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Testing the heart


Sometimes, putting your heart to the challenge is the only way to discover its strength.

By Adrienne Dy, M.D.

 
FEBRUARY 2013 


If you’ve ever gotten your heart broken, you know: The heart is stronger than we think. In a more literal and possibly less painful way, subjecting your heart to trials might be the best method to reveal its strength.


Cardiac challengers

No, we’re not asking you to date jerks to see how many heartbreaks you can withstand. But it will mean having regular dates with a generalist or internist—whether or not you feel any heartaches—just to be on the safe side.

Carmen Chungungco, M.D., a cardiologist at St. Luke’s Medical Center-Global City, recommends yearly visits to a doctor, even when you don’t exhibit any symptoms. “A family history of heart disease, vices like smoking or excessive drinking, night shift work, or [being] overweight are risk factors that [warrant a consult] with even just an internist, not necessarily a specialist right away, who can recommend specific tests as necessary,” she elaborates.

We’ve compiled a list of some cardiac diagnostic modalities—or heart challengers, if you will—worth knowing about.


Beginner’s level: the easy G

A common test to investigate heart health is the electrocardiogram or ECG. It’s painless and over in a few minutes. Electrodes called “leads” are placed on the chest, arms and legs by suction or adhesives. A machine records the heart’s rhythm and electrical activity from the leads onto paper in what looks like squiggly lines for the physician to read and interpret. Easy enough, right? Just make sure you’re perfectly relaxed during the test so results stay accurate. Dr. Chungungco recommends a yearly ECG for those 40 years old and up, as part of an annual checkup.

Another quick test is the chest x-ray. It’s used to detect heart enlargement or problems with the aorta, the largest artery in the body.


Intermediate level: closer surveillance

The Holter monitor is basically a 24-hour ECG. A portable version of the machine is strapped to the body to continuously observe the heart for electrical or rhythm abnormalities. “[This] is for those with frequent palpitations, or syncope [fainting] at any time,” says Dr. Chungungco. The constant watch and wiring can be a hassle; plus, an activity or symptom diary must be kept in that time period. Despite these, the Holter is very useful in catching problems outside of clinic hours.

The echocardiogram or 2D-echo also takes a closer look at your heart. An ultrasound is used to gather information on the inner workings, or walls and valves, of the heart. Brave the probe and cold gel on your skin to find out just how effective your heart muscles are, and if all the tiny portals of your heart are opening and closing as they should.


Difficult level: pressure and penetration

The stress test is designed to uncover problems that only appear when the heart works extra hard. It involves an ECG while on an increasingly tilting and accelerating treadmill. For those who can’t exercise, drugs can be administered to quicken the heartbeat artificially. “[It] can diagnose ischemia [or blockage] in the heart’s arteries, find out if medications are working to control blood pressure, or see if arrhythmias can be induced,” explains Dr. Chungungco, who recommends it be done once between ages 40 and 50, and once when 50 and up, or more frequently if with risk factors.

Other tests go deeper. Transesophageal echocardiography gets the 2D-echo probe down the throat to take clearer images of your heart. It requires local anesthesia and may cause a bit of a sore throat.

The most invasive is cardiac catheterization or angiography, reserved for heart blockage patients. Warning: There will be blood, as a large needle will pave the way for a catheter or thin tube that will snake through an artery in the groin or arm to get to your heart. The arteries supplying blood to the muscles of your heart are visualized by injecting a dye, while real-time imaging reveals any blockage or narrowing. This sounds scary, especially since it can only be done in the OR or cath lab. The upside: Beyond diagnosis, it also offers treatment. In the same procedure, any constrictions can be dilated by a small balloon or stent.

An electrophysiologic study or EPS is also invasive. Wires are placed into chambers of the heart to find the areas causing abnormal rhythm. Like angiography, this can be used as treatment; while inside the heart, areas of arrhythmia can be ablated or burned, so they won’t cause problems again.

For more articles on cardiac care, check out the February issue of HealthToday magazine, out now in major bookstores and newsstands.








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