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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.
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Overview of Heart Failure in Children | Cardiology

What is heart failure in children?

The most common cause of heart failure in children is congestive heart failure, in which the heart cannot pump enough blood to meet the needs of the body’s organs. The heart continues to pump, but not as efficiently as a healthy heart. In general, heart failure reflects a progressive underlying heart condition.

For a child to grow and develop, the heart needs to maintain a normal pumping function, providing adequate blood flow throughout the body. However, sometimes a child’s heart may not function normally. The term “cardiac arrest” describes a dysfunctional heart. This does not mean that the heart has stopped working, but that it is not working.

Heart failure in children is caused by smoking, high blood pressure, diabetes, coronary artery disease, and faulty heart valves. It can occur in newborns, young children, young children, and adolescents for other reasons. Because heart failure has different causes and outcomes, it is important to identify how it is diagnosed, treated, and cured in young children.

How is heart failure in children identified?

Heart failure in children is often accompanied by shortness of breath, poor diet, poor growth, excessive sweating, or low blood pressure. Sometimes heart failure can be similar to other problems, such as colic, pneumonia, or other respiratory infections.

Parents often notice that it takes a long time to feed the baby or that they are not interested in feeding after a short time. If the heartbeat is caused by a very fast heartbeat, parents may experience a rapid heartbeat through the chest wall while the baby is sleeping or resting peacefully.

Older children and teens can quickly complain of fatigue, especially if the virus infection damages the heart muscle.

Causes of heart failure in children

Heart failure is more common in children with certain congenital heart defects (congenital heart defects). These include defects like holes in the heart, which increase blood flow from one side of the heart to the other. It alters the dynamics of blood flow and weakens one side of the heart. The heart then becomes unable to support blood flow, resulting in further deterioration of heart function.

Other types of heart problems, such as cardiomyopathy, can also cause heart failure, a condition that affects the pumping function of the heart. Some non-heart problems, such as kidney failure, are caused by changes in the body’s fluid balance or hormonal changes that lead to high blood pressure.

Risk factors for heart failure in children

  • Smoking
  • High blood pressure
  • Diabetes
  • The high blood level of cholesterol
  • Physical inactivity
  • Obesity
  • Family history of early-onset heart disease

Symptoms of heart failure in children

Symptoms are slightly different for each child. They can include:

  • Swelling of the feet, ankles, calves, abdomen, liver, and cervix (edema)
  • Difficulty breathing, especially with rapid breathing, shortness of breath, or excessive coughing
  • Poor diet and weight gain (in babies)
  • Feeling tired
  • Excessive sweating when eating, playing, or exercising
  • Irritated

Older children may also have:

  • Weight loss
  • Passing out
  • Chest pain

The severity of the symptoms depends on how much the heart’s pumping ability is affected.

The symptoms of heart failure are similar to those of other conditions. See your child’s healthcare provider for a diagnosis.

Diagnosis of heart failure in children

Your child’s doctor will obtain a complete medical history and physical exam by asking questions about your child’s appetite, breathing patterns, and energy level. Other diagnostic procedures for heart failure may include:

  • Blood and urine tests
  • Chest X-ray: A diagnostic test that uses invisible X-rays to produce images of internal tissues, bones, and organs onto film.
  • Electrocardiogram (ECG or EKG): A test that records the electrical activity of the heart shows abnormal rhythms (arrhythmia or dysrhythmia) and can detect problems with the heart muscle.
  • Echocardiogram (echo): A noninvasive test that uses sound waves to study the movement of the heart’s chambers and valves. The echo sound waves create an image on the monitor when the ultrasound transducer passes over the heart.
  • Cardiac catheterization (cath): Assault test that inserts a small catheter into the heart from the groin or arm. It allows the different pressures within the heart to be measured to help detect heart failure. Also, a heart tissue biopsy can be obtained to determine the root cause of heart failure.

Treatment for heart failure in children

Treatment of heart failure in children depends on the cause of the problem. Most heart defects resolve on their own over time, and some can resolve with medication. Sometimes surgery or other procedures may be necessary. In some cases, your child may need a combination of therapies.   

Medicine

For some heart problems, children can take medicine after they get better. Medicines sometimes need to be taken for many years or even the child’s entire life.

Surgery

Heart surgery can provide a lifelong cure for certain heart conditions. The cardiac surgeon will discuss the risks and benefits with you in detail. Sometimes surgery can be delayed until your child is older and stronger, which means they will be able to tolerate the surgery better. Depending on the condition of your child, multiple operations may be required.

In very rare cases where surgery, procedures, or medications do not help, children may need a heart transplant.

Other procedures

Some procedures involve placing a narrow tube called a catheter into the heart through a vein to treat a heart defect. Your child will be given general anesthesia for this procedure.

Prognosis

All results depend on the cause. If the bleeding is constant due to a structural problem of the heart, the result is excellent.

Children with large ventricular septal defects, whose pores are small or surgically closed, can lead normal lives. Children with more complicated congenital heart disease may have more variable outcomes.

Older children with cardiomyopathy can progress if the cause of the cardiomyopathy is not reversible. The key to managing heart failure is making a proper diagnosis, staying in contact with a cardiologist, and taking prescribed medications daily.

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What are Heart Problems in Children? | Cardiology

Overview of heart problems in children

Congenital malformations are abnormalities in the formation of the heart and/or its main blood vessels. These heart problems occur at birth in eight out of 1,000 babies, but go undiagnosed for many years. The abnormalities range from simple defects, such as a small hole in the wall between the two chambers of the heart, to more complex problems.

Although congenital heart defects are one of the most common birth defects, it can be difficult to know if your child has one. Most heart problems recover during pregnancy or immediately after birth, but others may not be apparent until the baby is a little older.

Heart disease in children

Heart disease is very difficult when touched by adults, but it is especially tragic in children. Heart disease can occur for a variety of reasons, from viral infections to chromosomal abnormalities, and can arise as problems secondary to other diseases or conditions in the body. In most cases, the cause of heart disease is unknown.

The good news is that with the advancement of medicine and technology, many children with heart disease are living full and active lives.

