Risk Factors, and Results of Electrocardiogram | Cardiology

What is an electrocardiogram (ECG)?

An electrocardiogram is commonly called an ECG or EKG and it is a simple test used to check the rhythm and electrical activity of your heart. Sensors attached to the skin are used to detect the electrical signals your heart produces each time it beats. A machine records these signals, and the doctor sees if they are abnormal.

The electrocardiogram can be ordered by a cardiologist or any doctor who thinks you have a heart problem, including your GP. This test can be done by a hospital, clinic, or healthcare professional who is specially trained in surgery by your GP. Despite the similar name, the electrocardiogram is not the same as the echocardiogram, which is a scan of the heart.

Natural electrical impulses coordinate the contractions of different parts of the heart, causing blood to flow. An electrocardiogram records these impulses to show the strength and timing of the electrical impulses as the heartbeats, the rhythm of the heartbeat (constant or irregular), and the passage through different parts of the heart. Changes in the ECG indicate heart conditions.

Why is an electrocardiogram done?

Your doctor may recommend an electrocardiogram to assess the health of your heart. This is a common part of checkups, especially for those over 40.

An electrocardiogram by itself does not diagnose all types of heart conditions or predict future heart problems. Provides important information about your heart health-related to your age, physical exam, medical history, and other tests.

  • Identify abnormal heart rhythms that cause blood to clot.
  • Identifying heart problems includes a recent or ongoing heart attack, abnormal heart rhythms (arrhythmia), coronary artery occlusion, damaged areas of the heart muscle (from a previous heart attack), inflammation of the broken heart, and shock around the heart.
  • Identify non-cardiac conditions such as electrolyte imbalance and lung and lung diseases.
  • Heart attack, the progression of heart disease, or recovery from the effect of certain medications or pacemakers.
  • Eliminate hidden heart disease in patients undergoing surgery.

When are ECGs needed?

In some cases, having this test is very important. If you have symptoms of high blood pressure or heart disease, chest pain, shortness of breath, irregular heartbeat, or large heartbeat, you may need an electrocardiogram. You may need screenings or tests for professional purposes or if you have a personal or family history of heart disease, diabetes, or other accidents and want to start exercising.

How the test is done

You will be asked to remove all clothing and jewelry from your waist (including women’s bras) to place electrodes on specific areas of the chest wall, arms, and legs. The electrodes are held in place by rubber bands, suction cups, or adhesive pads.

Sometimes it is necessary to shave the skin where the electrode recording patches are placed to easily detect the electrical signal and reduce discomfort when removing the patches. For a standard 12-bottle ECG, the electrodes are placed in 4 positions on the 4 extremities and 6 on the chest wall. Sometimes additional leads are added for a 15-lead electrocardiogram.

You will be prompted to remain normal when the machine is turned on, and typically a sample (usually 3-4 seconds) from each electrode site is recorded. The electrocardiogram is usually constantly monitoring and may ask you to hold your breath for a short time during the procedure (to stop chest wall movement that interferes with the signal). The machine captures the electrical activity of the wires and then produces a graph with an up and down row that looks a bit like a geographic map but indicates the activity of your heart.

Types of electrocardiogram

The types of ECG are:

  • Standard (resting) ECG: The electrocardiogram measures the electrical activity of your heart while you lie down or rest in a semi-reclined position. This is the most common type of ECG.
  • Stress test (exercise ECG or tape test): This usually involves taking an electrocardiogram on a treadmill while you exercise. Show how exercise affects your heart. Helps diagnose and diagnose coronary artery disease and other types of heart disease. Medications are sometimes given instead of mimicking the effect of exercise on the heart.
  • Holter monitor (24-hour ECG or ambulatory ECG): This includes the use of an electronic electrocardiogram recorder 24 hours a day. It records the electrical activity of your heart for 24 hours. It can help diagnose arrhythmias (irregular or abnormal heartbeats).
  • Cardiac event recorders record an electrocardiogram for an extended period, a year or more. Portable cardiac event recorders record the electrical activity of the heart when you have symptoms. Adjustable loop recorders are mounted under the skin on your chest. They constantly record the electrical activity of your heart.

Results of ECG

For most people, an electrocardiogram is just a series of lines. However, each line corresponds to an electrical signal sent from the heart. Doctors can read and understand these lines, which indicate the general condition of the heart.

The operating physician or healthcare professional places the electrodes on a person’s skin, usually around the chest, and at 10 different points on the extremities. Each beat sends an electrical impulse. These electrodes select this pulse and record the activity as a waveform on a graph.

All of these take place in the eyelid, so an EKG is very important. An ECG can capture all these little details and record them for the doctor to analyze.

Risk factors of ECG

Electrocardiograms (EKGs) are safe, non-invasive, painless, and accident-free tests. The electrodes (adhesive patches) that connect the sensors to your chest do not send electrical shocks. People who undergo stress tests have a higher risk of having a heart attack, but this is related to exercise, not the EKG.

You may develop a mild rash or irritation of the skin where the electrodes are placed. If paste or gel is used to place the electrodes, you may have an allergic reaction. This irritation usually disappears without the need for treatment, once the patches are removed.

Specialists who handle ECG

  • Cardiac surgeons specialize in the surgical treatment of the heart and its vascular conditions. They are also known as cardiothoracic surgeons.
  • Pediatric cardiologists and cardiologists are interns or pediatricians who specialize in diagnosing and treating diseases or situations of the heart and its blood vessels.
  • Emergency medicine specialists specialize in the diagnosis and treatment of sudden illness or injury and difficulties of chronic illness.
  • Interventional cardiologists are cardiologists who specialize in diagnosing and treating conditions and diseases of the heart and its blood vessels. They use catheter-based non-surgical procedures and imaging techniques.
  • Primary care providers include interns, family practitioners (family medicine physicians), pediatricians, geriatricians, physician assistants (PA), and nurse practitioners (NP). Primary care providers provide comprehensive health services and treat a wide variety of ailments and conditions.
  • Thoracic surgeons train in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. They are also known as cardiothoracic surgeons.

Overview of Cardiac Electrophysiology | Cardiology

What is cardiac electrophysiology?

All heart activity is regulated by cardiac electrophysiology stimuli. The area called the sinoatrial node produces electrical impulses that stimulate the rest of the heart muscle to contract rhythmically. Problems with the heart’s electrical system can contribute to arrhythmia (abnormal heart rhythms).

