Any and all cardiovascular diseases (coronary artery disease, hypertension, heart failure, heart valve diseases, cardiac rhythm disorders) are diagnosed and treated in the light of up-to-date guidelines at the cardiology outpatient clinic, while our cardiology team (cardiologist, internist and dietician) offers a multidisciplinary approach for risk factors that threat health of the heart (obesity, hypertension, hyperlipidemia, diabetes and smoking).
ELECTROCARDIOGRAPHY (ECG)
It implies recording electrical activity of the heart with electrodes placed on the skin of the chest wall. It may be safely used for everybody. It has a vital importance for diagnosis of myocardial infarction, while it plays a major role in the evaluation of past myocardial infarction, diagnosis and follow-up of rhythm and conduction disorders, diagnosis and follow-up of heart failure and assessment of myocardial and valvular dysfunctions.
ECHOCARDIOGRAPHY (ECHO, Cardiac Ultrasound)
Color Doppler Echocardiography, Stress Echocardiography and Contrast Echocardiography tests are available in our clinic.
Echocardiography uses sound waves (ultrasound) to evaluate structure and performance of the heart. It is a pain-free procedure that can be safely used in pregnant women and lactating mothers, as no drug is used, no invasive procedure is performed and the test does not cause radiation exposure. The patient is placed on a patient bed; a sterile gel is poured on the skin of the anterior chest wall and images are acquired using a probe. Detailed measurements and calculations are made over the images. Thus, detailed information is obtained about the structure of the heart (dimensions of cardiac chambers and the great arteries, such as aorta, structure and functions of heart valves, operating mechanics of the heart, structure of the pericardium, intracardiac masses, clots, heart tumors, heart holes and other congenital heart abnormalities) and thus, numerous diseases can be diagnosed and followed up.
STRESS (EXERCISE) ECHOCARDIOGRAPHY
Stress echocardiography is a type of echocardiography characterized by the use of exercise methods or medicines that accelerate heart beats. Stress echocardiography uses exercise methods during the test. In exercise echocardiography, echocardiographic images are acquired immediately before and after the treadmill exercise protocol; those images are compared to evaluate functions of the heart.
Stress echocardiography is primarily used to detect occlusion and severity of coronary arteries in patients with chest pain and differentiation of angina from other factors that lead to pain. Most valuable fields of use include inadequacy of the stress test alone in the evaluation of the vascular occlusion, presence of pacemaker in the patient, left branch block and certain special findings (pre-excitation) in ECG and hypertrophy of the left ventricle. Stress echocardiography is safely performed, after the patient is informed in detail before the test.
CONTRAST ECHOCARDIPGRAPHY
In contrast echocardiography, a contrast agent is infused via an intravenous line inserted into a vein of the arm before the procedure while images of the heart are acquired with echocardiography. The primary intended use involves detection of congenital heart diseases (holes such as ASD, VSD and PFO) and intracardiac right-to-left communication (shunts). Its diagnostic value is high particularly in detection of heart holes. Moreover, the contrast agent offers better evaluation of myocardial movement disorders and intracardiac masses by visualizing margins of the myocardium more remarkably. Since saline or patient’s own blood is used as a contrast agent, it can be safely used even in patients with contrast agent allergy.
EXERCISE TEST (Treadmill Test)
In an exercise test, the patient walks and runs in a treadmill to increase the cardiac load, while ECG traces and blood pressure alterations are continuously monitored and recorded at certain intervals. Thus, the heart is forced to limits and its reaction to the exercise is evaluated. It has a very valuable position for conditions that cannot be seen in tests carried out at rest.
Exercise test may help diagnosis of the coronary artery disease (occlusion or stenosis in arteries that feed the heart) or it may be used to modify and adjust treatment in patients with documented coronary artery disease. In addition, stress test can be done to determine the exercise capacity, blood pressure response to the exercise, rhythm and conduction disorders provoked by exercise and underlying causes of syncope.
BLOOD PRESSURE HOLTER MONITORING
This device allows physicians measure the blood pressure for 24 hours and record the readings at particular intervals. It may be safely used for everybody. It consists of a cuff and a recorder device. The data is saved to a computer to analyze numerous measurements and get detailed information about the daily course of the blood pressure. Blood pressure Holter monitoring is performed for objective diagnosis of hypertension, detecting underlying causes of secondary hypertension by assessing daily variability of the blood pressure and reviewing efficacy of the medication treatment.
RHYTHM HOLTER
Electrical activity of the heart is recorded for at least 24 hours with electrodes attached to relevant body parts. It may be safely used for everybody. The 24-hour data recorded by a rhythm holter device (mean 100.000 beats) are saved in a computer and analyzed by the physician. It is primarily used to detect cardiac rhythm disorders and review patients regarding treatment of the condition and implantation of pacemaker. It is also used to detect daily average heart rate to guide treatment of other heart diseases and to evaluate the coronary artery disease.