Causes of heart problems in children

A congenital heart defect is a condition (or one of the main heart problems in children) that you are born into. Certain genetic (inherited) diseases or disorders, such as Down syndrome, are associated with congenital heart defects. Certain substances or diseases that a pregnant woman is exposed to can cause congenital heart defects in the fetus, some of which include prescription drugs, rubella (German measles), and uncontrolled diabetes.

Risk factors for heart problems in children

Risk factors for these heart problems in children are divided into two categories: major and contributing. The major risk factors of heart problems in children have been shown to increase your risk of heart disease. There is a risk of heart disease due to proportionate risk factors.

If you have higher risk factors, you are more likely to have heart disease. Some risk factors of heart problems in children can change, treat, or modify and others cannot. But by controlling as many risk factors as possible through lifestyle changes, medications, or both, you can lower your risk of heart disease.

Major risk factors for heart problems in children are:

  • High blood pressure (Hypertension)
  • High blood cholesterol
  • Diabetes
  • Obesity and Overweight
  • Smoking
  • Physical Inactivity
  • Gender
  • Heredity
  • Age

Contributing risk factors to heart problems in children are:

  • Stress
  • Sex hormones
  • Birth control pills
  • Alcohol

Symptoms of heart problems in children

  • Heart murmurs (abnormal heartbeats), depending on the location and nature of the disorder.
  • Symptoms of cardiac arrest, increased breathing rate, shortness of breath, tachycardia
  • “Blue baby” syndrome, in which the skin changes color from lack of oxygen to blue or purple.
  • Clubfoot or spread with a nail that extends the fingers and toes
  • An abnormal increase in red blood cell circulation.
  • Liver dilation
  • Pulse that is hard to hear or has no pulse
  • Cold hands and feet
  • Signs of organ failure, including low urine output or kidney failure
  • The expansion of the heart’s chambers results in the need to work harder to overcome the defect.

Diagnosis of heart problems in children

To diagnose a congenital heart defect or any heart problems in children, your doctor may recommend that you or your baby have some of the following tests and procedures:

  • Echocardiography: Track your / your child’s progress over time to diagnose or not diagnose heart failure. Fetal echocardiography can sometimes diagnose congenital heart defects before the baby is born.
  • Electrocardiogram (EKG or ECG): To evaluate the rhythm of the heartbeat.
  • Cardiac catheterization: Measure the pressure and oxygen levels within the chambers of the heart and blood vessels. This helps to know if blood is flowing from the left side of the heart to the right side of the heart instead of going to the rest of the body.
  • Chest X-ray: To show if the heart is dilated. It also shows whether there is excess blood flow or excess fluid in the lungs, which is a sign of heart failure.
  • Genetic testing: To find out if specific genes or genetic syndromes like Down syndrome are causing congenital heart defects. Your doctor can refer you or your child to a genetic testing specialist.
  • Cardiac MRI: Track your / your child’s progress over time to diagnose heart failure or not.
  • Pulse oximetry: Estimate the amount of oxygen in the blood. The small sensor is placed on the hand or foot of the baby or on the finger or toe of the elderly person.

Treatment for heart problems in children

Treatment for heart problems in children depends on the part of the heart affected. Some children do not need treatment if the effect on blood flow is minimal. Others require medication or intervention, such as cardiac catheterization or surgery. Some heart problems in children may not be treated right away, but wait until the child is an adult. Some heart problems in children are dealt with in stages. In such cases, there are options:

● Medications: Many medications help the heart work more efficiently. Some are also useful for preventing blood clots and controlling irregular heartbeats.

● Implantable heart devices: Some devices, such as pacemakers, can help control abnormal heart rates and implantable cardiovascular defibrillators (ICDs), which can correct irregular heart rates and prevent some of the problems associated with congenital heart defects.

● Catheter procedures: These allow doctors to surgically correct or repair congenital heart defects without opening the chest or heart. Here, the doctor inserts a catheter through a vein in the leg to guide the heart. Using small tools threaded through the catheter, he/she proceeds to correct the error. With the advancement of technology, many heart defects can be closed at the cathode in cathode procedures. This reduces the risks and complications of heart surgery.

● Open-heart surgery: These may be necessary if catheter procedures do not correct the error. These can close the openings of the heart, dilate the blood vessels, or repair the heart valves.

● Heart transplant: In cases where the congenital heart defect is too difficult to repair, a heart transplant may be used. In the process, the healthy donor heart replaces the patient’s heart.

Complications of heart problems in children

Congenital heart disease or heart problems in children can cause complications including:

  • Arrhythmia: The heart may beat very fast, very slow, or abnormally due to a defect or scarring after surgery.
  • Congestive heart failure: When the heart cannot efficiently pump oxygen-rich blood to the rest of the body, symptoms affect various body systems.
  • Heart infections (endocarditis): This infection of the thin layer that lines the inside of the heart occurs when bacteria or other germs enter the bloodstream from another part of the body and remain in the heart. If left untreated, it can damage your heart valves or lead to a stroke.
  • Pulmonary hypertension: This type of high blood pressure only affects the arteries in the lungs. Some heart defects cause more blood to flow to the lungs. As pressure increases, the heart has to work harder, causing the muscles to weaken and sometimes fail. Permanent damage to the pulmonary artery can also occur.
  • Slower growth and development: Children with severe congenital heart defects may be younger and learn to walk and talk later than other children.
  • Stroke: Although rare, blood clots can travel to the brain through a hole in the heart or occur during corrective surgery.
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Symptoms and Treatment for Brain Stem Stroke | Cardiology

What is a brain stem stroke? 

The brain stem stroke regulates breathing, eye movement, facial movement, heart rate, and blood pressure. Sitting just above the spinal cord, the brain stem controls your breathing, heartbeat, and blood pressure. It also controls your speech, swallowing, hearing, and eye movements. Impulses sent by other parts of the brain travel through the brain stem on their way to various body parts.

We’re dependent on brain stem function for survival. A brain stem stroke threatens vital bodily functions, making it a life-threatening condition. When the blood supply to a part of the brain is cut off, a stroke occurs because the blocked artery or blood vessels are leaking. The brainstem is located at the base of the brain and is responsible for receiving and transmitting information throughout the body.

