Cardiology

Cardiology is a branch of internal medicine that deals with cardiovascular diseases. Specialists in the field are called cardiologists.

It is recommended to visit a cardiology clinic as soon as possible if the following symptoms are observed:

• Stronger than usual heartbeat
• Shortness of breath
• Swelling of the feet
• Chest pain, heart pressure
• Chest complaints of uncertain origin
• Dizziness, weakness or loss of consciousness
• High or low blood pressure

Cardiology deals with the diagnosis and treatment of the following diseases:

• hypertension
• coronary artery disease
• arrhythmias: atrial fibrillation, tachycardia, bradycardia
• heart failure
• acquired or congenital valve defects, valvular insufficiency, aortic stenosis, mitral valve prolapses
• congenital heart disease
• inflammatory diseases of the heart – myocarditis, pericarditis, endocarditis

Cardiological examination begins with the establishment of the medical history, considering complaints and previous illnesses. This is followed by measuring the patient’s heart rate as well as blood pressure. The cardiologist then uses a stethoscope to listen to the heart sounds that occur during the operation of the heart. Based on the results of the primary physical examinations, the cardiologist can order additional, specific diagnostic tests to make an accurate diagnosis.

An essential and indispensable examination of any cardiology clinic is the ECG examination. The ECG gives a picture of ​​the electrical activity and changes that accompany the heart activity (heartbeat). The ECG curve is displayed on paper or on a monitor. The test is painless and does not have any side effects.

The cardiologist, with this examination, monitors how the heart responds to exercise. During a stress ECG, a blood pressure monitor is placed on the arm and electrodes on the body. During the examination, the patient “rides a bike”. The doctor determines the heart rate to be reached per minute before the test, and gradually loads the patient.

Echocardiography is one of the most important methods of non-invasive cardiac diagnosis. This imaging procedure is based on the use of ultrasound to produce a moving image of the beating heart. In addition to exploring the anatomy of the heart and large blood vessels, echocardiography is also used to assess left ventricular function. It can be used not only to examine the function of the left ventricle, but also to detect fluid in the pericardium, tumours, thrombi or other lesions in the heart.

During a 24-hour blood pressure measurement (ABPM), the patient is given a device that automatically measures and records the pressure on the blood vessel wall at regular intervals throughout the day. During the measurements, the patient can resume their usual daily activities. The doctor may ask them to keep an event log during the ABPM test, in which they should write down when they experienced more stress during the 24 hours of the test, when they had any complaints, when they did stressful physical work.

The Holter device is a small radio-like box that records electric signals coming from the heart. A disposable self-adhesive electrode is attached to the appropriate places on the patient’s chest to which the leads are connected. If it is necessary, men’s hair is shaved under the pads for accurate measurement. The device should be worn in a portable case that can be hung around the neck or waist belt and should not be removed for 24 hours or exposed to water.

Cardiovascular magnetic resonance imaging (cardiac MRI) uses a strong magnetic field, radio frequency waves, and a high-performance computer to take very detailed images of different parts of the heart (heart cavities, heart valves, myocardium, pericardium) and its surroundings.

The stress cardiac MRI scan is a special cardiac MRI scan, in which, in addition to a complete and detailed examination of the heart at rest, images are also taken under a short-term, 5-6 minute drug (adenosine) load.

The adenosine stress cardiac MRI scan is one of the examinations that can reliably diagnose coronary artery disease in a non-invasive way.

The heart is located in the chest, behind the sternum, at its anterior, lower part, slightly to the left of the midline of the chest. It is made up of myocardial fibres, which are capable of continuous, strong contractions against our will, but due to neural and hormonal effects, the frequency of contractions adapts to changing loads. Its size is approximately proportional to body weight, averaging 4 grams per kilogram body weight. In healthy adults, the average size is 250-350 grams.

In terms of the structure of the heart, it is a hose with muscular walls and a complex cavity system. It consists of two atria and two ventricles, where the atria receive blood from the veins and the ventricles continue to pump it into the arteries.

Arteries and veins are also structurally different because blood flows in different directions in them. It flows from the heart to the peripheries through the arteries and back to the heart through the veins from the peripheries.

The connective tissue of the arteries is a dense fibrous connective tissue made up of elastic fibres, the veins are thinner and less elastic-walled, however, the pulmonary valves in them help the blood flow.