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Most common heart-related conditions

- provided by America's leading cardiologists

Imaging

Achievements made by scientists in medicine are often most obvious in treatments and cures. But imaging and the tests performed to screen for and prevent disease are equally important. As cardiac imaging grows more detailed it becomes even more helpful in providing physicians the information needed to assess your condition. Staying aware of the latest developments will help you understand that techniques available to help keep your heart healthy.

 


What are the Various Diagnostic Imaging Tests?

Cardiovascular medicine has a variety of diagnostic imaging tests used by doctors to help identify and diagnose abnormalities in your heart.

Participants:
Richard P. Lewis, MD, MACC
Professor of Internal Medicine, Ohio State University, Columbus, Ohio
Jacqueline A. Noonan, MD, FACC
Pediatric cardiologist, University of Kentucky College of Medicine, Lexington, Kentucky

Webcast Transcript:

ANNOUNCER: For anyone with questions about the health of their heart, there are a variety of diagnostic tests available to physicians that can help provide some answers.

RICHARD P. LEWIS, MD: Cardiovascular medicine has more imaging tests than anybody else, by a long ways. Actually, the first diagnostic imaging test was a chest x-ray invented around the turn of the 20th century, so it's over 100 years old. It's still helpful.

JACQUELINE NOONAN, MD: You know, in the olden days, people used to use their stethoscope. And with the stethoscope, if you had trained well, you could diagnose rheumatic heart disease, what kind of valve was involved, by listening. And this could be helped by looking at an electrocardiogram, which would tell you which side of the heart was thicker than normal, whether the atrium was enlarged and use certainly the chest x-ray.

Then cardiac catheterization came into vogue where one could put a catheter into the heart and measure pressures, put dye in and show defects, show whether there was rheumatic heart disease, congenital heart disease or whether the heart, which is not functioning well. You could look at the coronary arteries with coronary angiography.

RICHARD P. LEWIS, MD: The rest of the cardiac testing has mostly been developed in the last 50 years, and they fall into two basic categories: invasive and non-invasive. And invasive means puncturing the surface of the body. Non-invasive means not having to do that.

The non-invasive tests consist of electrocardiogram and chest x-ray; echocardiography, which is a widely used test today; nuclear studies, where you inject a radioisotope into the blood, and then look at where it goes in the heart to see if there's areas that aren't getting enough blood, that's a perfusion scan. Or you can actually watch the heart contract with the isotope that's inside the heart's blood pool and watch the blood pool pass through the heart, and you can define how well the heart's working. That's a widely used test.

The echo is an extremely versatile test, because it'll show you all of the heart valves and how they work, the heart muscle, what kind of condition it's in, whether there's fluid in the sac around the heart, and a lot of other things that you could do. And echo's an easy test to do, and you can do it on really sick people in the intensive care unit, emergency rooms.

Now, the invasive studies, diagnostic studies, are mostly cardiac catheterization, which involves putting a catheter in blood vessels, usually the leg blood vessels, and advancing them into the heart. And there we measure pressures inside the heart, which is critical when you have abnormal heart valves, and we can also inject contrast material, that you can take an x-ray movie and see the outline of the heart chambers and see how well the heart's working, or you can see, most importantly, the heart arteries and see how they're doing.

JACQUELINE NOONAN, MD: There are CAT scans, and now there are improvements in the CAT scans, and then there's the magnetic resonant imaging, MRIs. So there are many different diagnostic tests that can be used. There are also tests that can be used to look for how good the oxygen in your heart is, which reflects the coronary blood flow. Nuclear scans, where one can do nuclear scans, both when you're resting and when you're exercising, will help us to understand whether your coronary arteries are supplying the heart sufficient blood. So there are many, many different kinds of diagnostic tests available today.

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What is Ejection Fraction and Why is it Important?

How does the amount of blood you heart pump affect your health? Get the facts about this key function of the heart.

Participants:
Eric L. Michelson, MD, FACC
Senior Director, Clinical Development, AstraZeneca
Jacqueline A. Noonan, MD, FACC
Pediatric cardiologist, University of Kentucky College of Medicine, Lexington, Kentucky
Nanette K. Wenger, MD, M.A.C.P., F.A.C.C., F.A.H.A.
Professor of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia

Webcast Transcript:

ANNOUNCER: In understanding how the heart works, it important to know the meaning of the term "ejection fraction."

ERIC MICHELSON, MD: The heart is a very effective pump, and under normal conditions every time the heart fills with blood, the pumping chambers, the major chambers, the ventricles, eject that blood into the major blood vessels. Ejection fraction is a measure of the pumping function of the heart. At rest, a normal person may have an ejection fraction of approximately 55 percent. That means when the pump is full and contracts, 55 percent of the blood that was in the heart before it began to contract is now ejected.

JACQUELINE NOONAN, MD: When you're not able to maintain that normal level, it's usually because your heart is not functioning well as a pump. Because, remember, the heart is a pump. It's a muscle that pumps blood and, when your ejection fraction is low, it means the pump isn't working as well as it should.

NANETTE KASS-WENGER, MD: The lower the ejection fraction, the worse the pumping function of your heart, and ejection fractions lower than 30 or 35 percent have a number of adverse consequences on your health.

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The information published on this page has been provided by the Heart Authority
in collaboration with Cardiosource – American College of Cardiology
Copyright 2005 Whitby Cardiovascular Institute. All rights reserved.