Whether you have coronary heart disease, your doctor can tell you through a series of simple examination methods. Initial information z. As a pulse and blood pressure measurement, listening with the stethoscope and a detailed description of the symptoms. However, in order to be able to assess the condition of your heart and your coronary vessels even more, further investigations are often necessary. These include the electrocardiogram, echocardiogram and angiography.
An ECG records the electrical activity of the heart. For this purpose, small electrodes are attached to the upper body of the patient, which forward the electrical impulses of the heart to an ECG device via cables. The ECG informs the physician of earlier heart attacks, can detect but not rule out an acute myocardial infarction, and can detect cardiac arrhythmias.
- However, the normal resting ECG is not very sensitive to most major heart disease. It is Z. B. not particularly informative with stress-related complaints.
- One variant is the exercise ECG using a bicycle ergometer or treadmill. The patient is under controlled control as far as it is possible without pain. But also the stress ECG does not allow an absolute statement, it has a marksmanship of about 80%, so that the statement can be inaccurate with every fifth patient.
- Sometimes an additional long-term ECG is required. This is because cardiac arrhythmias often occur when the patient is not connected to an ECG device at the doctor's. The device for a long-term ECG is portable and is placed on the patient for at least 24 hours. Thus, the function of the heart during a normal day and night course can be recorded and checked.
An echocardiogram is an ultrasound of the heart. The ultrasound is reflected by the tissue so that the movement and the structure of the heart are made visible. The echocardiogram provides z. B. important information about existing heart valve defects and abnormalities in the heart contraction. Pathological changes in the coronary vessels, however, can not yet be detected by means of echocardiography.
Also in echocardiography, it is possible to perform a stress test, the so-called stress echocardiography. By administering a circulating drug, the oxygen consumption of the heart is increased, so that z. B. a circulatory disorder of the heart muscle can be identified.
Angiography is the most accurate method of assessing the coronary arteries. Under local anesthesia, a long, thin tube (catheter) is inserted into an artery in the groin and advanced to the heart and coronary arteries. An X-ray contrast medium is then injected into the region of the heart to be examined via the catheter in order then to be able to assess the coronary vessels with the aid of X-ray images. On the X-ray film is clearly visible whether, how many and where are vessel narrowings.