While some types of arrhythmia are not serious, others can lead to cardiac arrest, heart disease problems, and other life-threatening conditions. When the heart needs medical help, structural problems sometimes require a “mechanic” or a “plumber” to fix circulatory problems. In other cases, you may need an “electrician” or a cardiac electrophysiologist.

Syncope expert assessment and management of sudden loss of consciousness, which is sometimes associated with a heart rhythm disorder. Treatment of abnormally fast heart rhythms with pharmaceuticals, cardiac electro auto, or ablation therapy.

Management of atrial fibrillation, which is the most common cardiac arrhythmia in adults in the United States. This condition is associated with impaired physical function, thromboembolic stroke, and heart failure. Our cardiac electrophysiologists offer multiple treatment options (individual and in combination) including specialized medical management, catheter ablation, electro-nautical alignment, and left atrial appendage closure.

Dynamic electroanatomic mapping to guide catheter-based interventions to replace or remove defective tissue that causes abnormal heart rhythms. Setting up a pacemaker or coordinating electrical impulses in the heart to treat unacceptable slow or unreliable heart rates. Placement of defibrillators for the treatment of dangerous heart rhythms and the restoration of a healthy heart rhythm. 

Understanding cardiac electrophysiology

It is important to understand how the heart’s electrical system works. The heart muscle contains specialized cells that can produce electrical impulses. In healthy hearts, these impulses propagate in a reversible pattern, causing the heart muscle to contract and pump blood. However, if you have a heart rhythm disorder or arrhythmia, the electrical signals do not travel throughout the heart muscle.

Electrophysiology studies (EPS) are done to evaluate the electrical activity of your heart. By using special catheter tubes that can transmit electrical impulses, doctors can see where electrical signals begin and travel in your heart. This will help them identify the exact area of your heart that is the source of the problem.

If your doctor decides where your arrhythmia starts, he or she can treat your condition in the same way. In many cases, doctors destroy a small area of tissue in the heart that causes arrhythmia in a low-risk procedure called catheter ablation. Depending on the type of rhythm disorder you have, your doctor may set up a pacemaker or implantable cardiovascular defibrillator (ICD) to monitor and correct your heart arrhythmia when it begins. 

Techniques performed by specialists in cardiac electrophysiology

A cardiac electrophysiologist can perform a variety of tests to diagnose problems with the electrical activity of the heart, including:

Electrocardiogram: An electrocardiogram measures the electrical activity of the heart through electrodes placed on the skin.

Tilt table test: Designed to detect problems associated with dizziness or fainting, you must lie on the table while monitoring the EKG and blood pressure monitor for the bow table test. The table stands out from the lie, and the cardiologist describes the changes in heart activity and blood pressure.

Ambulatory monitors: Your heart specialist may ask you to wear a special heart monitor attached to your chest throughout the day, which will give you a better idea of ​​potential problems with heart function.

Electrophysiology study: During an electrophysiology study, the cardiologist makes a small puncture in the blood vessel, which allows small catheters to be placed in the heart. Patients are awake during the procedure, although they receive local anesthesia to prevent pain at the catheter insertion site. The doctor sends information about the origin of the arrhythmia through electrical catheters through catheters. 

Cardiac electrophysiology treatments

  • Electrocardiogram
  • Holter monitor
  • Cardiac event monitor
  • Tilt table test
  • Electrophysiology study

Your treatment will depend on the type and severity of the arrhythmia (depending on where it occurs and how it affects your heart rhythm). These treatments can include:

Lifestyle changes: Reducing or eliminating triggers such as alcohol, certain medications, caffeine, and stress can ease the arrhythmia on its own (persistent arrhythmia).

Medications: Antiarrhythmic medications, such as calcium channel blockers, beta-blockers, and blood thinners (such as aspirin or warfarin), can help control abnormal heart rhythms. Actions need careful monitoring to prevent side effects, and you may need other tests to see if this treatment is working.

Catheter procedures: Long, flexible leads to enter the heart and stop the arrhythmia at its source, often to cure the arrhythmia. These minimally invasive procedures include cutting abnormal power lines using radiofrequency heat (catheter ablation) or coagulation therapy (known as cryotherapy or cryoablation).

Robotic catheterization and surgery: Specialized system for catheter-based mapping of the chambers of your heart. The system allows for more precise and consistent catheter movement during complex cardiac procedures.

Cryoablation: This procedure restores normal electrical conduction by clotting the heart tissue or pathways that block the normal movement of electrical impulses from the heart.

Cardioversion: If your heart is beating too fast, cardiac electrophysiology can apply an electrical shock to the chest wall to restore normal heart rhythm.


Equipment for the treatment of arrhythmias and atrial fibrillation (AFib) As part of your treatment plan, your doctor may recommend an implantable device:

Monitoring device: People with atrial fibrillation are at increased risk of stroke because clots form in the chambers above the heart. The Watchman device can reduce this risk and provide an alternative to blood-thinning medications such as warfarin (which prevents clotting).

Pacemakers: We use pacemakers to treat slow heartbeats. The device sends electrical impulses to the heart to maintain an optimal heart rate.

Implantable cardioverter-defibrillator (ICD): This device corrects malignant arrhythmia in the heart’s ventricles (the lower chambers that send blood to the rest of the body). The ICD monitors your heart rhythm and interrupts dangerous arrhythmias by giving an electric shock.

Life west: This temporary external body device detects and counteracts malignant heart rhythm abnormalities.

  • Example of an x-ray showing a pacemaker
  • Living with an adjustable device

After you have received the mountable device, you need to take more precautions to ensure that it works properly.


Overview of Non-Invasive Cardiology | Cardiology

What is non-invasive cardiology?

Non-invasive cardiology focuses on the detection and treatment of heart disease,  using external tests, rather than instruments inserted into the body such as needles, fluids, or other instruments, to evaluate and diagnose heart disorders. Patients with a history of heart disease, suspected valve disease, or unexplained chest pain may be referred by their physician for a noninvasive evaluation.

Non-invasive cardiology tests

Nuclear cardiology: Non-invasive study of cardiovascular disorders using various types of images that can use radioactive elements.

Echocardiography: The use of ultrasound waves to create images of the heart and surrounding structures in order to identify how well the heart pumps blood, infections, and structural abnormalities.

