Cardiac assessment: why and when to do it?

2015-09-29 07:30:00

Your health is good, your blood pressure is normal, less than 14/9 centimeters of mercury (cm Hg), and yet here you are at the cardiologist.

The general practitioner requests a cardiac assessment when the person complains of unexplained cardiological symptoms, indicates Dr Natalia Kpogbemabou, cardiologist.

What is a complete cardiovascular assessment?

A complete cardiac assessment consists of several medical examinations whose objective is to check the state of the heart of a patient at cardiovascular risk or look for pathology in a patient with cardiovascular symptoms.

It includes a heart and lung auscultation looking for a breath or abnormal sounds as well as palpating the pulses in the lower limbs, carotid arteries (neck arteries), and abdominal aorta.

During a complete cardiovascular assessment, we also generally practice:

Why and when to do a cardiovascular check-up?

This is an essential test for preventionthe diagnostic and the treatment any heart disease (heart rhythm disorders, heart failure, ischemic heart disease, blood pressure, etc.).

“This check-up, associated with the general medical check-up, is intended for all those who, past the age of 40, wish make sure their heart is working perfectly and thus limit cardiovascular risk factors”, indicates the site of the American Hospital of Paris (source 1).

A recommended check-up following the age of 60 for a woman and 50 for a man

The more cardiovascular risk factors there are, the more thorough the examination:

  • Overweight;
  • Smoking;
  • Type 2 diabetes ;
  • Age (over 50 for a man, 60 for a woman);
  • Cardiovascular family history…

Particular attention is paid to women in premenopause who have, during their pregnancy(ies), developed hypertensionandGestational Diabetesor a preeclampsia.

How to do an electrocardiogram (ECG)?

It’se tracing of the electrical activity of the heart necessary for its contractions, and therefore for its functioning.

  • Chest pain;
  • Palpitations ;
  • Loss of consciousness or dizziness that seems abnormal.

What it can detect:

  • Damage to the arteries;
  • An overly large heart (hypertrophic heart disease);
  • A morphological abnormality of the right ventricle;
  • Arrhythmias (arrhythmia, tachycardia, atrial fibrillation);
  • Abnormal electrical signal conduction. “Slightly slowed conduction can cause loss of consciousness”, says Dr. Kpogbemabou.

In case of suspicion, the installation of an ECG holter

If your cardiologist suspects arrhythmias or cardiac conduction but cannot confirm it with the ECG, they may prescribe placement of a cardiac Holter monitorwhich makes it possible to record the electrical activity of the heart over several days, in the daily life of the patient (unlike the ECG which only allows it to be captured for a few minutes).

How is a stress test carried out?

It consists of having an electrocardiogram while running on a treadmill or pedaling a bicycle. The metabolic exercise test adds a mask to it to measure the consumption of oxygen and the release of carbon dioxide (CO2) by the body.

  • Unusual, bothersome shortness of breath associated with cardiovascular risk factors.

What it can detect: a narrowing of the arteries of the heart.

During exercise, oxygen requirements increase, but they cannot be met if the arteries are already narrowed at rest. This test generates abnormalities during exercise that an electrocardiogram at rest would not see, explains the cardiologist.

The test with measurement of gas exchange makes it possible to discriminate between a cardiac or respiratory problem or a « effort deconditioning ». “Due to lack of activity, the heart is no longer able to sustain prolonged physical effort. He draws on his reserves, he gets carried away, one is out of breath, and the heart rate can be very high without there being an underlying heart disease. »

A check-up with the cardiologist before resuming a sporting activity

You wantplay sports once more? IIt’s best to make sure you’re in good shape before putting on your sneakers overnight. “The interrogation is almost police, the complete clinical examination, coupled with an electrocardiogram which can be carried out from the age of 12”, insists Dr. Kpogbemabou. After 35, she recommends the stress test if you want to start a sustained activity. “At this age, coronary artery disease is higher and remains the leading cause of sudden death. »

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