fpji”width=”gbr8iawibQsdV5WE000″ width=”gbr8iawibQsdV5WE000″ /img>House Circuit:The electrical conduction system of the heart, which makes the pulsation of the sinoatrial node Propagates to the myocardium and stimulates it to contract
As we all know, if there are problems in different parts of the house, you need to find relevant institutions or professionals for evaluation or maintenance. For example, if there is a problem with the house structure, you need to find a professional house quality appraisal agency for evaluation; Electrician, if the pipe is broken, please find a plumber. In the same way, if there is a problem in this small house of the heart, you should choose the corresponding inspection method according to the location of the problem.
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Common heart repair methods
Housing Quality Appraisal Agency – Heart Color Doppler
Also known as echocardiography.You can observe the size and shape of each “room” of the heart, whether the “doors and windows”, Whether the “wall” is complete and the function is normal; on this basis, color Doppler and spectral Doppler are added to observe whether the blood flow of the heart is normal, whether there is abnormal shunt, and measure the blood flow velocity to evaluate the blood flow of the heart Kinetic parameters.Diseases suitable for echocardiography
Congenital heart disease: atrial and ventricular septal defect; patent ductus arteriosus; tetralogy of Fallot; transposition of the great arteries, bicuspid aortic valve, etc.;
Acquired structural heart disease: Valve stenosis, insufficiency; chordae tendineae, papillary muscle rupture; ventricular septal perforation; ventricular aneurysm; mural thrombus, cardiac tumor etc.;
Cardiomyopathy: Hypertrophic, dilated, restrictive cardiomyopathy, etc.;
< strong>Functional heart disease: Left and right ventricular diastolic and systolic dysfunction, segmental wall motion abnormalities, etc. Cardiac color Doppler ultrasound can visually see the internal structure of the heart and accurately assess the characteristics and severity of structural lesions. “.
apical four-chamber view
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Color Doppler Flow Imaging
Circuit Check—ECG
< span>The regular and orderly activity of the human heart depends on the electrical conduction system to transmit the electrical stimulation generated at the sinus node of the heart to each myocardium in an orderly manner and to induce its contraction. Like wires buried in walls, the heart’s electrical conduction system runs through the heart muscle tissue. By connecting the ECG machine through the leads on the chest and the surface of the human body, the circuit activity of the heart is amplified and recorded, showing a specific waveform, the ECG, which is like an electrician checking the circuit with a multimeter connected to different locations on the circuit .
When there is a problem with the electrical conduction system, such as ectopic pacing, conduction block, abnormal pathway, etc., premature beats, Arrhythmias such as tachycardia, bradycardia, and conduction block all show specific waveforms on the ECG, along with their classification and severity, from which a definitive diagnosis can be made.
In addition, lesions of myocardial tissue and cells such as myocardial ischemia, infarction, myocardial hypertrophy, and abnormal potassium ion concentration caused by coronary heart disease and so on will affect the changes in the circuit or potential, so these diseases can also be diagnosed by the electrocardiogram.
normal ECG
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Aqueous tube examination – coronary CTCoronary CT is a rapid multi-slice CT scan and image reconstruction technology, a method of examining a patient’s coronary arteries. Coronary CT examination is fast and non-invasive, and a clearer coronary artery can be obtained without injection of contrast agentThe image of the coronary artery allows doctors to have a preliminary understanding of the location of coronary lesions and the degree of stenosis. If severe coronary stenosis is found, further coronary angiography is required. This is the ‘gold standard’ for determining coronary artery disease and severity, but it is an invasive test that requires catheterization of the aorta through the femoral femoral artery or other peripheral arteries, contrasted with iodine The injection of the agent allows the coronary arteries to be visualized, and the location, extent and extent of the coronary obstruction are more clearly displayed. In addition, stent implantation or coronary balloon dilation can also be completed at the same time during the angiography, which is a method integrating diagnosis and treatment.
Coronary CT showed calcified plaque caused lumen stenosis (red circle) >The above are the three most commonly used examination methods for the heart. After understanding their principles and focus, you can correctly choose the examination method that suits you. In addition, the diagnosis of a disease is not limited to one examination method. For example, the diagnosis of coronary artery stenosis in coronary heart disease relies on coronary CT or coronary angiography, but the complications of coronary heart disease include: The diagnosis of papillary muscle rupture, ventricular septal perforation, ventricular aneurysm, etc. is the use of cardiac color Doppler ultrasound! Of course, the auxiliary examinations of the heart also include MRI,myocardial nuclear scintigraphy, etc. Although they are not commonly used, they all have their own advantages and disadvantages. Focus. According to each patient’s main complaints, symptoms and signs, the doctor will select the appropriate examination method for the patient. The heart is like a priceless house that everyone owns. We must cherish our heart and do regular inspection and maintenance. When checking, you should trust the advice of professional doctors and follow the principle of “select only the right ones, not the expensive ones”.