Cardiology

The diseases which affect the heart and blood vessels are collectively known as cardiovascular conditions. The objectives of a clinical examination by a specialist cardiologist are to prevent, to diagnose and to treat such conditions, as well as to agree on an appropriate recovery plan after a major cardiovascular event.

Some of the most common cardiovascular affections are hypertension, chronic and acute coronary syndromes, heart failure, rhythm and conduction disorders, diseases of the arteries and veins, inflammations and infections of the heart’s muscle and valves, genetic disorders, and various cardiovascular issues caused by other conditions (systemic, endocrine, hematologic) or by life’s natural physiological stages, among which pregnancy.

Pregnancy, in particular, subjects the female body to a series of adaptations, some cardiovascular, in response to the increased metabolic needs of both mother and foetus. It is important to know and to interpret these changes with maximum accuracy, because the clinical presentation of a pregnancy may sometimes disguise the signs of an emerging cardiovascular disease.

Also, in some cases, pre-existing or newly diagnosed cardiovascular issues affecting the mother may complicate the pregnancy. In an interdisciplinary approach, the cardiologist is a valuable member of the ‘pregnancy team’, able to conduct a preconception specialist assessment and to provide counsel to a female patient known or found to be at cardiovascular risk. The medical team can then carefully monitor all the changes that occur throughout the 9 months of pregnancy and after the baby’s birth.

Here are the cardiovascular investigations that we carry out at Origyn, and some general information about them:

The resting electrocardiogram test:
it is the main diagnostic tool in arrythmias;
it provides information about the ischemic modifications that may affect the muscle of the heart (the word ischemic refers to a local deficit of blood)
it helps the cardiologist to prescribe adequate treatment.

Transthoracic echocardiography:
it is the most common imaging investigation in cardiology;
it helps the doctor establish the diagnosis, management and prognosis of the patient;
it is risk free and quick; also, it may be safely repeated, including in the case of children and pregnant women;
it provides accurate information about the structure of the heart, the heart valves and the principal blood vessels, as well as about their functioning.

Ambulatory blood pressure monitoring:
it enables the measurement of blood pressure variations throughout the day and night in order to adjust medication appropriately or to monitor the effects of treatment in case of a pre-existing chronic condition;
it provides objective information by preventing the ‘white coat’ effect, namely the influence that the patient’s emotional state can have on their blood pressure when in the presence of the doctor or during a medical examination.

The 24-hour ECG Holter monitor test:
it is the ambulatory monitoring of the patient’s heart rate over the course of an entire day (24 hours) by means of a surface electrocardiogram conducted continuously with the help of a portable Holter device;

it is useful in the diagnosis of rhythm disorders and events which may often occur silently (without any noticeable sensations or symptoms), and it can even help reveal potentially malignant electrocardiographic modifications.

The cycle ergometer test:
by having the patient ride a static bicycle in a carefully controlled environment, the cardiologist can assess the patient’s physiological tolerance to effort, including the behaviour of blood pressure and heart rate during physical exertion;
although this exercise test cannot reveal the scale of the ischemia (which imaging investigations can), it can provide useful prognostic clues;
it is recommended to patients who are found to be at risk of coronary disease.

The ankle brachial pressure index test:
it is the ratio between the highest value of systolic blood pressure measured at the ankle and the highest value value of systolic blood pressure measured at the upper arm using a 5-10 MHz Doppler probe;
it is a first-line investigation method in the case of lower limb peripheral arterial disease;
it is quick, non-invasive, painless and it can also be used in prevention and screening;
it helps the doctor assess the degree to which the lower limbs may be affected and prognosticate the evolution of the disease.

The cardiology consultation consists in the anamnesis (the interview with the cardiologist), the clinical examination, the resting electrocardiogram test, upper arm blood pressure and pulse oximetry measurements, the transthoracic echocardiogram and, if necessary, other subsequent investigations.

Based on the results, the cardiologist will devise a personalised care and monitoring plan to discuss with the patient and agree on. Also, these initial results will help the doctor decide if further tests and investigations are necessary for a complete diagnosis.

To benefit from a cardiology consultation at Origyn Medical Center, request an appointment at 0756 397 565.