- 1. X-ray of the chest
- 2. Electrocardiogram
- 3. MAP
- 4. Holter
- 5. Stress test
- 6. Echocardiogram
- 7. Myocardial scintigraphy
- Laboratory tests to assess the heart
The functioning of the heart can be assessed through several tests that must be indicated by the cardiologist or general practitioner according to the person's clinical history.
Some tests, such as electrocardiogram, chest X-ray can be done routinely with the aim of doing cardiovascular check-up, while other tests, such as myocardial scintigraphy, stress test, echocardiogram, MAP and the holter, for example, they are done when specific diseases are suspected, such as angina or arrhythmias.
Thus, the main exams for assessing the heart are:
1. X-ray of the chest
A chest X-ray or x-ray is an examination that assesses the outline of the heart and aorta, in addition to assessing whether there are signs of fluid accumulation in the lungs, indicating the possibility of heart failure. This examination also examines the outline of the aorta, which is the vessel that leaves the heart to carry blood to the rest of the body. This examination is usually done with the patient standing and with lungs filled with air, so that the image can be obtained correctly.
The X-ray is considered an initial exam, and it is usually recommended by the doctor to perform other cardiovascular exams to better assess the heart and with greater definition.
What it is for: indicated to evaluate cases of enlarged heart or blood vessels or check if there is deposition of calcium in the aorta, which can happen due to age. In addition, it allows to assess the condition of the lungs, observing the presence of fluids and secretions.
When it is contraindicated: it should not be done in pregnant women, especially in the first trimester because of the radiation emitted during the exam. However, if the doctor believes that the test is essential, it is recommended that the pregnant woman perform the test using a lead shield in the belly. Understand what are the risks of x-rays in pregnancy.
2. Electrocardiogram
The electrocardiogram is an exam that evaluates the heart rhythm and is done with the patient lying down, placing cables and small metallic contacts on the skin of the chest. Thus, like a chest X-ray, the electrocardiogram is considered one of the initial tests that assess the electrical functioning of the heart, being included in the routine examinations of the consultation with a cardiologist. It can also be used to assess the size of some cardiac cavities, to exclude some types of infarction and to assess arrhythmia.
The electrocardiogram is fast and not painful, and is often performed by the cardiologist himself in the office. Find out how the electrocardiogram is done.
What it is for: designed to detect arrhythmias or irregular heartbeat, assess changes suggestive of new or old infarction and suggest hydroelectrolytic changes such as decreased or increased potassium in the blood.
When it is contraindicated: anyone can be submitted to an electrocardiogram. However, there may be interferences or difficulties in performing it, in people with an amputated limb or with skin lesions, excess hair on the chest, people who have used moisturizing creams on the body before the exam, or even in patients who have not are able to stand still when registering the electrocardiogram.
3. MAP
Ambulatory Blood Pressure Monitoring, known as MAPA, is done for 24 hours with a device to measure blood pressure in the arm and a small tape recorder attached to the waist that measures at intervals determined by the cardiologist, without the need to stay in the hospital.
All blood pressure results that have been recorded are analyzed by the doctor, and therefore it is recommended to maintain normal day-to-day activities, as well as write down in a diary what you were doing at each time the pressure was measured, as activities such as eating, walking or climbing stairs can usually change the pressure. Know the price and the care you should take to do the MAP
What it is for: it allows investigating the pressure variation throughout the day, when there is doubt as to whether the patient has high blood pressure, or in case of suspicion of White Coat Syndrome, in which the pressure increases during the medical consultation, but not in others situations. In addition, MAPA can be performed with the aim of verifying that the medicines to control the pressure are working well throughout the day.
When it is contraindicated: it cannot be done when it is not possible to adjust the cuff on the patient's arm, which can happen in very thin or obese people, and also in situations where it is not possible to measure pressure reliably, which can happen in people who have tremors or arrhythmias, for example.