The brain stem regulates essential bodily functions, namely:

  • Breathing
  • Swallow
  • Eye movement
  • Facial movement and sensation
  • Listening
  • Heart rate
  • Blood pressure
  • Brain stem strokes affect a person’s basic bodily functions and can lead to chronic problems.

Symptoms of brain stem stroke

Dizziness and loss of balance are common symptoms of a stroke. Because the brain stem regulates different types of motor functions, strokes in this area of the brain can cause a wide variety of symptoms. Brainstem strokes affect important bodily functions, including:

  • Breathing
  • Swallow
  • Heart rate

The brain stem receives different signals from the brain and sends them to different parts of the body. Brainstem strokes interrupt these signals, so people may experience physical symptoms, such as numbness or weakness in the face, arms, or legs.

Other common symptoms of a stroke:

  • Dizziness
  • Loss of balance
  • Vertigo
  • Blurred or double vision
  • Trouble speaking or swallowing
  • Headache
  • Confusion

Stroke syndromes of the brain system

Some stroke syndromes of the brain system have an unrelated set of symptoms because their control is in small concentrated areas of the brain system that share the same blood supply.

Ondine’s curse: Ondine’s curse due to a lower spinal injury affects voluntary breathing.

Weber syndrome: Weber syndrome is a stroke of the midbrain that causes weakness in the front of the body, which is accompanied by weakness of the eyelids and weakness of eye movements.

Blockage syndrome: Blockage syndrome affects strokes and leads to complete paralysis and inability to speak, the ability to move consciousness, and intact eyes. This may be due to a very abnormal salt and fluid balance.

Wallenberg syndrome: Also known as a lateral spinal syndrome, Wallenberg syndrome causes sensory deficits of the face on the same side as stroke and sensory deficits of the body.

Types of brain stem stroke 

There are two main types of strokes, both of which affect the brain stem:

Ischemic stroke:

  • Ischemic strokes occur when blood clots form in narrow arteries in the head or neck and cut off the blood supply to an area of the brain.
  • Ischemic strokes are the most common type, accounting for 87% of all strokes. About 10% of all ischemic strokes affect the brain stem.
  • A transient ischemic attack (TIA), also known as a mini-stroke or warning stroke, when the blood supply to the brain is briefly interrupted. TIAs cause milder symptoms than full ischemic strokes, and most symptoms clear up within an hour.

Brain-vascular hemorrhagic accident:

  • Brain bleeding or hemorrhage occurs when weak blood vessels leak or open, creating swelling and pressure. This stress damages the tissues and cells of the brain.
  • Hemorrhagic strokes are less common than other types of strokes but account for 40 percent of all stroke deaths.

Risk factors of brain stem stroke

High blood pressure increases the risk of stroke. Anyone can have a stroke, but specific genetic factors such as family history, gender, race, and age put some people at higher risk for stroke than others. Women have more strokes than men and are more likely to die from a stroke than men.

Some risk factors specific to women:

  • Use of hormone replacement therapies
  • Long-term use of birth control pills in combination with other risk factors such as smoking
  • The pregnancy
  • People of African American and Hispanic descent are also at risk for stroke.
  • Most strokes occur in people over the age of 65. However, research suggests that the rate of stroke hospitalizations and the presence of risk factors for stroke in young children has increased significantly.

Medical conditions that increase the risk of stroke:

  • Hypertension
  • High cholesterol
  • Atrial fibrillation (AFib)
  • Diabetes
  • is blackberry
  • Heart disease (CVD)
  • Lifestyle risk factors

People cannot control genetic factors, but they can control lifestyle factors that increase the risk of stroke. Behaviors that increase the risk of high blood pressure or clotting increase the risk of stroke.

Behaviors that increase the risk of stroke:

  • Smoke tobacco
  • Excessive drinking
  • Consumption of illicit drugs
  • Sedentary lifestyle
  • Lack of food 

Diagnosis of brain stem stroke

Brain stem stroke is a fatal medical emergency. If you have symptoms that indicate a stroke, your doctor may order imaging tests such as an MRI, CT scan, Doppler ultrasound, or angiogram. The cardiac function test may include an EKG and an echocardiogram. Additional diagnostic procedures may include blood tests, as well as kidney and liver function tests. 

Treatment for brain stem strokes

When an ischemic stroke occurs, the first line of treatment is clotting or drawing the blood. If a stroke is diagnosed quickly, blood thinners can be given. If possible, a catheter can be used to clot during a procedure called an embolectomy. In some cases, angioplasty and stenting are used to widen and keep the artery open. Bleeding For a stroke, the bleeding must stop.

Sometimes a clip or coil is placed over the aneurysm to stop the bleeding. Medications to reduce clotting may also be needed. During this time, your medical team will need to take extra steps to keep your heart and lungs working. Brain stem stroke is a medical emergency. You need immediate treatment to save lives and reduce the risk of permanent complications.

Treatment depends on the type, location, and severity of the stroke:

Ischemic stroke: In the treatment of ischemic stroke, blood flow is restored through clotting. The methods include the following:

  • Anticoagulant drugs, such as tissue plasminogen activator (T-PA), help dissolve clots and restore blood flow to the affected area.
  • Antiplatelet drugs such as warfarin. The doctor may prescribe aspirin if a person has a lower risk of having a heart attack or stroke and bleeding. Current guidelines do not recommend the use of aspirin as in the past.
  • Endovascular therapy, which is a surgical procedure that involves the use of mechanical reclaimers to clot the blood.
  • Other devices, such as balloons or stents, can be used to open narrow blood vessels and improve blood flow.

Brain-vascular hemorrhagic accident: Treatment of hemorrhagic strokes focuses on controlling bleeding and reducing stress on the brain. Treatment methods:

  • Give medicine to control blood pressure and prevent seizures.
  • Spiral embolization, which is a surgical procedure that helps blood to clot in a weakened vessel. Clotting reduces bleeding and prevents blood vessels from reopening.
  • Once bleeding in the brain has been controlled, doctors can perform surgical procedures to prevent the ruptured blood vessel from bleeding again.

