Procedures in Diagnosing Cardiovascular Diseases

If you are hypertensive or there are abnormalities found in your heart during a general check-up, your primary doctor in Singapore will recommend heart screening to determine if you have a cardiovascular disease.

If you see symptoms that are associated with heart diseases, you should look for the best cardiologist at the nearest hospital. Different techniques are employed by the cardiologist whom you will be referred to. Let’s look at each procedure.

Checking Your Blood Pressure

The first part in a heart screening is the manual checking of your blood pressure. In this procedure, a cardiologist will use a sphygmomanometer to check the systolic and diastolic pressures. This is usually a good indicator if you have hypertension. The systolic pressure is the upper number and indicates the pressure of the blood on the artery walls. The diastolic pressure is the lower number indicating the pressure on the artery walls when the heart is at rest. The result is measured in mm Hg, and the normal blood pressure is no more than 120/80 mm Hg.

Electrocardiogram

Electrocardiogram or ECG or EKG is a procedure that records the electrical activity of the heart. The result, which is read by either a technician or cardiologist, will show if there are abnormal rhythms or arrhythmias and heart muscle damage in the heart. Each electrical impulse that causes the muscles of the heart to pump will be recorded, particularly the timing of the top and lower chambers of the heart. The cardiologist will look at the interval of the waves and the amount of electrical activity.

Echocardiogram

Echocardiogram, also called echo, uses high-pitched sound waves to assess the condition of the chambers and valves and the pumping action of the heart. You can click here for more info on heart check before going for one. On a monitor, this heart screening process will show an image created by the sound waves that bounce off the parts of the organ. The heart doctor will use an ultrasound probe over the skin surface of the patient. There are three types of echocardiograms; Doppler, transthoracic, stress and transesophageal echocardiogram.

Cardiac CT Scan

The computed tomography scan uses X-rays to check the heart and the blood vessels. There are three types of cardiac CT scan based on what the cardiologist is trying to look for. Coronary calcium scan is for determining the build-up of calcium deposits in the arteries. CT angiography is done to monitor blockages and changes in the arteries. A cardiac CT scan is also done to check the pulmonary arteries and aorta. This last technique is a combination of the two.

Magnetic Resonance Imaging

Magnetic Resonance Imaging or MRI of the heart uses radiofrequencies and magnets to create images of the heart and blood vessels. This procedure will determine the health of your heart’s valves, the major vessels and even the presence of other abnormalities in the system. A heart surgeon will also require a magnetic resonance angiography or MRA before any heart procedure is performed on a patient.

Thallium Scans

Thallium scans are also called myocardial perfusion scans. In this procedure, a laboratory technician will intravenously inject radioactive sestamibi so that a camera can take photos of the heart. It is recommended by a cardiologist so that the blood supply to the heart can be viewed. This will tell him/her if there are areas in the heart that do not receive enough blood. There are four types of thallium scans used in hospitals in Singapore today.

Blood Tests

Blood tests will also be recommended by the cardiologist especially for hypertensive patients who are taking medication. The tests will check the level of cholesterol and triglycerides, sugar, C-reactive protein or CRP, ceramides, brain or B-type natriuretic peptide, creatine kinase or CK, creatine kinase-MB, cardiac troponin or troponin T, myoglobin, and urine albumin/creatinine ratio. The cardiologist will ask you to have a 12 to 14-hour fast before cardiac blood tests are performed. Don’t forget to tell him/her about other medications and supplements that you’re taking.

Stress Test

A stress test may be done by asking the patient to use a treadmill or a stationary bike. Also called exercise ECG, the result of this test will tell the heart doctor in Singapore if a person’s breathing and blood pressure are within normal range during and after a strenuous physical activity. The cardiologist may also administer medicines which will stress the heart during the procedure. The result will help the heart doctor determine if the patient has a high risk of developing coronary artery disease. This is also a way for the heart surgeon to determine if the patient can start exercising after a heart surgery was performed.

Cardiac Catheterization

Cardiac catheterization or coronary angiogram is done by placing a narrow hollow tube into the artery in your upper leg, arm or the heart. When the dye is injected, X-ray photos will be taken as it travels through the patient’s heart. The cardiologist will recommend this procedure to determine the extent of the narrowing in the arteries, the functioning of the valves and others.

Positron Emission Tomography Scan

Also called PET scan, it a procedure that looks for signs of damage or abnormalities in the flow of blood and the heart muscles. PET scan is a nuclear scan that uses a radioactive tracer that is given intravenously. You will be asked to lie down in a scanner so the technician can record the signals on the monitor. The heart doctor might recommend a PET F-18 FDG scan to look for damages in the heart. The heart surgeon will also ask for this procedure to assess your condition after a heart surgery.

Tilt Table Test

In this test, you will be asked to lie down on a table. The laboratory technician will secure you on the table with straps and connect an ECG and a blood pressure monitor. The table will tilt you in standing and lying positions alternately to see if your blood pressure and pulse rate suddenly change when you are lying down or standing up.

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