By: Louie Tirador, M.D., FPCP, FPCC
SPHI Internal Medicine-Cardiologist
WHAT are non-invasive procedures of the heart? A medical procedure is non-invasive if no breaks in the skin or any contact with the mucosa is made using medical instruments.
A person with a heart problem may manifest in many ways. The patient may complain of chest pain, shortness of breath, palpitations, loss of consciousness, swollen legs, elevated blood pressure, nape pains, and many more. As you visit a doctor, they will get a thorough history based on your complaint and perform a physical examination. He/she is likely to request for a blood examination, chest x-ray, and an electrocardiogram (ECG) to complete the initial assessment. Various non-invasive procedures such as stress test, 2D echocardiogram with color flow Doppler studies, peripheral Doppler studies, Holter monitoring, and ambulatory BP monitor may be necessary not only to diagnose a particular heart condition but also to stratify and prognosticate the said condition.
An ECG indirectly records the electrical activity of the heart. By performing an ECG, one can determine the rate (slow to fast), rhythm (heart blocks and pauses), axis, chamber enlargement, ischemia, and infarction. This simple procedure can diagnose an impending heart attack and presence of symptomatic heart blocks.
In cases where a patient complains of palpitations with or without associated near syncope or loss of consciousness, a 24-hour Holter ambulatory monitoring may be warranted. This Holter monitor is like taking a 24-hour recorded ECG tracing with the purpose of documenting and recording presence of heart blocks, heart beat irregularities (atrial fibrillation and atrial and ventricular arrhythmias). This modality is of great help in decision-making whether a particular patient needs an implantable pacemaker or an automatic implantable cardio defibrillator device (AICD).
A 2D echocardiogram with color flow Doppler gives much information regarding the status of the heart and great vessels from the chamber enlargement, wall thickness and dilatation, valve status (leaking or obstructed), hole in the heart (VSD, ASD), presence of thrombus (blood clot) fluids outside the heart (pericardial effusion) wall motion abnormalities, as well as systolic and diastolic dysfunction. This tool is not only used to get a diagnosis but also to assess the severity and outcome of the heart condition and becomes a guide in recommending a medical or invasive kind of treatment.
A Peripheral Doppler Ultrasound (vascular flow studies) can detect abnormal flow within an artery or venous blood vessel. This can help to diagnose and treat a variety of conditions including blood clots and poor circulation. This is requested if a patient shows signs of decreased blood flow in the arteries or veins in the legs, arms or neck (deep venous thrombosis), thrombophlebitis, and arteriosclerosis.
A Stress Test (Treadmill Test) on the other hand is requested to determine how the heart works during exercise. This is often recommended among patients complaining of chest pains or rhythm disturbances (arrhythmia). This test makes the heart pump faster and harder (increase the workload of the heart). Thus, it can reveal problems of blood flow to the heart. The test records the heart rate, blood pressure, and ECG changes during and after exercise. The test may be a guide for treatment decisions, measure the effectiveness of treatment, and determine severity of a diagnosed heart condition. A stress echocardiography, a combination of 2D echocardiography, and stress test are often requested in lieu of a stress test especially in patients with abnormal baseline ECG tracing and 2D echocardiography. The findings are more sensitive and specific in diagnosing coronary artery disease.
These non-invasive modalities are affordable, low risk with little or no discomfort procedure and informative in assessing severity and outcome of a heart condition. They are available at our Cardio Unit located at the 3rd Floor SPICE Building. We are open on Mondays – Sundays (including holidays) at 7 A.M-6P.M. You may contact us at telephone numbers (033) 3372742 to 49 local 6343. You may also reach us through our FB page at SphiloiloOfficial and our website at www.sphiloilo.com./PN