Prevention of brain stem strokes

It is estimated that 80 percent of strokes are preventable. People can reduce their risk of stroke by making the following lifestyle changes:

  • It controls the levels of lipids and cholesterol
  • Control blood pressure with medications and behavior changes
  • Manage medical conditions like diabetes
  • Give up smoking
  • Eat a diet low in fat and sodium
  • Make sure you have plenty of fresh fruits and vegetables in your diet
  • At least 150 minutes of moderate-intensity aerobic exercise per week or at least 75 minutes of vigorous aerobic exercise per week
  • Restoration and perspective
  • Brain stem stroke can lead to serious chronic problems. Medications and behavior changes can help reduce the risk of future strokes.
  • Physical therapy improves muscle strength and coordination and ultimately helps people regain lost motor skills.
  • Speech and language and occupational therapy can help people improve their cognitive skills, such as memory, problem-solving, and judgment.
  • Some people with stroke and severe disabilities need counseling to adjust.
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Congenital Heart Defects in Children – an Overview | Cardiology

What are congenital heart defects in children?

Congenital heart defects in children (CHDs) are the most well-known sort of birth deformity. With advances in medical care and treatment, children with CHD live longer and healthier lives. Find out more facts about coronary heart disease below.

What are congenital heart defects (CHDs)?

Coronary artery disease is present at birth and can affect the structure and functioning of a baby’s heart. It can affect how blood flows through the heart and out to the rest of the body. Coronary artery disease can vary from mild (such as a small hole in the heart) to severe (such as missing or poorly formed parts of the heart).

About 1 in 4 babies born with a heart defect suffer from critical coronary heart disease (also known as a serious congenital heart defect). Babies with critical coronary heart disease need surgery or other procedures in the first year of life.

Types of congenital heart defects in children

Babies and children with all types of congenital heart defects receive expert diagnosis and treatment from specialists at the Pediatric Congenital Heart Program. Congenital heart defects in children occur at birth and affect the heart or blood vessels. Hundreds of heart defects can arise as a baby develops in the womb, and some infants may have more than one. Some defects cause no health challenges for years; in fact, some may never pose a health risk.

However, many infants require treatment with surgery or catheter procedures to repair congenital heart defects in children immediately or in the first few months of life. Others may need medication as a bridge to surgery or other procedures, or as the only therapy to manage symptoms.

Our experts treat babies and children with all types of congenital heart defects in children, including:

  • Aortic valve stenosis
  • Atrial septal defect
  • Ebstein’s anomaly
  • Hypoplastic left heart syndrome
  • Interrupted aortic arch
  • Coarctation of the aorta
  • Complete atrioventricular canal defect
  • Patent ductus arteriosus
  • Total anomalous pulmonary venous return
  • Transposition of the great arteries
  • Tricuspid atresia
  • Pulmonary valve stenosis
  • Tetralogy of Fallot
  • Truncus arteriosus
  • Ventricular septal defect

Symptoms of congenital heart defects in children

Serious congenital heart defects in children usually appear soon after birth or within the first few months of life. They can include signs and symptoms:

  • Pale gray or blue skin color (cyanosis)
  • Rapid breathing
  • Swelling in the legs, abdomen, or areas around the eyes
  • Shortness of breath during feeding, resulting in poor weight

Less serious congenital heart defects in children may not be diagnosed until later in childhood, because your child may not show any noticeable signs of a problem. If signs and symptoms occur in older children, they may include:

  • Feeling short of breath easily during exercise or activity
  • Fatigue easily during exercise or activity
  • Fainting during exercise or activity
  • Swelling in the hands, ankles, or feet

Causes of congenital heart defects in children

Doctors don’t always know why a child has a congenital heart defect. It tends to run in families. Things that make congenital heart defects in children more likely include:

  • Genetic or chromosomal problems in a child, such as Down syndrome
  • Taking certain medications or alcohol or drug abuse during pregnancy
  • A viral infection, such as rubella (rubella) in the mother in the first trimester of pregnancy

How are heart defects treated?

Youngsters with minor heart deformities may not require any treatment. However, some children suffer from severe symptoms that require medical or surgical treatment during the first year of life. They will be taken care of:

  • Pediatric cardiologists: Doctors who specialize in treating children’s heart problems
    or
  • Pediatric heart surgeons: Specialists in pediatric heart surgery

Procedures performed through cardiac catheterization – such as balloon angioplasty or valvuloplasty – can dilate blood vessels or a blocked valve. Another procedure, blockage of the catheter device, can close abnormal openings or holes in the heart or blood vessels without surgery.

Some problems, such as small or medium-sized ventricular septal defects, may close or get smaller as the child grows. While waiting for the hole to close, the child may have to take medications. Complex Congenital heart defects in children detected early may need a series of processes ending when the child is approximately 3 years old.

Testing and diagnosis of congenital heart disease

Several serious congenital heart diseases are detected during pregnancy, during a routine ultrasound examination. Other conditions may be diagnosed soon after birth. Less serious heart conditions may not be diagnosed until children get older and begin to show certain signs or symptoms of congenital heart disease.

During pregnancy, if your doctor thinks your baby may have CHD, you will likely be referred to a pediatric cardiologist for further testing. The type of diagnostic tests performed will depend on the form of coronary heart disease your child may have. Examples of tests used include a fetal echocardiogram, electrocardiogram (EKG), magnetic resonance imaging of the heart (MRI), and cardiac catheterization. If you are referred to the Children’s Hospital of Philadelphia, you will be seen through the Heart Center’s Fetal Heart Program.