Cardiac electrophysiology: Study and test the electrical currents that generate the heartbeat.

Stress tests: Stress tests generally involve exercise controlled by your cardiologist. These exercises give your cardiologist information about how your heart works under physical stress.

Heart monitors: Heart monitors may also be called a Holter monitor or cardiac occasion recorder. Heart monitors are essentially tape recorders for the electrical activity of your heart over a set period of time.

CT scans: CT scans produce images that your cardiologist can examine for heart disease and atherosclerosis. Once your specialist has identified risk factors or existing conditions, he or she may recommend medications and lifestyle changes to improve your heart health.

Chest x-ray: An X-ray test can help physicians diagnose and monitor conditions such as heart failure, pneumonia, lung cancer, sarcoidosis, tuberculosis, and fibrosis. Doctors also use chest X-rays to see how treatments are working and to check for complications after a patient has undergone specific surgeries or procedures.

Electrocardiogram (EKG / ECG): The electrocardiogram test records the electrical activity of your heart to conclude if you have had a heart attack or if one is developing one. It also detects changes in the heart rhythm, which helps doctors identify complexities.

Computer imaging: Computer images can take the form of a CT scan or an MRI. The computer generates a three-dimensional image that can help show blockages in your heart caused by a heart condition or calcium deposits that you may have in your arteries. It can also notice pulmonary embolism or other heart ailments or cardiovascular diseases.

  • Exercise stress test
  • Tape test
  • Cardiac exercise stress test
  • General exercise test

These tests are carried out to check aspects such as:

  • Breathing
  • Blood pressure
  • Heart rate
  • Resistance

The test can diagnose various heart problems, including coronary artery disease or the possible cause of chest pain. It could also simply determine your safe level of exercise, especially if you’ve already had heart surgery.

Nuclear scan of the heart

A nuclear scan of the heart is a test similar to a standard stress test but is done with photos of the heart in action. Patients will receive an injection of dye to make problems more visible before the test begins. The images can help find blockages, measure blood flow, or identify heart muscle damage caused by a heart attack.

Results-based treatment

If your cardiologist signs that something is wrong, you will receive a set of dietary and nutritional recommendations and lifestyle changes to join. People with heart disease can be healthy with the right tests and management plan. These plans can also include medication, meditation, and other relaxation methods in addition to diet and lifestyle changes, as mentioned above. If the situation is not curable with the means indicated above, the non-invasive cardiologist refers the patient to a specialist who can treat him.

An invasive cardiologist, meanwhile, will offer surgery and other treatments in addition to medication and lifestyle, as mentioned above these changes could cure the ailment facing the patient.

Responsibilities of Non-Invasive Cardiology

Non-invasive cardiology must complete an internal medicine residency program after they have completed their medical degrees. However, after residency, they are required to spend two years completing a fellowship in cardiology. The standard procedure for cardiologists is to serve as a non-invasive cardiologist and focus on performing pre-diagnostic tests and treating patients.

Those training to become invasive cardiologists can do similar work with cases, but can also perform medical tests to find arterial blockages. However, non-interventional invasive cardiologists do not complete the same procedures as interventional cardiologists.

  • Assessment of cardiovascular and cardiac health problems of patients
  • Refer patients to other specialists
  • Interpret the results of ECG and other electronic tests.
  • perform cardiac catheterizations

Information About Invasive Cardiologist | Cardiology

What is an invasive cardiologist?

An invasive cardiologist (also known as an interventional cardiologist) is a minimally invasive procedure to identify abnormalities of the human heart. Invasive cardiology processes are generally minor surgeries that require penetrating the patient’s skin for treatment. It uses open or slightly invasive surgery to identify or treat structural or electrical abnormalities within the structure of the heart.

Invasive cardiologists do a variety of slightly invasive procedures to diagnose and treat cardiovascular disease.

Education and training of Invasive cardiologists

Invasive cardiologists are physicians who have been specifically trained in the tools and techniques to diagnose or treat cardiovascular disease or defects. Like most doctors, these doctors usually go through medical school first. After completing medical school, they will spend an additional seven to eight years of training to specialize in invasive cardiology. They will also need to complete a certification in internal medicine if they ultimately want to become board certified as a cardiologist.

This process involves completing:

  • An average of four years in medical school
  • A three-year residency in internal medicine or pediatrics if you wish to specialize in working with children
  • A three-year communion in cardiology where they work with physicians and gain additional unconventional training in cardiology, prevention, diagnosis, and patient care
  • A one to two-year invasive (interventional) cardiology fellowship for additional specialized training

What does an invasive cardiologist do?

Invasive cardiologists are a subspecialty of cardiology like interventional cardiologists. Invasive cardiologists are qualified to diagnose and treat conditions such as coronary artery disease, vascular disease, acquired structural heart disease, congestive heart failure, valvular heart disease, and congenital heart disease.

To understand your overall heart health and any problems, the invasive cardiologist will appraisal your medical records, medical history, and symptoms. Tests such as X-rays, blood tests, or electrocardiogram (ECG) may be done if these tests have not already been done before your visit. These types of tests help determine the problem.

Additionally, an invasive cardiologist is capable to perform minimally invasive tests to further identify or treat structural or electrical abnormalities in the structure of the heart or arteries that other cardiologists may not be talented to perform. Performing these minimally invasive tests helps the invasive cardiologist to properly diagnose and treat his patients. Invasive cardiologists must be prepared to respond to emergencies immediately, as their services may be needed quickly to prevent a patient from having a heart attack.

Common types of invasive cardiology

Angioplasty: When plaque clogs arteries, it is difficult for blood to flow normally. Angioplasty inserts a small balloon into the blocked vein and pushes the plate against the walls, allowing more blood flow.

Stent placement: The placement of a stent is usually performed in conjunction with angioplasty. A cardiac stent is a small metal coil that permanently holds a blocked vein open.

Cardiac catheterization: In a cardiac catheterization procedure, a cardiologist guides a catheter (a catheter is a thin, medical-grade tube used for a wide range of functions in the medical field) into the heart to complete diagnostic tests and perform diagnostic procedures. treatment as follows.