4. Holter
The holter is an exam to assess the heart rhythm throughout the day and at night using a portable recorder that has the same electrodes as the electrocardiogram and a recorder that is attached to the body, recording each heartbeat of the period.
Although the exam period is 24 hours, there are more complicated cases that require 48 hours or even 1 week to properly investigate the heart rhythm. During the performance of the holter, it is also indicated to write down the activities in a diary, such as greater efforts, and the presence of symptoms such as palpitations or chest pain, so that the rhythm in these moments is evaluated.
What it is for: this test detects cardiac arrhythmias that can appear at different times of the day, investigates symptoms of dizziness, palpitation or fainting that can be caused by heart failure, and also assesses the effect of pacemakers or remedies to treat arrhythmias.
When it is contraindicated: it can be done on anyone, but it should be avoided in people with skin irritations that alter the fixation of the electrodes. It can be installed by any trained person, but it can only be analyzed by a cardiologist.
5. Stress test
The stress test, also known as the treadmill test or exercise test, is done with the aim of observing changes in blood pressure or heart rate during the performance of some effort. In addition to the treadmill, it can be performed on an exercise bike.
The evaluation of the stress test mimics situations required by the body, such as climbing stairs or a slope, for example, which are situations that can cause discomfort or shortness of breath in people at risk of heart attack. Find out more details about stress testing.
What it is for: allows you to assess the functioning of the heart during exertion, detecting the presence of chest pain, shortness of breath or arrhythmias, which may indicate a risk of heart attack or heart failure.
When it is contraindicated: this test should not be done by people who have physical limitations, such as the impossibility of walking or cycling, or who have an acute illness, such as an infection or heart failure, as it can get worse during the exam.
6. Echocardiogram
The echocardiogram, also called echocardiogram, is a kind of ultrasound of the heart, which detects images during its activity, evaluating its size, the thickness of its walls, the amount of blood pumped and the functioning of the heart valves.
This exam is painless and does not use x-rays to obtain your image, so it is very performed and provides a lot of important information about the heart. It is often done to investigate people who experience shortness of breath and swelling in their legs, which can indicate heart failure. See the step-by-step instructions for performing the echocardiogram.
What it is for: helps to assess the functionality of the heart, detecting heart failure, heart murmurs, changes in the shape of the heart and vessels, in addition to being able to detect the presence of tumors within the heart.
When it is contraindicated: there are no contraindications for the exam, however, its performance and, consequently, the result, may be more difficult in people with breast or obese prostheses, and in patients where it is not possible to lie on the side, such as people with fractures in the leg or that are in serious condition or intubated, for example.
7. Myocardial scintigraphy
Scintigraphy is an examination performed by injecting a special medication into the vein, which facilitates the capture of images from the heart walls. The images are taken with the person at rest and after the effort, so that there is a comparison between them. If the person cannot make the effort, it is replaced by a medication that simulates, in the body, a forced walk, without the person leaving the place.
What it does: evaluate changes in blood supply to the heart walls, as can happen in angina or infarction, for example. It is also able to observe the functioning of the heartbeat in its effort phase.
When it is contraindicated: myocardial scintigraphy is contraindicated in case of allergy to the active substance of the substance used to perform the exam, people with severe arrhythmias or with kidney problems, since the elimination of the contrast is done by the kidneys.
The cardiologist can also decide whether this test will be performed with or without the stimulation of drugs that speed up the heartbeat to mimic a patient's stress situation. See how the scintigraphy is prepared.
Laboratory tests to assess the heart
There are some blood tests that can be performed to assess the heart, such as Troponin, CPK or CK-MB, for example, which are muscle markers that can be used in the assessment of acute myocardial infarction.
Other tests such as blood glucose, cholesterol and triglycerides, requested in cardiovascular check-up, for example, although not specific to the heart, indicate that if there is no control with medication, physical activity and a balanced diet, there is a great risk of developing cardiovascular disease. in the future. Better understand when to have a cardiovascular check-up.
