What is important to understand? There are no methods of research or analysis that answer the question: "How do you do things at all, is it all right?"
Each method can answer a question addressed exactly by this method. The question should be asked by the doctor who raised the issue. If something worries you - talk to a doctor that do not assign yourself research yourself - sorry and time and money.
Often, the patient says, "Let's remove the cardiogram, something sometimes my heart is ticking." He thinks that if the cardiogram is okay, then there are no problems. False and sometimes dangerous idea! Even with severe angina, ECG, taken off of a painful attack, may be absolutely normal. A well-off patient is not examined further, he does not receive the necessary treatment.
And what better: ECG or ECHOCHARDIOGRAPHY (echocardiography)?
Frequently Asked Questions. And nothing "is not better"! These methods answer different questions and do not replace each other. For example, in case of violations of the heart rate, only the ECG will help the physician understand exactly which arrhythmia is. And the echocardiogram will only show the irregular heartbeat. And then not always.
In an attack-like (always) rhythm disturbance, the usual cardiogram may not give information, since it registers less than a minute. For such cases, the method of Holter monitoring was invented.
A small cardiograph (slightly more than a matchbox) connects to the patient for a day (sometimes for three days), and the patient lives his usual life: walking, running, running. The recording then looks automatically, and the doctor gets information about many important things that slip away from the attention of the usual cardiogram.
And echocardiography? An indispensable method for diagnosing heart disease, some not frequent, thank God, but for dangerous diseases from the group of cardiopathies, for assessing the condition of the heart muscle and the effectiveness of some drugs in the treatment of heart failure. But for the diagnosis of angina, echocardiography is not used, this method does not provide information about coronary blood flow. Therefore, the doctor's recommendation: "You have chest pain (or rhythm disturbance), let's do ECHO" is absolutely not substantiated.
And cardiogram alone, as mentioned above, will not give a clear diagnosis. For such cases, the so-called stress-ONLINE is used.
Both the cardiogram and the echocardiography can be done under load, on a bicycle or on a treadmill. Here, both methods give very important information: ECG demonstrates signs of ischemia, and echocardiography - a violation of local contractility of the heart. This is serious! Then we are waiting for coronary angiography.
But do not be afraid of it right away!
Because this study is done in many clinics, it usually takes no more than 30 minutes and is already "on the flow". How do they do it? Through the artery on the thigh or on hand to heart, promote a thin catheter. Then, in the cardiovascular system, the contrast is introduced - a solution that is visible on the x-ray. At this moment they shoot "X-ray film".
Immediately visible which heart vessels are and to what extent narrowed by atherosclerotic plaques, namely, these narrowing (stenosis) are the cause of angina or heart attack.
Why should you know this?
Indeed, a diagnosis of coronary heart disease (CHD), such as angina pectoris, has already been established by previous studies. To appoint a doctor can and without coronary angiography. Such an old treatment will probably improve your well-being and reduce chest pain. But the disease remains! Sooner or later there will be a deterioration or a complication.
If you want to become a HEALTHY person, you need to be treated for the modern one - they did stenting.
This is also quite an ordinary procedure, nothing special. Possibility of stenting is resolved during coronarography. Through the same catheter in a vessel of the heart, directly into the stenosis, a second catheter with a cartridge and stents at the end is carried out.
Stent - a metal net in a folded state. The cartridge is fueled by air and expands the lumen of the vessel to normal size, simultaneously spreading the stent. Then the cylinder is removed, the stent is already in the squeezed state remains, is fixed.
Everything: the vessel is expanded and strengthened, the blood flow in it is normal. And so, there are no symptoms of angina - the heart gets enough blood.
If several vessels are affected, put 2 or more stents as needed. In the whole world, millions of people have passed this procedure (we will not call it a surgery) and consider themselves healthy. In Moscow and in the cardiological centers of large cities of Ukraine, this procedure has been carried out for a long time and well-developed.
Unfortunately, not all patients with coronary artery disease and stenocardia can perform stenting. Sometimes (in about 20% of cases) during coronography, the doctor sees that the stenoses are so uncomfortable that stenting is technically unfeasible. Or narrowing in the vessels of the heart is so pronounced that even the catheter does not pass through them. In these cases, cardiologists recommend surgery to the patient - coronary artery bypass grafting.
This is a real heart surgery. The essence of her here is what: from the aorta to the heart vessel after the site of stenosis, a shunt is written down - a bypass path for blood.
A section of a vessel for a shunt is taken either from the vein of the leg or from the artery of the hand. Thus, blood enters the mainstream of the heart vessels bypassing the stenosis. And everything is in order, the person is practically healthy, he transfers physical activity as before, to the illness.
If necessary, put 5-6 shunts in different vessels. The operation is time-consuming, it may take 6-8 hours. However, they have been doing it for a long time, the technique has been established, and it has been successfully mastered in many Cardiac Surgical Centers of Ukraine. One and a half - two months after the operation - and you are practically healthy. Sutures, however, in bad weather, can be damned.
What conclusions can we draw from all this?
If you have chest pain, especially if they arise during exercise, when walking - contact a good cardiologist, do not pull. Attentive conversation with the doctor - 80% of the diagnosis. The doctor will direct you to the research you need.
If the diagnosis of CHD is confirmed, if your pain attacks are really related to angina - agree on coronary angiography.
But, let's repeat, making it makes sense only if you are set to follow up on health. Just so - there is no sense.
If according to the results of coronary angiography offer stenting or surgery - agree! The risks of complications of these operations are not comparable with the risks of the complications of the disease. Otherwise, who would do these operations! It's better to be healthy than sick!