  • Balloon angioplasty: The cardiologist guides a catheter with a small balloon at the tip to the affected artery. The plaque is pushed against the artery wall by inflating the balloon against it, which helps to restore blood flow in the artery.
  • Catheter ablation: Here, a catheter delivers radiofrequency energy (it is comparable to microwave energy) to eradicate a small part of the heart tissue that is causing a fast and irregular heartbeat. Ending this tissue helps heal your heart’s steady rhythm. This procedure solves the problem that originates in the pulmonary veins.
  • Coronary stents: A catheter is used to inject a small, mesh-shaped metal tube into the area of the constricted coronary artery. Medications can also be delivered to the heart through stents which can reduce the risk of blocked arteries.

Electrophysiology studies: Using an electrode-tipped catheter, a cardiologist measures the heart’s electrical impulses, identifies the precise location of the injured heart muscle, and delivers small electrical impulses to affect heart rhythm problems to learn more about them.

Electrical cardioversion procedure: Using a low-voltage electrical current that is delivered to the chest via patches or paddles, a cardiologist can restore the heart rate to an average rate. The procedure is used in conjunction with a short-acting anesthetic.

Integrated devices: Modern cardiologists use several small battery-powered devices that can be implanted close to the heart to treat complex heart rhythm disorders. Some of the tools that are used are:

  • Implantable cardioverter-defibrillator (ICD): ICDs constantly monitor the heart rhythm and deliver an electrical current to regulate it when abnormalities are detected. The device calibrates the current to react differently when slowing down is required or when defibrillation is required to restore the heart rhythm to a stable rhythm.
  • Implantable pacemakers: These pacemakers help keep the heart from dropping below the recommended pulse. Pacemakers also include heart rate sensors that can track and stabilize the pulse as needed.

Additionally, the invasive approach is performed to treat

  • Coronary artery bypass surgery
  • Coronary angiography
  • Electrophysiology studies
  • Arrhythmia ablation
  • Valve replacement surgery right heart catheterization permanent pacemaker insertion
  • Implantable automatic (Acid), Cardiac defibrillators, and More

Overview of Electronystagmography (ENG) | Neurology

What is Electronystagmography (ENG)?

Electronystagmography (ENG or electrocardiogram) is used to evaluate people with vertigo (a false sense of spinning or movement that can cause vertigo) and some other disorders that affect hearing and vision. Electrodes are set at areas above and underneath the eye to record electrical activity.

By measuring changes in the electrical field within the eye, ENG can detect nystagmus (rapid, involuntary eye movement) in response to various stimuli. If nystagmus does not occur upon stimulation, there may be a problem within the ear, the nerves supplying the ear, or certain parts of the brain. This test may also be used to distinguish lesions in different parts of the brain and nervous system.

Purpose of an ENG

ENG detects disturbances in the parts of the inner ear responsible for steering, posture, and balance, as well as in the nerves that connect your brain to your eyes and ears.

Your doctor may recommend this test if you have any of the following symptoms:

  • Severe or persistent dizziness
  • Vertigo (meaning the room is spinning)
  • Problems with balance
  • Unexplained hearing loss

Your doctor may also perform ENG if you have any of the following conditions:

  • Usher syndrome: A genetic disorder that affects vision, balance, and hearing
  • Acoustic neuroma: A benign tumor of the auditory nerve (vestibular-cochlear)
  • Labyrinthitis: Inflammation of the inner ear
  • Meniere’s disease: A problem of the inward ear that influences equalization and hearing
  • Any suspected lesion on your inner ear

What are the risks of an ENG test?

There is very little risk of Electronystagmography (ENG). A few people may encounter wooziness or sickness during the test. Electronystagmography (ENG) ought not to be utilized in the event that you have a pacemaker. The device may interfere with the pacemaker function.

Rapid changes to the posture needed for the test may worsen back or neck problems. The test for calories in water may cause mild discomfort. If you have previously been diagnosed with a perforated tympanic membrane, you should not have a portion of water calories on the ENG test.

There may be various risks depending upon your specific affliction. Talk about any worries with your medical services supplier before the strategy. Certain factors or circumstances may interfere with ENG. These include:

  • Earwax
  • Impaired vision
  • Frequent blinking
  • Certain medicines, those are sedatives, tranquilizers, and anti-vertigo medicines

How to prepare for the test?

Before the tests, you’ll likely be asked to do the following:

  • Tell your doctor about the medications you are taking: It may ask you to stop taking it 72 hours before the test.
  • Abstain from caffeine and alcohol: No drinking or coffee for 48 hours before the completion date.
  • No food: Most doctors recommend avoiding eating at least 4 hours in advance.
  • Clean your ears: Ear blockage and earwax can distort the results, so a medical assistant may wash the ear canals before the procedure if they are not clear.
  • Prepare a trip afterwards: Usually, this is good advice for many medical procedures, just in case you do not want to drive.

The test can be distorted if you have double vision or blink a lot. Also, you shouldn’t have an Injex device if you have a pacemaker for your heart. You can usually go home after your recovery, although the test can also be taken during a hospital stay. The test takes up to 90 minutes.

What happens during an electronystagmography?

So now it’s time for ENG. You might be a little hungry, you might be tired, and you might be nervous. What can you expect? In fact, the procedure includes several tests. Prior to beginning, your primary care physician will clean your brow, sanctuaries, and cheeks with liquor. Then, you attach the electrodes to those areas using a paste.

In some testing facilities, instead of electrodes, you may be provided with a binocular camera that looks like virtual reality glasses. The tests performed with this system are known as videography or VNG. These devices capture your eye movements on video and can measure them just like electrodes.

The tests include:

  • The calibration test: Utilizing just your eyes, you will be gotten some information about 6 to 10 feet away or think to and fro between focuses on a divider. This test measures visual impairment, a condition in which your pupils have difficulty judging distances to targets.
  • The tracking test: Also known as the nystagmus test, it is similar to the sobriety test offered by the police. But in Muhandis, you are usually sitting or lying down. (Nystagmus is a condition in which your eyes are out of your control.) In this test, you try to stare at a steady light, directly in front of you or at an angle, without moving your eyes around you.

There are two related tracer tests:

  • The first is the pendulum tracking test. In it, you are tracking a light that moves back and forth like a pendulum without moving your head.
  • The other is the optokinetic test, in which you track multiple moving objects without turning your head. Things may move at high speeds and enter and leave your field of vision.

The positional test: Now is the time to move your head. Often your doctor will ask you to perform what is called the Dex-Halpike maneuver. While sitting at a table, you will turn your head to one side and quickly lie down with your head – supported by your doctor – about 20 degrees below the surface of the table. You’ll remain there for 30 seconds, at that point sit upstanding once more. You will repeat it with your head on the other side. Your doctor will notice the effect on your eyes.

