cardiac checkup


 

The diagnostic tests in cardiology are methods of identifying heart conditions associated with healthy vs. unhealthy or pathologic heart function.

Obtaining a medical history is always the first "test", part of understanding the likelihood of significant disease, as detectable within the current limitations of clinical medicine. Yet heart problems often produce no symptoms until very advanced, and many symptoms, such as palpitations and sensations of extra or missing heart beats correlate poorly with relative heart health vs disease. Hence, a history alone is rarely sufficient to diagnose a heart condition, and specific tests are to be done.

Hridaya Care Heart Institute employs a state of the art laboratory for assessing the overall condition of the heart, the evolution of coronary artery disease and evidence of existing damage.

The Hridaya Care Cardiac Checkup includes the following tests:

Total Cholesterol

Everyone over the age of 20 should get their cholesterol levels measured at least once every five years. High cholesterol itself does not cause any symptoms; so many people are unaware that their cholesterol levels are too high. Lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it.

To assess your cholesterol level, your doctor will usually perform a simple blood test called a lipoprotein profile. The lipoprotein profile evaluates the following: 

LDL (low density lipoprotein cholesterol, also called "bad" cholesterol)
HDL (high density lipoprotein cholesterol, also called "good" cholesterol)
Triglycerides (also called very low density lipoprotein)
Total cholesterol level

In addition to the blood test, your doctor will perform a full physical exam, discussing your medical history, checking your heart rate, listening to your heartbeat, and taking your blood pressure.

If your cholesterol is found to be high, especially if you have other risk factors for heart disease, your doctor will recommend various treatment options ranging from dietary and lifestyle changes to medication and therapy to lower your cholesterol.

Further tests may be recommended if your doctor feels you are at risk for heart disease.

Triglycerides

Good cholesterol, bad cholesterol, saturated fat, and unsaturated fat -- sometimes it seems like you need a program to keep track of all the fat players in the story of heart disease.

In some ways, the function of triglycerides in our body is the easiest to understand. Simply put, triglycerides are fat in the blood and are used to provide energy to the body. If one has extra triglycerides, they are stored in different places in case they are needed later. A high triglycerides level can increase the risk of heart disease. Just what your triglyceride levels mean and how much lowering triglycerides reduces heart disease risk is less clear.

What are Triglycerides?
Triglycerides are important to human life and are the main form of fat in the body. When you think of fat developing and being stored in your hips or belly, you're thinking of triglycerides.

Consider these things:
The fat we eat exists in relatively huge molecules inside food. Triglycerides are the end product of digesting and breaking down these bulky fats. Any extra food we eat that's not used for activity right away -- carbohydrates and fats -- are also chemically converted into triglycerides.Triglycerides are then bundled together into globules after they are eaten. These are transported through the blood to the liver. After they leave the liver, triglygerides are packaged inside a type of protein (called very low density lipoprotein) and then can be transported in the blood to where they are needed. Excess triglycerides are taken up by adipose (fat) cells to be used for energy if food isn't available later -- or during your next diet.

The American Heart Association recommends that everyone over the age of 20 should get a lipid panel to measure cholesterol and triglycerides and if normal should have the panel repeated every five years.

Fasting Blood Sugar (FBS)

Fasting blood sugar is what it means -- it's fasting, you haven't eaten, and usually in the diabetes world that means that you haven't eaten for about eight hours before you have the test done.

Screening

Fasting blood sugar's really very important particularly in diagnosing diabetes and oftentimes in therapeutic management and cardiac diagnosis and it's important because the system is clean of at least any sugar you've eaten prior to that test, because, when you're measuring blood sugar levels, depending on what you eat that adds to that number. So if you want a clean, cleansed number, a 'fasting' is a very good barometer.

Post Prandial Blood Sugar (PPBS)

The post-prandial blood sugar is a measure of your blood glucoses after you've eaten. This number is highly variable and dependent on what you've taken in. For example, if you've had a meal that's high in carbohydrate, your blood sugars will go up quickly but may come down more rapidly. If you've had a meal that's high in protein or fat, it may stay up longer but it tends to rise more slowly. PPBS is an important measure of cardiac function as most diabetic patients have or will have diabetic angiopathy and diabetic neuropathy, which has a definite role in coronary artery disease.

When we ask patients to check their blood sugars after they've eaten, we typically will request they check at the two-hour mark, because that's the most consistent time, given the variability of what kind of food they've eaten. We also know that any blood glucose over 180 (mg/dL) at two hours after you've eaten is certainly worrisome, and in fact, the American Diabetes Association goal for your two-hour reading after your meal is less than 180 (mg/dL).

The reason this is important is because that is the first thing that we lose when you become diabetic -- that is, the inability for the pancreas to make enough insulin to cover the food.

SGOT (AST)

An aspartate aminotransferase (AST, also known as SGOT - serum glutamic oxaloacetic transaminase) measures the amount of this enzyme in the blood. AST is normally found in red blood cells, liver, heart, muscle tissue, pancreas, and kidneys.