Risk factors for congenital heart defects in children

Most Congenital heart defects in children are caused by problems early in the development of your baby’s heart, and the cause is unknown. However, some environmental and genetic risk factors may play a role. They include:

  • Rubella (German measles): German measles infection during pregnancy can cause problems with the development of your baby’s heart. Your doctor can test for immunity to this viral disease before pregnancy and vaccinate you against it if you are not immune.
  • You can reduce the risk of Congenital heart defects in children by carefully controlling diabetes before trying to conceive and during pregnancy. Gestational diabetes generally does not increase your baby’s risk of developing a heart defect.
  • Some medications taken during pregnancy may cause birth defects, including congenital heart defects. Provide your doctor with a complete list of all medications you take before trying to conceive.
  • Medicines known to increase the risk of congenital heart defects include thalidomide (Thalomide), angiotensin-converting enzyme (ACE) inhibitors (ACE), statins, acne medication isotretinoin (Absorica, Amnstim, and Claravis), and lithium.
  • Drinking alcohol during pregnancy: Avoid drinking alcohol during pregnancy because it increases the risk of Congenital heart defects in children.
  • Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby.
  • Congenital heart defects in children sometimes run in families and may be associated with an inherited syndrome. Many children with Down syndrome – which is caused by an extra chromosome 21 (trisomy 21) – have heart defects. A missing (deleted) piece of genetic material on chromosome 22 also causes heart defects.
  • Genetic testing can detect such disturbances during fetal development. If you already have a baby with a congenital heart defect, a genetic counselor can estimate the odds that your next child will have it.

Complications of congenital heart defects in children

Complications depend on the type of congenital heart defect you have. Include some potential complications:

  • Arrhythmia
  • Blood clots
  • Developmental disorders and delays: Children with congenital heart defects are more likely to have behavior problems. They are also more likely to have speech and attention-deficit / hyperactivity disorder.
  • Emotional health issues: Depression, anxiety, and PTSD are common among people with congenital heart defects.
  • Endocarditis: A type of heart inflammation
  • Endocrine disorders: Include thyroid problems, bone health problems, and diabetes. Problems with the hormones that deal with calcium can cause bone problems.
  • Heart failure: Heart failure is the leading cause of death in adults with congenital heart defects. Some children with congenital heart defects develop heart failure.
  • Kidney disease
  • Liver disease
  • Pneumonia: Pneumonia is a leading cause of death in adults with congenital heart disease.
  • Pregnancy complications: Women with congenital heart defects are at increased risk of developing complications during pregnancy and childbirth. Read more in the Living With section.
  • Pulmonary hypertension
  • Stroke

Outlook and follow-up care for congenital heart disease

Children with congenital heart disease are monitored by specialists called pediatric cardiologists. These doctors diagnose heart disease and help manage children’s health before and after surgical repair of a heart problem. The specialists who correct heart problems in the operating room are known as pediatric cardiovascular surgeons or cardiothoracic surgeons.

It is imperative that individuals born with congenital heart disease who have reached adulthood transition to the appropriate type of heart care. The type of care required depends on the type of CHD the person has. Generally, people with mild types of Congenital heart defects in children can be cared for by a community adult cardiologist. People with more complex types of coronary heart disease will need care at a center that specializes in adult congenital heart disease, such as the Philadelphia Adult Congenital Heart Center.

How can congenital heart disease be prevented?

Women who are pregnant or planning to become pregnant can take certain precautions to reduce the risk of having a baby with a congenital heart defect:

  • If you are planning to become pregnant, talk to your doctor about any prescription or over-the-counter medicines you are taking.
  • If you have diabetes, make sure your blood sugar levels are controlled before pregnancy. It is also important to work with your doctor to manage illness during pregnancy.
  • If you have not been vaccinated against rubella or rubella, avoid exposure to the disease and talk to your doctor about prevention options.
  • If you have a family history of congenital heart defects, ask your doctor about genetic testing. Certain genes may contribute to abnormal heart development.
  • Avoid drinking alcohol and using drugs during pregnancy.
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Specialists

Why You Need a Cardio Oncologists? | Cardiology

Who are cardio oncologists?

Cardio oncologists is a new medical speciality that focuses on the optimal treatment of any cardiac conditions associated with patients who have been treated for cancer or are currently being treated for cancer. Cardio oncologists can evaluate patients for potential risks of developing certain heart diseases, especially if they are receiving certain types of cancer drugs or after radiation therapy to the chest.

A group of specialist cardiologists and cardio oncologists have special expertise in preventing and treating adverse effects of the heart from cancer and cancer treatment and can provide consultations on diagnostic testing, medical management, interventional and surgical procedures.

The University of Washington Cardiology and Oncology Center works closely with the Cancer Center to facilitate cancer treatment and reduce any potential cardiac toxicity associated with the ultimate goal of improving the survival and quality of life of our cancer patients.

What does cardio oncologists do?

Our Cardiology Oncology Program is led by trained cardio oncologists to evaluate and treat people who have heart disease or who may develop heart disease before, during, and after cancer treatment. Some malignant growth therapies, including radiation treatment and chemotherapy, can intensify or even reason heart issues.

Our cardio oncologists aim to:

  • Advice and guidance for people with existing heart conditions or at risk of developing heart disease before starting cancer treatment
  • Monitor people before and during cancer treatment to identify early any heart complications and any heart-toxic side effects from cancer treatments.
  • Preventing or reducing further heart damage – and reversing its course if possible
  • Screening for any heart complications after cancer treatment is complete
  • Offer lifestyle changes to help reduce heart disease risk and maintain health
  • Elimination of heart disease as a barrier to effective cancer treatment
  • A better understanding of heart problems in cancer patients through participation in research studies

Our cardio oncologists work alongside oncologists to discuss patients’ heart functions and create a specialized treatment plan to prevent and reduce heart risks without interfering with cancer treatment.

Diagnostic cardiac tests recommended by cardio oncologists

In order to monitor your heart and determine the need for cardiac tumor treatment, there are several tests that may be evaluated while receiving cancer treatment. An echocardiogram is an ultrasound imaging of the heart. Measurements are made on images, and with each heartbeat, an estimated volume of blood pumped out of the heart can be calculated.

This estimated percentage is called the left ventricular ejection fraction (LVEF). It is known that several anti-cancer drugs can reduce LVEF. Your cardio oncologists may perform an echocardiogram at the start of treatment and periodically during and after treatment.

If there is a 10% decrease in percentage volume, you will likely be referred to a cardiac tumor care provider to determine if any medications could be helpful to protect your heart. Other tests, including simple or imaging blood tests, may also be performed during routine laboratory work and testing. Common laboratory tests recommended by cardio oncologists and imaging of the heart:

  • BNP, NT-proBNP
  • Cardiac MRI
  • Lipid Profile
  • Electrocardiography (EKG)
  • Troponin I or T
  • Echocardiography (Echo)

The cardio oncologists will monitor the results of these lab and imaging tests. If any results show a change in heart function, you may need to start taking the routine medications used to protect the heart. Often, once the cancer treatment is finished, the heart’s function may improve.