The water caloric test: While lying down, your doctor will inject a stream of cold or warm water into one ear, then the other. (Air is sometimes used.) If you are not vertigo, your eyes should reflexively twitch. Your doctor may not perform all of the tests. On the off chance that you have neck or back issues, she may recommend something different.

After the electronystagmography test

  • Once the test is finished, your provider will remove the electrodes and wash off the electrode paste. Do not rub your eyes to prevent spreading the electrode paste.
  • Your provider will monitor you for any signs of weakness, dizziness, and nausea. You may need to rests or sit for a couple of moments to recuperate.
  • Your healthcare provider will tell you when to start any medications you stopped taking before the test. Your healthcare provider may give you other instructions after the procedure, depending on your specific situation.
  • You may also have vertical videography (VNG). This is a test that likewise identifies eye development. But it uses video cameras instead of electrodes.


If your ENG test results are abnormal, it could indicate a problem with your inner ear or the area of the brain responsible for controlling the movement of your eyes.

Other diseases or injuries to the auditory nerve can cause vertigo, including:

  • Vascular disorders that cause bleeding in the ear
  • Ear tumors
  • Genetic disorders
  • Damage to the inner ear
  • Ototoxic drugs
  • Multiple sclerosis
  • Viral infections such as chickenpox, measles, and influenza
  • Movement disorders
  • Chemical poisoning

Treatment and Diagnosis of Pericardial disease | Cardiology

What is a pericardial disease (pericarditis)?

Pericardial disease or pericarditis is an inflammation of any layer of the pericardium. The pericardium is a clash of thin tissue around the heart and includes:

  • Visceral pericardium: The inner layer that covers the entire heart. Fluid layer between the visceral pericardium and parietal pericardium to avoid friction
  • Parietal pericardium: The outer layer made of fibrous tissue.

Signs and symptoms of pericardial disease

You may not have symptoms. This occurs most often in the case of a mild spill. You may have symptoms from the causes of pericardial disease. For example, you may have a fever if you have a pericardial infection.

When the stroke is more severe, you may have symptoms similar to:

  • Chest pain or discomfort
  • Dilation of the neck veins.
  • Epilepsy
  • Breathe faster
  • Increase in cardiac frequency
  • Nausea
  • Pain in the upper right abdomen
  • Difficulty breathing
  • Swelling of the hands and feet

If the stroke is too severe, it can even lead to very low blood pressure. It causes symptoms of shock. In addition to:

  • Mild headache or dizziness
  • Cold hands and feet
  • Clammy skin
  • Weakness
  • Fast breathing
  • Nausea or vomiting
  • Pale skin
  • Less urination
  • Shock is a medical emergency.

The symptoms of the pericardial disorder are similar to other health problems. See your healthcare provider for a diagnosis.

Types of pericardial disease

Idiopathic pericarditis: The cause of acute pericarditis is very difficult to establish and idiopathic pericarditis remains the most common diagnosis. In most cases, a viral etiology is assumed.

Viral pericarditis: Coxsackievirus B and Echovirus are the most common viruses and diagnosis requires a four-fold increase in antiviral titers. Patients often experience a prodrome of upper respiratory infection. The prognosis for viral pericarditis is generally good, with a self-limited course, and if uncomplicated, patients can be treated on a patient basis.

Pure pericarditis: Before the age of antibiotics, pneumonia was the leading cause of purulent pericarditis. Currently, there are extensions of thoracic surgery, chemotherapy, immunosuppression, and hemodialysis, as well as pneumonia and emphysema. The appearance is usually severe with high fever, chills, night sweats, and dyspnea, but the classic findings of chest pain or friction rub are very rare. Cardiac tamponade is common (42–77% of patients in the selected series) and mortality is high.

If the purulent pericardial disease is suspected, hospitalization, treatment with broad-spectrum intravenous antibiotics, and emergency drainage are recommended. Pericardial fluid analysis findings include a high protein level (> 6 g / dL), a low glucose level (<35 mg / dL), and a very high white blood cell count (6,000 to 240,000 / mm3).

Tuberculous pericarditis: Tuberculous pericarditis occurs in 1% to 2% of pulmonary tuberculosis cases. It is the leading cause of pericardial disease in some developing countries. Human immunodeficiency or immunosuppressed virus (HIV): Patients are at risk. Special symptoms such as dyspnea, fever, chills, night sweats develop slowly and often there is no rubbing or chest pain. A patient with suspected or diagnosed pericardial tuberculosis should be hospitalized and antituberculous treatment started immediately.

Analysis of the pericardial fluid shows a high specific gravity, a very high protein level (often> 6 g / dl), and mainly lymphocytic cells. Pericardial biopsy with an acid-fast bacilli polymerase chain reaction test is recommended for all patients with tuberculous pericarditis. However, a simple pericardial biopsy does not rule out the diagnosis.

Uremic and dialysis-associated pericarditis: Uremic pericarditis occurs with moderate renal failure in 6% to 10% of patients before the start of hemodialysis; Blood urea nitrogen levels are usually above 60 mg / dL. Normal ST-segment elevation on ECG is usually absent. Although tamponade is very rare, heavy bleeding can occur, facilitated by impaired platelet function. Alternatively, a serous pericardial effusion related to fluid overload may occur. With both forms, the onset or severity of hemodialysis is indicated, which generally leads to improvement in 1 to 2 weeks5,6.

Pericarditis after myocardial infarction: Pericarditis after myocardial infarction is a common complication (25% to 40% of patients with myocardial infarction) and begins within 3 to 10 days after myocardial infarction. Its development is associated with the extent of necrosis, is more common earlier than malignant infarcts, and is associated with a 1-year mortality rate and an increased risk of circulatory heart failure.

The diagnosis of post-myocardial infarction pericarditis requires symptoms or new pericardial friction; Pericardial effusion alone is not specified. In addition to the general ST elevation seen with severe pericarditis, which is difficult to distinguish from true MI in this setting, ECG findings show normalization of positive T waves more than 2 days after MI or T waves previously transversal.

