When carrying out diagnostic measures aimed at detecting heart disease, the specialist chooses the safest and most effective methods for collecting information about a progressive disease. Before conducting instrumental examinations, laboratory tests and anamnesis are collected. The choice of diagnostic method will be directly influenced by the results of the tests, the initial examination of the patient. Each examination method has its own distinctive features, and invasive techniques do differ in some contraindications. Cardiac probing is an invasive research method that is used in the diagnosis of heart diseases: catheterization of blood vessels, cavities of the heart, as well as its right and left sections.
Main types of procedures
Specialists distinguish the following sounding methods:
- extensive catheterization (or catheterization of the left heart) is most often performed, specialists advance the catheter for sounding the heart through the aorta to the left ventricle until reaching the coronary vessels;
- small catheterization (or right heart catheterization) – catheter to the right heartheart and pulmonary arteries passes through special veins located in the groin area or in the elbow, but in some cases floating catheters are used, which enter the heart together with venous blood.
In addition, the doctor may prescribe a synchronous (or simultaneous) catheterization, in which several catheters are inserted into the heart through an artery and a vein at once. During the examination, catheters can be placed opposite each other so that only the cardiac canal (for example, mitral or aortic) separates them. This diagnostic method helps to determine the pressure gradient that occurs in the openings of the heart valves.
Who should do it?
Heart sounding for a child and an adult is carried out for diagnostic purposes if a specialist needs to obtain detailed information about the coronary vessels and heart, and other research methods cannot provide full information about the degree of development of the disease, its causes and distinctive 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, performing an operation to sound the cavities of the heart).
When appointed?
Diagnostic cardiac catheterization may be indicated for the following conditions:
- congenital heart defects;
- diseases of the cardiac system (valvular disease);
- ischemic diseases;
- cardiomyopathy;
- heart failure;
- mild hypertension;
- cardiac amyloidosis.
Diagnostic measure helps to accurately identify the type of damage to the coronary vessels, myocardial tissues and heart valves, which cannot be determined using simpler examinations (or when they show an inaccurate result). In addition, the procedure for probing the vessels of the heart helps to fully assess the severity of damage and examine the pathophysiological mechanisms of changes in myocardial function. Most often, this diagnostic method is prescribed for patients who are to undergo cardiac surgery.
Diseases requiring diagnosis
Cardiac catheterization can be performed at:
- heart disease treatment;
- need to open narrow channels;
- intracoronary thrombolysis;
- stenting or angioplasty of diseased arteries.
Cardiac catheterization can be performed in both adults and children, provided there are no contraindications to the procedure.
Main contraindications
There are cases when it is forbidden to carry out sounding of the heart to the patient. These include the following contraindications:
- fever;
- cramps in limbs;
- dangerous infections;
- systemic lesions;
- puffiness in the lungs;
- if the patient has digitalis intoxication or hypokalemia;
- severe form of peripheral atherosclerosis;
- presence of arrhythmia or hypertension;
- decompensated heart failure;
- severe anemia;
- coagulopathy;
- presence of allergies when taking certain medicines;
- GI bleeding;
- acute renal failure;
- carrying a child or lactation.
The need for a heart sounding operation in the presence of the above lesions is established for each patient individually, taking into account the overall clinical picture of the disease. As a rule, diagnostics can be carried out after the elimination of the contraindication or after preliminary preparation of the human body.
In some cases, doctors have to avoid catheterization because the patient himself refuses to perform it.
Expert Tips
When prescribing venous catheterization, the patient must inform the doctor about the following factors without fail:
- bearing a baby, especially in the early stages;
- use of medicines or dietary supplements;
- taking hypoglycemic drugs;
- allergic to iodine, radiopaque, 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 preparation
It is especially important to carefully prepare the patient for the examination in the followingcases:
- the presence of dangerous pathological diseases (insulin-dependent diabetes, pulmonary and renal insufficiency, serious diseases of the cerebral and peripheral vessels);
- heart failure;
- marked disturbances in the left ventricle;
- childhood or old age.
In the presence of the conditions described, it is important to conduct cardiac catheterization with extreme care, in the presence of such lesions, the risk of death greatly increases.
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 about possible complications and adverse reactions.
After that, the patient is given documents on consent to catheterization and all the basic recommendations on preparing for the diagnostic procedure.
Preparation for examination
The preparation will include the following rules:
- 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 changes the regimen for taking certain medications and medicines before the procedure.
- The patient can come for diagnostics on the appointed day or be hospitalized a few days before catheterization. When registering at the clinic, the patient needs to take with him all the required things (slippers, cleanand comfortable clothing, hygiene products). The same items will also be needed if the patient, after the diagnosis, will remain in the clinic for medical reasons. It is for this reason that you should take everything you need with you before visiting the clinic.
- In some cases, the doctor prescribes a test for a local anesthetic, which is used to relieve pain during the procedure, or a contrast agent. This is important to prevent an allergic reaction.
- It is important to take the medicines prescribed by the doctor on time before the procedure.
- In the evening, before the diagnosis, you should take a shower and remove hair from the catheter insertion area.
- It is important to stop eating and drinking 6-8 hours before the procedure.
- If, after catheterization, the patient is going to go home, then an accompanying person must be with him.
- Before conducting a heart sounding, the patient must leave dentures, glasses, a telephone, a hearing aid and other means in the ward that will not allow a full study.
Features
The patient should 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 instructs him.
In some cases, during the study, the patient feels his heartbeat, a slight burning sensation in the area of the catheter insertion, orfeels hot. Such discomfort should not be very disturbing and make the patient nervous, since they do not indicate any complications during the procedure. After the end of the examination, all discomfort immediately disappears.
Procedure technique
How is a heart sounding done? Features of the procedure:
- The patient is sedated one hour before the exam.
- After the patient is taken to an office equipped with special equipment. He is offered to change clothes and laid on the doctor's table.
- A nurse punctures a patient's vein to administer appropriate medications.
- If necessary, an additional catheter is inserted into the bladder.
- The attending specialist treats the catheter insertion site (elbow or groin) with antiseptics and performs local anesthesia. After obtaining the desired analgesic effect, the doctor makes a small incision to insert the catheter or punctures the vessel with a thick needle.
- Next, a catheter is inserted into the selected blood vessel, using a special fluoroscopic device to help advance the catheter to the ventricles of the heart or coronary vessels.
- After the device is passed to the left or right ventricle, a special manometer is attached 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 identify the ventricles and coronary vessels on the monitor. Doctorscarefully examine the organ, study its condition, take pictures and the necessary conclusions.
- At the end of the procedure, the doctor removes the cardiac catheter and stitches it if necessary.
After heart sounding, the patient can go home after complete stabilization of the condition (most often this happens after a couple of hours) or stay in the hospital until the next day.
The cost for the probing procedure will reach up to 15,000 rubles, but additional treatment will not be included in this price.
