Cardiology is one of the medical specialties that has advanced the most in recent years in terms of diagnostic techniques and treatment possibilities, which has led to a considerable increase in the life expectancy of cardiovascular patients.
The incorporation of a series of basic techniques in the outpatient clinical consultation allows the expert cardiologist to study the functioning of the heart and find out if there is any alteration in its behavior.
What is the heart?
The heart is basically a complex muscular framework that acts as a pump and propels blood first to the lungs and then to the rest of the body. It incorporates a series of valves that allow the flow to be always continuous and in the same direction. This muscle maintains high requirements throughout the day, especially with stress or exertion, so it needs specific channels that can transport oxygen and nutrients: these are the coronary arteries. In turn, the cardiac muscle is activated and regulated by an electrical stimulus that is generated at the back of the heart and travels through a preferential network called the conduction system.
Techniques for studying the heart
The techniques currently available allow the different parts of the heart to be studied individually.
A detailed clinical history and a thorough clinical examination are the first steps to be taken in the consultation room. The recording of the heart rate and blood pressure at rest will provide the first basic information on the work to be done by the heart.
The study continues with the performance of a 12-lead electrocardiogram; this test allows the cardiac conduction system to be assessed, and may also reflect alterations in the coronary circulation, enlargement of certain chambers or thickening of the cardiac muscle, among other pathologies.
Echocardiography is a technique that uses ultrasound to visualize the heart in real time. It is highly dependent on the experience and knowledge of the operator, and is key in the study of the functioning of the cardiac muscle, valves, the different layers that make up the heart and the aorta.
Occasionally, it is also considered to complete the study with ergometry. This test consists of walking on a moving treadmill on which the speed and gradient are increased, keeping the heart and blood pressure monitored at all times. It can reveal problems in the coronary arteries, which is its main indication, but also assess some arrhythmias or evaluate the capacity of effort.
Symptoms are not always manifested by the patient at the consultation. Sometimes, they are short episodes of palpitations, dizziness or loss of consciousness, which can be evaluated with Holter devices. These are 24-hour continuous monitoring systems, which are performed on an outpatient basis and allow the detection of different cardiac rhythm pathologies. The ABPM, or ambulatory blood pressure measurement systems, also provide us, in a more accurate and precise way, with the blood pressure figures of the patient throughout the day and night.
Although more specific tests may sometimes be necessary, the information provided by the above tests allows the cardiologist to evaluate the heart as a whole, detect problems that interfere with the proper functioning of the organ and apply, if necessary, the necessary treatment.