Post-cardiac injury syndrome: Dressler syndrome usually occurs 2 to 3 weeks after a heart attack or open-heart surgery. The sensitive autoimmune component is believed to be responsible for myocardial infarction during infarction. Fully expressed syndromes include pleurisy chest pain, fever, leukocytosis, and pericardial rubbing. Pleural effusions or pulmonary infiltrates may be observed.

Malignancy: Malignant pericarditis is caused mainly by metastatic disease. Bronchogenic metastatic pericarditis or breast carcinoma, common in Hodgkin’s disease and lymphoma 

Causes of pericardial disease

  • Pericardial disease is caused by inflammation of the pericarditis in response to illness or injury.
  • The pericardial disease also occurs when the flow of pericardial fluid is blocked or blood collects at the pericardium from a chest injury.
  • Sometimes the cause cannot be determined (idiopathic pericarditis).
  • Inflammation of the pericarditis after heart surgery or a heart attack.
  • Autoimmune disorders such as rheumatoid arthritis or lupus.
  • Cancer (metastasis), especially lung cancer, breast cancer, melanoma, leukemia, non-Hodgkin’s lymphoma, or Hodgkin’s disease
  • Heart cancer.
  • Radiation therapy for cancer if the heart is in the radiation field.
  • Chemotherapy treatments for cancer include doxorubicin (Doxil) and cyclophosphamide.
  • Dysfunctional thyroid (hypothyroidism).
  • Viral, bacterial, fungal, or parasitic infection.
  • Trauma or puncture wound near the heart after open-heart surgery.
  • Some prescription drugs, including hydrolyzing, a drug for high blood pressure; Isoniazid, a drug for tuberculosis; And phenytoin (Dilantin, Fenitech, et al.) and Antiepileptic drug.

Risk factors of pericardial disease

Pericarditis affects people of all ages, but men in their 20s and 50s are more likely to develop it.

The cause of pericarditis is unknown in many cases. However, some factors can trigger pericarditis:

  • Recovering from a heart attack
  • Autoimmune diseases
  • Injury or injury from an accident
  • Some bacterial, viral, and fungal infections
  • Renal insufficiency
  • In rare cases, some medicines, such as phenytoin to treat seizures and procainamide to treat irregular heartbeat

Diagnosis of pericardial disease

The doctor will do a physical exam and listen to your heart with a stethoscope. If you have signs or symptoms of pericardial disease, a series of blood and imaging tests will be done to confirm the diagnosis, identify possible causes, and determine treatment. Sometimes a pericardial disease is found when testing is done for other reasons.

  • Echocardiogram: An echocardiogram uses sound waves to create real-time images of your heart. This test allows your doctor to see how much fluid has accumulated in the space between the two layers of the pericardium. The echocardiogram also shows how well your heart is pumping blood and diagnostic tamponade or shock in one of the heart’s chambers.
  • There are two types of echocardiograms: Transthoracic echocardiogram. This test uses a sound-emitting device (transducer) that is placed on your chest and your heart.
  • Transoesophageal echocardiogram: A small transducer is placed in a tube in your digestive system that goes from your throat to your stomach (esophagus). Because the esophagus is so close to the heart, placing the transducer there provides a more detailed image of the heart.
  • Electrocardiogram: An electrocardiogram, also known as an ECG or EKG, records electrical signals as they travel through your heart. Your cardiologist can look for samples that indicate tamponade.
  • Chest x-ray: If you have too much fluid in the pericardium, a chest X-ray will show an enlarged heart.
  • Other imaging technologies: Computed tomography (CT) and magnetic resonance imaging (MRI) can detect pericardial effusion, although they are not commonly used to look for it.

Treatment for pericardial disease

Treatment for pericardial disease depends on the underlying condition causing it and whether the effusion produces severe symptoms, such as shortness of breath or shortness of breath. Medical history, the examination of the patient, diagnosis, examination of the pericardial fluid, and the physician will help determine the cause and treatment.

Depending on the cause, excess fluid may be high in protein (exudate) or water (translate). Both categories help doctors determine the best course of treatment for pericardial effusion.

Medical administration

The goal of medical treatment for the pericardial disease is to treat the underlying cause. Medical treatments for pericardial effusions:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to treat pericardial disease caused by inflammation. These medications include ibuprofen or aspirin.
  • Diuretics can be used to treat pericardial effusions caused by heart failure.
  • Antibiotics are used to treat pericardial disease caused by infection.
  • However, if the pericardial effusion is related to the presence of cancer, treatment may include chemotherapy, radiation therapy, or intramuscular injection.

Procedures for the treatment of pericardial disease

Regardless of whether the pericardial disease is transudative (watery fluid) or exudative (made from a protein-rich fluid), the large pericardial disease is caused by respiratory symptoms or cardiac tamponade may be the main cause of the elimination of excess fluid, to avoid its return or to increase the liquid.

Large pericardial effusions can be drained through:

  • Ultrasound-guided pericardiocentesis: It is a safe and effective procedure to remove excess fluid from the pericardium. This is more common after fluoroscopy.
  • Video-assisted thoracoscopic surgery (VATS): Also known as thoracoscopy, is the least invasive technique performed under general anesthesia. VATS allows visual evaluation of the pericardium and is used when the diagnosis of pericardial effusion has not yet been made despite previous less invasive tests. It is also used to drain excess fluid and prevent relapse. A pericardial disease that may not be treated with medical maintenance or drainage of excess fluid may require surgical treatment.
  • The pericardial window (subluxated pericardiotomy): It is a minimally invasive procedure in which an opening is made in the pericardium to drain fluid that has accumulated around the heart. The pericardial window can be completed with a small incision under the end of the breastbone or with a small incision between the ribs on the left side of the chest.
  • Percutaneous balloon pericardiotomy: It is a non-surgical procedure performed with an x-ray guide to view the pericardium and place the balloon dilator catheter. This approach is not common.

Complications of pericardial disease

  • Pericarditis can be one of two serious problems: cardiac tamponade and chronic gastric pericarditis.
  • Cardiac tamponade a medical emergency and, if left untreated, can quickly become fatal.
  • It develops when there is excess fluid between the heart muscle (myocardium) and the pericardium, putting obstructive pressure on the heart to prevent it from working properly.

Cardiac tamponade causes several symptoms, including:

  • Anxiety
  • Breathing problems and chest pain.
  • Dizziness and epilepsy
  • Swelling of the abdomen
  • Drowsiness
  • Weak pulse
  • Rare, even chronic, chronic constrictive pericarditis can be fatal if left untreated.

