When conducting diagnostic measures aimed at identifying heart diseases, the specialist chooses the safest and most effective methods of collecting information about a progressive disease. Before conducting instrumental examinations , laboratory tests and anamnesis are collected. The choice of diagnostic method will directly affect the results of the tests, the initial examination of the patient. Each examination method has its own distinctive features, and invasive techniques are completely distinguished by some contraindications. Cardiac sounding is an invasive research method that is used in the diagnosis of heart diseases: catheterization of blood vessels, cardiac cavities, as well as its right and left departments.
The main types of procedure
Experts distinguish the following sensing methods:
- extensive catheterization (or catheterization of the left heart) is carried out most often, specialists advance the catheter for heart sounding along the aorta to the left ventricle until the coronary vessels reach;
- small catheterization (or catheterization of the right heart) - a catheter in the right heart and pulmonary arteries passes through special veins located in the groin or elbow, but in some cases, floating catheters that enter the heart along with venous blood are used.
In addition, the doctor can prescribe a simultaneous (or simultaneous) catheterization, in which several catheters are inserted into the heart through an artery and vein. During the examination, the catheters can be located opposite each other so that they are separated only by the heart channel (for example, mitral or aortic). This diagnostic method helps to determine the pressure gradient that occurs in the openings of the heart valves.
Who should be carried out?
Cardiac sounding for a child and an adult is carried out for diagnostic purposes if the specialist needs to obtain detailed information about the coronary vessels and heart, and other research methods cannot provide complete information about the degree of development of the disease, its causes and distinguishing features.
After receiving the results of the study, the doctor will be able to make an accurate diagnosis and prescribe the correct and effective treatment (for example, conducting heart cavity probing).
When is it appointed?
Diagnostic cardiac catheterization can be prescribed in the presence of the following diseases:
- congenital heart defects;
- diseases of the heart system (valve damage);
- ischemic diseases;
- cardiomyopathy;
- heart failure;
- mild form of hypertension;
- cardiac amyloidosis.
The diagnostic measure helps to accurately identify the type of damage to the coronary vessels, myocardial tissue and heart valves, which cannot be determined using simpler examinations (or when they show an inaccurate result). In addition, the procedure for sensing the blood vessels of the heart helps to fully assess the severity of damage and to examine the pathophysiological mechanisms of changes in the work of the myocardium. Most often, this method of diagnosis is prescribed to patients who have to undergo cardiac surgery.
Diagnostic diseases
Cardiac catheterization can be performed with:
- treatment of heart disease;
- the need to disclose narrow channels;
- intracoronary thrombolysis;
- stenting or angioplasty of diseased arteries.
Cardiac catheterization can be performed in both adults and children, provided that there are no contraindications to the procedure.
The main contraindications
There are cases when it is forbidden for a patient to perform heart sounding. This includes the following contraindications:
- fever;
- cramps in the limbs;
- dangerous infections;
- systemic lesions;
- swelling in the lungs;
- if the patient has digital intoxication or hypokalemia;
- severe form of peripheral atherosclerosis;
- the presence of arrhythmia or hypertension;
- decompensated heart failure;
- severe anemia;
- coagulopathy;
- the presence of allergies when taking certain medications;
- GI bleeding
- acute renal failure;
- bearing a child or lactation.
The need for a heart sounding operation in the presence of the above lesions is established individually for each patient, while taking into account the overall clinical picture of the disease. As a rule, diagnosis can be carried out after eliminating the contraindication or after preliminary preparation of the human body.
In some cases, doctors do not have to carry out catheterization due to the fact that the patient independently refuses to perform it.
Expert Advice
When prescribing venous heart sounding, the patient must inform the doctor about the following factors:
- bearing a child, especially in the early stages;
- the use of medicines or dietary supplements;
- taking sugar-lowering drugs;
- allergies to iodine, radiopaque drugs, seafood, rubber or latex;
- the use of Viagra and other drugs that are aimed at restoring the state of the reproductive system.