Therefore, the cardio oncologists will monitor your test results even after you have been treated, and ultimately, it may be possible to reduce or stop the dose of heart medications altogether. There are new techniques being developed in cardiac imaging, called stress imaging, that may be useful in the future. Heart preventive medications used to treat cancer

  • Some beta-blockers, such as carvedilol, can improve heart rate control and reduce the resistance the heart has to overcome, thus helping to maintain heart muscle function. These are usually used in the general population for high blood pressure or congestive heart failure. There have been recent research studies showing that this drug may prevent the irreversible cardiac dysfunction associated with some anti-cancer drugs. Examples of these medications include carvedilol (Coreg) or nebivolol (Bystolic).
  • ACE inhibitors are another class of drugs that have been shown to protect the heart during treatment with anti-cancer drugs. Examples include lisinopril or enalapril.
  • Spironolactone may be used if LVEF (the left ventricular ejection fraction) decreases from the heart and begins to increase swelling in your legs or abdomen and increase shortness of breath.

About risk factors and cardiotoxicity explained by Cardio oncologist

Cancer survival has improved dramatically over the past 30 years with the introduction of new and effective cancer treatments. As a result, there is a significant increase in the number of cancer survivors. An increasing range of complex new treatments is allowing better comprehensive outcomes for patients being treated for cancer.

However, these treatments have toxicity, especially on the cardiovascular system. The good news is that providers are becoming increasingly aware of potential cardiac toxicities from various cancer treatments including arrhythmias, valvular heart disease, coronary artery disease, high blood pressure, and heart failure.

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Tests

How is a Spirometry Test Performed | Cardiology

What is spirometry?

Spirometry (Spy-Ram-Uh-Tree) is a simple office test used to assess how well your lungs are working by measuring how much air you breathe, how much you breathe, and how fast you breathe. Spirometry is used to diagnose asthma, chronic obstructive pulmonary disease (COPD), and other conditions that affect breathing.

Preparation for a spirometry test?

You should not smoke for an hour before the spirometry test. You should avoid alcohol even that day. Eating too much of a meal can also affect your breathing ability.

Don’t wear tight clothing that restricts your breathing. Your doctor may have instructions on whether to use inhalers or other options before the test.

Procedure of spirometry

You sit in a chair and place the clip over your nose to close your nostrils. Then take a deep breath and inhale into a tube as fast and hard as you can. You need to wrap your lips tightly around the tube to get all the air in. Generally, the test is administered three times each time so that the results are the same.

The tube is connected to a machine called a spirometer. It records how much air your lungs breathe and how fast you breathe. All of this information can help your doctor determine what is causing your breathing problems.

Duration of the test: The spirometry test usually takes 45 minutes. Depending on the waiting time, it may be longer. Ask your doctor if the test will take longer so that you don’t rush or delay other appointments.

Interpreting Results

As soon as your test results are available, your doctor can review them with you at your appointment. Spirometry provides two important measures of lung function:

Forced Key Capacity (FVC): A measure of the amount of air that can be expelled from the lungs with a full breath

Forced expiratory volume (FEV1): The amount of air you exhale from your lungs per second

Risk factors of spirometry

  • Spirometry is a painless test. Most people have no problem with this. Depending on your health, deep breathing can make you feel a little tired or light.
  • If you have heart disease or recent surgery, see your doctor to make sure spirometry is not a problem for you.

 

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Tests

About Cardiac Computerized Tomography (CT) Scan | Cardiology

What is a cardiac CT scan?

A cardiac CT scan of the heart is an imaging method that uses X-rays to create detailed images of the heart and its blood vessels.

However, unlike a traditional angiogram, which is an advanced X-ray of the arteries, the color is inserted into a small vein in the hand rather than the artery in the groin. You may also be given certain medications to slow your heart rate, which will make taking pictures easier.

  • This test is called a coronary calcium scan to see if there is calcium in your arteries.
  • This is called a CT angiogram if it looks at the arteries that carry blood to the heart. This test assesses whether these arteries are narrowed or blocked.
  • Tests sometimes look for problems with these structures along with scans of the aorta or pulmonary arteries.

When a cardiac CT scan is necessary?

A cardiac CT scan may be helpful if your cardiologist thinks you may not have coronary artery disease, but cannot explain what is causing your symptoms. Therefore, it is often used to rule out coronary heart disease rather than check for it. It is also helpful if you have a heart attack but your doctor doesn’t know why.

If your doctor thinks you have coronary artery disease, they are more likely to do a traditional angiogram.

Another reason you may need a coronary CT angiogram is if your doctor suspects that you have an abnormality in the structure of your heart.

Purpose of cardiac CT scan

A cardiac CT scan is a non-invasive procedure that is ideal for monitoring a patient with low-risk heart problems or symptoms of coronary artery disease. Doctors also use a cardiac CT scan to check for blockages and damage to the coronary arteries.

Doctors may request that patients undergo a cardiac CT scan before or after other coronary procedures.

Risk factors

A cardiac CT scan is a relatively low-risk procedure because it is non-invasive, rather than injected through the manual cannula.

During a cardiac CT scan, patients are exposed to more radiation than a normal X-ray because multiple images of the heart are taken, although the dose is usually lower than that of a standard coronary angiogram. Even if low doses of radiation are used, any radiation may slightly increase the risk of cancer in the future. The risk is slightly higher in younger patients.

Some people are allergic to the opposite and it is much higher if you have multiple other serious allergies. Allergic reactions to X-ray dye are usually mild and can be treated with medications.

There is a very small risk that patients will experience a severe reaction to the contrast medium and will experience:

  • Low blood pressure
  • Anaphylactic shock
  • Cardiac arrest

How cardiac CT scan is performed?

The cardiac CT scan is performed in the radiology department of the hospital or in a clinic that specializes in diagnostic procedures.