Pericarditis develops slowly when scar (fibrous) tissue forms on the pericardium, causing the sac to become thicker, harder, and firmer. Scar tissue shrinks over time, preventing the heart from fully expanding and filling with blood. Chronic constrictive pericarditis can lead to weakness and fatigue, shortness of breath, and swelling in the abdomen and extremities.

Prevention of pericardial disease

In general, acute pericarditis cannot be prevented. You can take steps to reduce the chance of another serious episode, complications, or chronic pericarditis. Getting prompt treatment during these stages, following your treatment plan, and getting ongoing medical care as advised by your doctor.


Symptoms, Causes and Risks of Heart attack | Cardiology

What is a heart attack?

Heart attack means the death of a part of the heart muscle due to loss of blood supply. Blood is usually cut off when a blood clot blocks the artery that supplies the heart muscle. When part of the heart muscle dies, a person experiences chest pain and electrical instability of the heart muscle tissue.

Other names

  • Myocardial infarction (MI)
  • Acute myocardial infarction (AMI)
  • Acute coronary syndrome
  • Coronary thrombosis
  • Coronary occlusion

Signs, symptoms, and Complications

If you experience these heart attack warning signs do not wait to get help. Some heart attacks are sudden and severe. Take care of your body and call a physician if you experience it.

Chest discomfort: Most heart attacks have discomfort in the middle of the chest for more than a few minutes, or it may go away and come back. It can feel like uncomfortable stress, squeezing, fullness, or pain.

Discomfort in other parts of the body: Symptoms include pain or discomfort in one or both arms, back, neck, jaw, or abdomen.

Shortness of breath: It occurs with or without chest discomfort.

Other signs: There are other signs such as cold sweats, nausea, or a mild headache.

Damage to the heart during a heart attack often leads to complications, which can lead to further complications. Arrhythmia (abnormal heart rhythms), heart failure, cardiogenic shock, and valve problems are the most common complications.

Causes of heart attack

When one or more of your coronary arteries become blocked it leads to a heart attack. Over time, fatty deposits, including cholesterol, form substances called plaques, which can narrow the arteries (atherosclerosis). This condition, called coronary artery disease, causes many heart attacks.

  • During a heart attack, a plaque breaks down and leaks cholesterol and other substances into the bloodstream. Blood clots at the site of the break. If the clot is large, it can block blood flow through the coronary artery, depriving the heart of oxygen and nutrients (ischemia).
  • You may have a partial or complete blockage of the coronary artery.
  • Complete inhibition means you have an ST-elevation myocardial infarction (STEMI).
  • Partial occlusion means you have a non-ST elevation myocardial infarction (NSTEMI).
  • Diagnosis and treatment can vary depending on what type you have.
  • Another cause of heart attack is a narrowing of the coronary artery, which blocks blood flow to the heart muscle. Using tobacco and illicit drugs such as cocaine can lead to fatal seizures.
  • COVID-19 infection can also damage your heart and lead to a heart attack.

Risk factors of heart attack

The risk factors of a heart attack include:

Smoking: Chemicals in tobacco smoke can damage blood cells. They can also damage the function of your heart and the structure and function of your blood vessels. This damage increases your risk of atherosclerosis. Atherosclerosis is the formation of a waxy substance called plaque in the arteries. Over time, the plaque hardens and narrows the arteries.

It restricts the flow of oxygen-rich blood to your organs and other parts of your body. Ischemic heart disease occurs when plaque forms in the arteries that supply blood to the heart, called the coronary arteries. Over time, heart disease can lead to chest pain, heart attack, heart failure, arrhythmia, or death. Smoking increases the risk of heart disease when combined with unhealthy blood cholesterol levels, high blood pressure, and other risk factors such as being overweight or the esophagus.

High blood pressure: Blood pressure is measured by estimating the pressure of the blood flowing through your arteries against the walls of those arteries. During a heart attack, blood flow to some part of the heart muscle is restricted or cut off because the blood clot blocks the artery. Without the necessary blood supply, the affected part of your heart will not receive the oxygen it needs to function properly.

High blood cholesterol: When you have high cholesterol in your blood, it forms on the walls of your arteries, causing a process called atherosclerosis, a form of heart disease. The arteries are narrow and slow or block blood flow to the heart muscle. Blood carries oxygen to the heart and if not enough blood and oxygen get to the heart, you can experience chest pain. If the blood supply to part of the heart is completely cut off, the result is a heart attack.

There are two forms of cholesterol known to most people low-density lipoprotein (LDL or “bad” cholesterol) and high-density lipoprotein (HDL or “good” cholesterol). These are the ways that cholesterol travels through the blood. The main source of arterial occlusion plaque is LDL. HDL works to remove cholesterol from the blood.

Overweight and obesity: His arrhythmia appears to be associated with a fatal heart attack. Inflammation is a major factor in cardiovascular disease, researchers say, and esophagitis is now increasingly recognized as an inflammatory condition.

An unhealthy diet: When it comes to heart disease risk, what you eat is yourself. Poor diet contributes to cholesterol and triglycerides, high blood pressure, diabetes, and balance. Several important studies provide compelling evidence that diet also affects the risk of complete coronary heart disease and heart attack.

Lack of routine physical activity: Not getting enough physical activity can lead to heart disease even for people who do not have other risk factors. It also increases the risk of developing other heart disease risk factors, including esophagitis, high blood pressure, high blood cholesterol, and type 2 diabetes.

High blood sugar due to insulin resistance or diabetes: The blood vessels and the nerves that control your heart and blood vessels can be damaged by high blood glucose from diabetes. If you have diabetes for a long time, you are more likely to get heart disease. People with heart disease are more prone to heart attack than with diabetes.

The most common causes of death in adults with diabetes are heart disease and stroke. Adults with diabetes are almost twice as likely to die of heart disease or stroke than those with diabetes. The good news is that the steps you take to manage your diabetes can also help reduce your risk of heart disease or stroke.

Risk factors such as arrears, high blood pressure, and high blood sugar can occur together. When they do, it is called metabolic syndrome. In general, a person with metabolic syndrome is twice as likely to have heart disease, and a person five times more likely to have diabetes than a person without metabolic syndrome.