The importance of training
It is especially important to prepare the patient for the examination in the following cases:
- the presence of dangerous pathological diseases (insulin-dependent diabetes, pulmonary and renal failure, serious diseases of the brain and peripheral vessels);
- heart failure;
- severe disorders in the left ventricle;
- children or old age.
In the presence of the described conditions, it is important to carry out cardiac catheterization with special care, in the presence of such lesions, the risk of a fatal outcome is greatly increased.
How to prepare for the procedure?
After the appointment of cardiac catheterization, the specialist without fail tells the patient all the techniques for performing the examination and warns of possible complications and adverse reactions.
After that, the patient is given documents on the consent to catheterization and all the main recommendations on the preparation for the diagnostic procedure.
Examination preparation
The following rules will be included in the preparation:
- Two weeks before the procedure, the patient is prescribed blood, urine, ECG, chest x-ray. In some cases, the doctor prescribes additional studies.
- If necessary, the doctor before the procedure changes the regimen of certain medications and medicines.
- The patient can come for diagnosis on the appointed day of its implementation or be hospitalized a few days before catheterization. When applying to the clinic, the patient needs to take with him all the required things (slippers, clean and comfortable clothes, hygiene products). The same items will be needed if the patient after the diagnosis will remain in the clinic for medical reasons. For this reason, before visiting the clinic you need to take everything you need with you.
- In some cases, the doctor prescribes a test for a local anesthetic, which is used to anesthetize the procedure, or a contrast agent. This is important to prevent an allergic reaction.
- It is important to take the medicines prescribed by your doctor before the procedure.
- In the evening, before the diagnosis, you should take a shower and remove the hair from the catheter injection zone.
- 6-8 hours before the procedure, it is important to stop eating and water.
- If after the catheterization the patient is going to go home, then an accompanying person must be with him.
- Before performing a heart sounding, the patient must leave dentures, glasses, a telephone, a hearing aid and other means in the room that will not allow a full study.
Features
The patient must remember that cardiac catheterization is a painless procedure that does not bring any discomfort. During the diagnosis, the patient will be conscious, can talk with a specialist and perform the actions that the doctor tells him.
In some cases, during the study, the patient feels his heartbeat, a slight burning sensation in the area of catheter insertion, or feels heat. Such unpleasant sensations should not bother or make the patient nervous, since they do not indicate any complications during the procedure. After the examination, all the discomfort immediately passes.
Procedure Technique
How do heart soundings do? Features of the procedure:
- One hour before the study, a sedative is administered to the patient.
- After the patient is taken to an office equipped with special equipment. He is offered to change clothes and put on a medical table.
- The nurse punctures the patient’s vein to administer the necessary drugs.
- If necessary, an additional catheter is inserted into the bladder.
- The treating specialist processes the injection site of the catheter (elbow or groin) with antiseptics and conducts local anesthesia. After receiving the desired analgesic effect, the doctor performs a small incision to insert a catheter or punctures the vessel with a thick needle.
- A catheter is then inserted into a selected blood vessel, and a special fluoroscopic device is used to help propel the catheter to the ventricles of the heart or coronary vessels.
- After the device, a special pressure gauge is attached to the left or right ventricle to the catheter, which monitors the patient's pressure. If necessary, carry out additional procedures.
- For antigraphy, a radiopaque agent is introduced into the catheter, which helps to determine the ventricles and coronary vessels on the monitor. Doctors carefully examine the body, study its condition, take pictures and the necessary conclusions.
- At the end of the procedure, the doctor removes the cardiac catheter and sutures if necessary.
After cardiac sounding, the patient can go home after full stabilization of the condition (most often this happens after a couple of hours) or remains in the hospital until the next day.
The cost for conducting the sounding procedure will reach 15,000 rubles, but additional treatment will not be included in this cost.