You will be given a beta-blocker before the scan. These drugs slow down your heart so that clearer pictures can be taken. Small, sticky discs called electrodes are placed on your chest to record the scan. The radiology technologist inserted an intravenous (IV) line into a vein so they could inject radioactive dye into your hand. You may feel a short or hot boil or a temporary metallic taste in your mouth when you inject the dye.

Before your cardiac CT scan, it is important to follow these instructions:

  • Fast for at least 4 hours
  • Sips of water may be taken
  • No smoking for at least 2 hours
  • No vigorous exercise for at least 4 hours
  • Avoid tea and coffee for at least 12 hours

Day of your cardiac CT scan,

  • Six hours before the test: do not eat anything that contains caffeine.
  • You can have breakfast and/or lunch. Drink water before your appointment.
  • Do not take metformin if you are taking it.
  • Take your other common medications unless prescribed by your doctor. Bring all your medications in the original bottles.

Before scanning, your heart must beat at a certain rate to ensure a correct diagnostic result. You may need to be given medication at your appointment if your heart rate is not at the required level. It comes in a tablet form called a beta-blocker. The radiographer performs pre-scan examinations, which determine it.

After cardiac CT scan

  • The ECG monitor and cannula are removed and you are asked to change your clothes again
  • If you have a beta-blocker, you will be asked to stay in the section for about 20 minutes for observation
  • You can go back to eating/drinking normally
  • You are advised to drink plenty of water within 48 hours after the scan to remove the color injection from your body

Details

The cardiac CT scanner has a large opening that passes through a flat platform or table. Some call this opening the “donut hole.” The patient was lying on the table while scanning. When the machine is turned on, a donut-shaped X-ray tube from the machine rotates rapidly and the patient moves through it. X-rays pass through the patient at different angles and hit special detectors. Images taken during the scan produce cross-sectional or three-dimensional views of the heart and blood vessels in less time.

Specialists who handle cardiac CT scan

  • Department of Cardiology and Cardio surgeons
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Tests

4 Types and Procedures of Stress Test | Cardiology

What Is a stress test?

Doctors use a stress test, also known as an exercise test or a treadmill test, to see how well a patient’s heart works during physical activity.

A stress test can also help a doctor advise patients on the best type of physical activity for them. A stress test usually involves walking on a treadmill or riding a stationary bike while monitoring the patient’s breathing, blood pressure, and heartbeat.

Some patients, such as those with arthritis, will not be able to do the activities involved in a stress test during exercise. Instead of exercising, the patient can take medication to make the heart work harder, as might happen during exercise.

Types of stress tests

We recommend different types of stress tests based on your general health and symptoms. Our doctors and imaging specialists are experienced in performing stress tests and interpreting the results.

1. Cardiopulmonary exercise test (CPET):

This comprehensive test assesses how well your heart and lungs are working together to deliver oxygen-rich blood to your body. It also shows how well your muscles are using oxygen while you exercise at increased levels. CPET can evaluate:

  • Reasons for shortness of breath
  • Fitness level and ability to exercise, especially after a heart attack or heart surgery
  • Lung function

The CPET test is similar to the exercise stress test but it also measures lung function, including:

  • The amount of oxygen your body uses during exercise
  • Your breathing pattern
  • The amount of carbon dioxide you produce

We use this test not only to identify many types of heart and lung disease but also to:

  • Monitor people who already have these conditions and check for disease progression
  • Measure how well treatments are working
  • Determine if the exercise restrictions are due to a heart or lung problem

2. Exercise stress test

This test uses an EKG during exercise to assess blood flow to your heart. We do a stress test while exercising on the treadmill or stationary bike at a gradually increasing rate. We use this test to raise your heart rate so we can detect heart problems affecting blood flow.

The exercise stress test only measures the electrical activity of your heart, not the lung function like CPET. We use this test to:

  • Determining safe levels of exercise after a heart attack or heart surgery
  • Diagnosing and determining the severity of coronary heart disease and other types of heart disease
  • Diagnose an arrhythmia
  • Find out what causes symptoms that only appear during exercises, such as shortness of breath, fainting or an irregular heartbeat
  • Treatment planning guidance, such as medications, cardiac catheterization (minimally invasive heart procedures), surgery or implantation

3. Pharmacologic stress test

This stress test assesses the blood flow to your heart using an EKG but does not involve any physical activity. We recommend a drug stress test for people who are unable to exercise due to physical limitations such as arthritis, joint or back conditions, injury or disability. For this test, you receive medication to stimulate your heart and make it beat harder and faster as if you were exercising.

Use the drug stress test to:

  • Determine safe levels of physical activity if you have a heart attack or heart surgery
  • Diagnosing many types of heart disease and determining their severity
  • Guiding decisions about treatment options, such as medication, cardiac catheterization (minimally invasive heart procedures), surgery or implantation
  • Evaluate how well your treatment increases blood flow to the heart

4. Nuclear stress test

This type of stress test includes a radioactive dye and imaging studies to show blood flow to the heart, both at rest and when the heart rate is elevated. As with other types of stress tests, we record the electrical activity of your heart with an EKG.

During a nuclear stress test, you receive an injection of a radioactive dye through an intravenous (IV) line. The dye travels through the bloodstream and your heart. While you’re still at rest, we scan your heart with a special camera that captures the radioactive dye to show blood flowing into and through your heart.

In the second part of the test, you start exercising on a treadmill or stationary bike. If you are unable to exercise, we can give you medicine to increase your heart rate. Then we check more images of your heart to capture blood flow to the heart during increased activity.

Nuclear stress tests show which parts of the heart are receiving enough blood and which ones are not. The tests provide details that can indicate heart disease and severity and show tissue damage from a previous heart attack.

Why stress test is done?