Diagnosis of heart attack

Tests to diagnose a heart attack include:

  • Electrocardiogram (ECG): This first test done to diagnose a heart attack records electrical signals as they pass through your heart. Adhesive patches (electrodes) are attached to your chest and limbs. Signals are recorded as waves displayed on the monitor or printed on paper. Because the injured heart muscle does not normally conduct electrical impulses, an ECG shows that a heart attack has occurred or is in progress.
  • Blood tests: Some heart proteins will slowly leak into your bloodstream after a heart attack from a heart attack. Emergency room doctors take samples of your blood to check for these proteins or enzymes.

Treatments for heart attack

If your doctor suspects a heart attack, you can treat it immediately:

  • Aspirin to prevent blood clots
  • Nitroglycerin to relieve chest pain and improve blood flow
  • Oxygen therapy

Once your doctor has diagnosed a heart attack, they will prescribe medication. They may recommend surgery if necessary.

  • Give your medicine: The medicine drug is called thrombolytic. It helps to clot the blood that clogs the coronary artery.
  • Do a coronary angiography: X-ray of the blood vessels.
  • Do an angioplasty or stent: Angioplasty involves inserting a small balloon into an artery in your arm or leg. The balloon threads the artery to the heart. The balloon pushes the open black coronary arteries. A small metal rod called a stent can be placed in the clogged artery to keep the artery open.
  • Do coronary artery bypass surgery: If angioplasty and/or stenting is not appropriate, you may need this major surgery. Your doctor will remove a healthy vein from your leg or artery from your upper body. He or she will bypass around the blockage in your coronary artery. This allows blood to flow around the blockage.

Cardiac screening

  • If screening tests reveal coronary artery disease, there are steps you can take to reduce your risk for heart attack or exacerbated heart disease. Your doctor may recommend lifestyle changes such as a healthy diet, exercise, and smoking cessation. Medications may also be required. Medications can treat risk factors for coronary artery diseases (CAD) such as high cholesterol, high blood pressure, irregular heartbeat, and low blood flow.
  • A negative cardiac CT for calcium scoring means that no calcification has been found in your coronary arteries, indicating that there is no coronary artery disease or not being seen by this technique. Under these conditions, you are less likely to have a heart attack in the next two to five years.
  • A positive cardiac CT for calcium scoring means you have CAD regardless of what symptoms you are experiencing. Calcification is expressed as the total calcium score. A score of 1 to 10 indicates minimal evidence of CAD, 11 to 100 indicates mild evidence, 101 to 400 indicates moderate evidence of disease, and a score of more than 500 indicates extensive evidence of disease.
  • Your calcium score can help assess the likelihood of myocardial infarction (heart attack) in the years to come and help your doctor decide whether you should take preventative medicine or take other measures such as diet and exercise to reduce your risk of a heart attack.
  • If there is coronary artery disease, lifestyle changes, medications, and if necessary, medical or surgical procedures in stages to reduce the person’s risk of heart attack and manage symptoms.
  • Angioplasty and stenting: In an angioplasty procedure, a balloon-tipped catheter is used to guide a long, thin plastic tube into the coronary artery and to propel the vessel into a narrow or obstructed area. The balloon is then inflated, inflated, and removed to open the vessel. During angioplasty, a small wire mesh tube called a stent can be placed permanently in the newly opened artery to help keep it open. There are two types of stents: bare stents (wire mesh) and drug-eluting stents.
  • Coronary artery bypass graft surgery (CABG): CABG is a surgical instrument used to re-circulate blood around diseased vessels. During this surgery, a healthy artery or vein from other parts of the body connects or sticks to the coronary artery, bypassing the barrier, creating a new way for oxygen-rich blood to flow to the heart muscle.

Prevention of heart attack

  • Control your blood pressure: It is important to check your blood pressure regularly, once a year for most adults, and if you have high blood pressure. Take measures, including lifestyle changes to prevent or control high blood pressure.
  • Keep your cholesterol and triglyceride levels under control: High cholesterol clogs your arteries and increases the risk of coronary artery disease and heart attack. Lifestyle changes and medications (if needed) can lower your cholesterol. High levels of triglycerides increase the risk of coronary artery disease, especially in women.
  • Stay at a healthy weight: Obesity increases your risk of heart disease. They are associated with high blood cholesterol and triglyceride levels, as well as other heart disease risk factors, including high blood pressure and diabetes. Controlling your weight will reduce these risks.
  • Eat a healthy diet: Foods high in sodium, saturated fats, and added sugars should be consumed in limited quantities. Eat plenty of fresh fruits, vegetables, and whole grains. The dash diet is an example of an eating plan that can help you lower your blood pressure and cholesterol, which can reduce your risk of heart disease.
  • Get regular exercise: Exercise has many benefits such as strengthening your heart and improving your circulation. It can help you maintain a healthy weight and lower cholesterol and blood pressure. All of these can reduce your risk of heart disease.
  • Limit alcohol: Excessive alcohol consumption can increase your blood pressure. It also adds extra calories, which can lead to weight gain. Both of these increase your risk of heart disease. Men should not have more than two alcoholic beverages per day and women should not have more than one.
  • Don’t smoke: Cigarette smoking raises your blood pressure and increases your risk of heart attack and stroke. If you do not smoke, do not start. If you smoke, quitting will reduce your heart disease. You can talk to your healthcare provider to help to find the best way to exit.
  • Manage stress: Stress is one of the causes of to increase in the risk of heart disease. It raises your blood pressure. Severe stress can “trigger” a heart attack. Also, some common ways to deal with stress, such as overeating, overeating, and smoking, are bad for your heart. Some of the ways that can help you manage your stress are exercise, listening to music, focusing on those who are calm or relaxed, and meditating.
  • Manage diabetes: Having diabetes doubles the risk of diabetic heart disease. This is because, over time, Blood vessels and the nerves that control your heart and blood vessels can be damaged by high blood sugar. So, it is important to get tested for diabetes, and if you have it, you need to keep it under control.
  • Make sure that you get enough sleep: If you do not get enough sleep, you will increase your risk of high blood pressure, esophagus, and diabetes. Those three things increase the risk of heart disease. 7 to 9 hours of sleep a night is required for adults. Make sure you have good sleep habits. If you have frequent sleep problems, consult your healthcare provider. One problem, sleep apnea, is that people often stop breathing during sleep. It can impair your ability to relax well and increase your risk of heart disease. If you think you may have it, ask your doctor about a sleep study. If you have sleep apnea, make sure you get treatment for it.