Low levels of AST are normally found in the blood. When body tissue or an organ such as the heart or liver is diseased or damaged, additional AST is released into the bloodstream. The amount of AST in the blood is directly related to the extent of the tissue damage. After severe damage, AST levels rise in 6 to 10 hours and remain high for about 4 days.

The AST test may be done at the same time as a test for alanine aminotransferase, or ALT. The ratio of AST to ALT sometimes can help determine whether the liver or another organ has been damaged. Both ALT and AST levels can test for liver damage.

Why It Is Done
An aspartate aminotransferase (AST) test is done to:

  • Check for liver damage
  • Help identify liver disease, especially hepatitis and cirrhosis. Liver disease may produce symptoms such as pain in the upper abdomen, nausea, vomiting, and sometimes jaundice
  • Check on the success of treatment for liver disease
  • Find out whether jaundice was caused by a blood disorder or liver disease
  • Keep track of the effects of cholesterol-lowering medicines and other medicines that can damage the liver

SGPT (ALT)

An alanine aminotransferase (ALT, also known as SGPT - serum glutamic pyruvic transaminase) test measures the amount of this enzyme in the blood. ALT is found mainly in the liver, but also in smaller amounts in the kidneys camera, heart camera, muscles, and pancreas camera.

ALT is measured to see if the liver is damaged or diseased. Low levels of ALT are normally found in the blood. But when the liver is damaged or diseased, it releases ALT into the bloodstream, which makes ALT levels go up. Most increases in ALT levels are caused by liver damage.

The ALT test is often done along with other tests that check for liver damage, including aspartate aminotransferase (AST), alkaline phosphatase, lactate dehydrogenase (LDH), and bilirubin. Both ALT and AST levels are reliable tests for liver damage.

Why It Is Done
The alanine aminotransferase (ALT) test is done to:

  • Identify liver disease, especially cirrhosis and hepatitis caused by alcohol, drugs, or viruses
  • Help check for liver damage
  • Find out whether jaundice was caused by a blood disorder or liver disease
  • Keep track of the effects of cholesterol-lowering medicines and other medicines that can damage the liver

Urea, Creatinine

This blood test checks if the kidneys are working properly by measuring the levels of urea & creatinine.

Urea is a waste product formed from the breakdown of proteins. Urea is usually passed out in the urine. A high blood level of urea ('uraemia') indicates that the kidneys may not be working properly, or that you are dehydrated (have a low body water content).

Creatinine is a waste product made by the muscles. Creatinine passes into the bloodstream, and is usually passed out in urine. A high blood level of creatinine indicates that the kidneys may not be working properly. Creatinine is usually a more accurate marker of kidney function than urea.

Blood Pressure

Blood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood to the body and it contributes to hardening of the arteries or atherosclerosis and the development of heart failure.

What Is "Normal" Blood Pressure?
There are several categories of blood pressure, including:

Normal: Less than 120/80
Prehypertension: 120-139/80-89
Stage 1 high blood pressure: 140-159/90-99
Stage 2 high blood pressure: 160 and above/100 and above

People whose blood pressure is above the normal range should consult their doctor about methods for lowering it.

ECG (EKG)

An electrocardiogram (also called EKG or ECG) is a test that records the electrical activity of your heart through small electrode patches attached to the skin of your chest, arms, and legs. An EKG may be part of a routine physical exam or it may be used as a test for heart disease. An EKG can be used to further investigate symptoms related to heart problems.

EKGs are quick, safe, painless, and inexpensive tests that are routinely performed if a heart condition is suspected. EKGs are quick, safe, and painless tests that are routinely performed if a heart condition is suspected.

Your doctor uses the EKG to:

Assess your heart rhythm
Diagnose poor blood flow to the heart muscle (ischemia)
Diagnose a heart attack
Evaluate certain abnormalities of your heart, such as an enlarged heart

Treadmill Test (TMT)

Patients with coronary artery blockages may have minimal symptoms and an unremarkable or unchanged EKG while at rest. However, symptoms and signs of heart disease may become unmasked by exposing the heart to the stress of exercise. During exercise, healthy coronary arteries dilate (develop a more open channel) than an artery that has a blockage. This unequal dilation causes more blood to be delivered to heart muscle supplied by the normal artery. In contrast, narrowed arteries end up supplying reduced flow to it's area of distribution. This reduced flow causes the involved muscle to "starve" during exercise. The "starvation" may produce symptoms (like chest discomfort or inappropriate shortness of breath), and the EKG may produce characteristic abnormalities. Most commonly, a motorized treadmill is used for exercise, while a stationary bicycle is used in some exercise laboratories. To cater for reliable and accurate results, Hridaya Care Heart Institute employs a state-of-art fully automated TMT system.

Pulmonary Function Test (PFT)

Pulmonary function tests are a group of tests that measure how well the lungs take in and release air and how well they move gases such as oxygen from the atmosphere into the body's circulation.

Pulmonary function tests are done to:

  •     Diagnose certain types of lung disease (such as asthma, bronchitis, and emphysema)
  •     Find the cause of shortness of breath
  •     Measure whether exposure to chemicals at work affects lung function
  •     Check lung function before someone has surgery
  •     Assess the effect of medication
  •     Measure progress in disease treatment

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