Your doctor may recommend a stress test to:

  • Diagnose coronary artery disease: Coronary arteries are the main blood vessels that supply your heart with blood, oxygen, and nutrients. Coronary artery disease develops when these arteries are damaged or sick – usually due to a buildup of plaques containing cholesterol and other substances (plaques).
  • Diagnose heart rhythm problems (arrhythmias): Arrhythmias occur when the electrical impulses that coordinate your heart’s rhythm do not work properly, causing your heart to beat too fast, too slowly or irregularly.
  • Guide treatment of heart disorders: If you’ve already been diagnosed with heart disease, an exercise stress test can help your doctor know how well treatment is working. It can also be used to help create a treatment plan for you by showing how much exercise your heart can handle.
  • Your doctor may use a stress test to help determine the timing of heart surgery, such as valve replacement. In some people with heart failure, results of a stress test may help a doctor determine whether you need a heart transplant or other advanced treatments.

Your doctor may recommend an imaging test, such as a nuclear stress test or an echocardiogram stress test if an exercise stress test doesn’t determine the cause of your symptoms.

By what means should I prepare for the exercise stress test?

  • Do not eat or drink anything except water for the 4 hours before the test.
  • Do not drink or eat anything containing caffeine for the 12 hours before the test.
  • Do not take the following heart medications on the day of the test, unless your doctor tells you otherwise or if medication is needed to treat chest discomfort on the day of the test:
    • Isosorbide dinitrate(for example, Isordil, Dilatrate SR)
    • Isosorbide mononitrate(for example, ISMO, Imdur, Monoket)
    • Nitroglycerin(for example, Deponit, Nitrostat, Nitro-Bid)
  • If you are using a breathing inhaler, bring it to the test.

You may also be asked to stop taking other heart medications on the day of the test. If you have questions about your medications, ask your doctor. Do not stop taking any medication without first consulting with it.

During the stress test

You will slowly start exercising on a treadmill or stationary bike, then gradually increase the speed of the treadmill or resistance bike until your heart works at the target heart rate for your age. Most often, the stress test includes an electrocardiogram to measure the electrical activity of your heart while you exercise on a treadmill or on a stationary bike. Your doctor may also measure the blood oxygen level, blood pressure, heart rate.

During the test, you’ll exercise for 10 to 15 minutes. And we have better stress test equipment. Your primary care physician will stop the test on the off chance that you give any indication of a heart issue, in the event that you are too worn out to even consider continuing the test.

If you are not able to exercise, your doctor will give you the medication for over 10 to 20 minutes through an intravenous (IV) line into a blood vessel.

Your doctor may also take pictures of your heart during or immediately after a stress test to see how well blood flows through your heart and how well your heart pumps blood when it beats. These images can be taken by echocardiogram or by injecting a radioactive dye into a vein, which is called a nuclear heart scan. The amount of radiation in the dye is safe for you and those around you. However, if you are pregnant, this test should not be performed due to the risks it may pose to your unborn baby.

If your doctor also wants to know how well your lungs are working, you may be asked to wear a mask or mouthpiece to measure the gases you breathe in during the stress test.

Following up after an exercise stress test

After the test, you will be given water and asked to rest. If your blood pressure rises during the test, the nurse may continue to monitor your blood pressure.

A couple of days after the test, your primary care physician will survey the outcomes with you. The test can reveal an irregular heartbeat or other symptoms that indicate coronary artery disease, such as blocked arteries.

If your doctor determines that you may have coronary artery disease or other heart problems, he may begin treatment or order further tests, such as a nuclear stress test.

Risk factors

These tests are usually safe. Sometimes, exercise or medication that increases the heart rate can cause symptoms such as chest pain, dizziness, or nausea. You will be monitored closely throughout the test to reduce the risk of complications or to treat any health problems quickly.

The radioactive dye used for a nuclear stress test is safe for most people. In rare cases, it may cause an allergic reaction. Also, a nuclear stress test is not recommended for pregnant women, as the dye may be harmful to a fetus.

Results

If the information gathered during the exercise stress test shows that your heart function is normal, you may not need any other tests. However, if the results are normal and symptoms continue to worsen, your doctor may recommend nuclear or other stress tests that include an echocardiogram before and after exercise or taking medications to increase blood flow to your heart. These tests are more exact and give more data about your heart work, yet they are likewise more costly.

If the stress test results indicate the possibility of coronary artery disease or an irregular heartbeat, your doctor will use the information to create a treatment plan. You may require extra tests, for example, a coronary angiogram. If you have a stress test to help determine a treatment for heart disease, your doctor will use the results to plan or change your treatment.

Categories
Tests

Overview of Electrocardiogram (ECG) Test | 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 ECG 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 ECG 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 ECG 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.

Purpose of electrocardiogram

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

An EKG 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 is the electrocardiogram test 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 ECG.

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 ECG 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 (ECG)

The types of an electrocardiogram are:

  • Standard (resting) ECG: The ECG 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 ECG 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 ECG 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 ECG 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.

Risk factors for electrocardiogram (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.

Procedure for electrocardiogram (ECG)

It is not necessary to limit food or drink before performing the ECG test. Always tell your doctor what medications you are taking before receiving the electrocardiogram and if you have any allergies to the adhesive tapes used to attach the electrodes.

When an ECG test is to be performed, the upper garment will need to be removed so that the electrodes adhere to the chest and extremities. (For women, wearing a special blouse with pants or a skirt can easily penetrate the chest.) If necessary, the selected sites can be shaved.

Electrodes (sensors) are attached to the chest, arms, and legs with suction cups or sticky gel. These electrodes detect the currents generated by the heart; they are measured and recorded by an electrocardiograph.

There are three main types of the electrocardiogram:

  • Resting ECG: You lie down for this type of ECG. No movements are allowed during the test, as electrical impulses generated by other muscles can interfere with those generated by your heart. This type of ECG usually takes 5 to 10 minutes.
  • Ambulatory ECG: If you have an ambulatory ECG or Holter, you must wear a portable recording device for at least 24 hours. Usually, you can turn it on when the monitor is connected. These types of ECG symptoms may not appear intermittently (stop-start) and on the resting ECG and are used to ensure that your heart is working properly in people recovering from a heart attack. Record your symptoms in a journal and note when they occur so that your own experience can be compared to an ECG.
  • Cardiac stress test: This test is used to record your ECG when you are riding an exercise bike or running on a treadmill. This type of ECG takes 15 to 30 minutes to complete.

Results of electrocardiogram

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.

Specialists who handle electrocardiogram

  • 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.