Last updated date: 30-Mar-2023
Originally Written in English
Cardiologists can diagnose cardiac problems using non-invasive procedures that don't involve injecting needles, liquids, or other tools into your body. The cornerstone of reasonable therapy, which will reduce morbidity and mortality, is accurate diagnostic assessment. A non-invasive evaluation may be recommended for patients with a history of heart disease, suspected valve dysfunction, or chest pain with no identified reason by their doctor.
The absence of scars and post-operative recovery is a benefit of non-invasive cardiology. Additionally, primary angioplasty, a non-invasive cardiology technique, is currently the gold standard of management for acute myocardial infarction.
Non-Invasive Cardiology Procedures
The following non-invasive diagnostic tests are prescribed by a doctor and carried out for inpatients at the hospital or as outpatient testing in a center of cardiology:
- Electrocardiogram (ECG)
- Holter monitor (24hr-Holter monitoring)
- 30-Day event monitor
- Echocardiography (with its different types)
- Stress Tests (including stress ECG and stress echocardiography)
An electrocardiogram (ECG) is a test that analyzes the electrical activity of the heart to determine how well it is working. Your heart sends an electrical impulse (or wave) with each heartbeat. The muscle contracts and pumps blood from the heart as a result of this wave. A heart's electrical activity can be measured and recorded using an ECG. If this electrical activity is regular or irregular, a doctor can determine it. If you have arrhythmia, chest pain, or palpitations, an ECG may be advised. An abnormal ECG result may indicate several various heart diseases.
ECG is used for the following purposes:
- To identify cardiac rhythm abnormalities that might have contributed to blood clot formation.
- Detect signs of heart disease, such as a recent or continuing heart attack, irregular heartbeats (arrhythmias), coronary artery blockages, areas of heart muscle damage (from a previous heart attack), enlargement of the heart, and inflammation of the sac around the heart (pericarditis).
- Identify non-heart issues like lung illnesses and electrolyte abnormalities.
- Monitor the effectiveness of specific heart drugs or a pacemaker, the recovery from a heart attack, the development of heart disease, or other conditions.
- Check for hidden cardiac problems in patients getting ready for surgery.
- Since an ECG is non-invasive, the body is not injected with anything during the technique.
- There are normally 12 to 15 electrodes attached to several parts of your body, including your arm, leg, and chest.
- Small suction cups or sticky patches are used to hold the electrodes in place.
- The pads have sensors that can pick up your heart's electrical activity.
- Typically, the exam is conducted while you lie still.
- The majority of the time, results are written down on graph paper and then interpreted or reviewed by a specialist or your doctor.
- It normally takes the test 5 to 10 minutes.
The Holter monitor is an example of a portable electrocardiogram (ECG). While you are away from the doctor's office, it constantly monitors the heart's electrical activity for 24 hours or longer. One of the simplest and quickest tests used to check the heart is a standard or resting ECG. At specific locations on the chest and belly, electrodes (small plastic patches that adhere to the skin) are applied. Wires link the electrodes to the ECG device. The heart's electrical impulses can then be monitored, recorded, and printed. The body receives no electric power.
The different heart muscle contractions are coordinated by natural electrical impulses. As a result, blood continues to circulate normally. These electrical impulses are recorded by an ECG to display the heart rate, the regularity or irregularity of the heartbeats, and the strength and timing of the electrical impulses. ECG abnormalities can indicate a variety of heart-related diseases.
Holter Monitor Indications
If your electrocardiogram (ECG), a kind of heart test, is inconclusive, you could require a Holter monitor. An inconclusive ECG indicates that there were no conclusive findings.
Perhaps the reason you visited the doctor was due to symptoms of a cardiac rhythm disorder, such as racing or fluttering heartbeats. Or you experienced unexplained fainting.
To identify the issue, your clinician chose to perform an ECG. However, the ECG only quickly records your heartbeat. Not always do you experience heart symptoms when you're in the doctor's office.
A Holter monitor can be useful if the ECG is unable to offer all the information your doctor needs. More details on the activities of your heart are obtained. Wearing it for a full day or two gives it additional opportunities to be seen.
Holter Monitor Application
You are given instructions and are connected to the cardiac monitor by a technician. Here's what to anticipate:
- Attach the electrodes. The technician fixes the electrodes to your chest after attaching them. Small, rounded, sticky patches make up the electrodes. To ensure that the electrodes stay in place, they might need to remove your chest hair.
- Place the monitor. The technician assists you with placing the monitor and connecting it to the electrodes. They describe how to manage the monitor.
- Store the monitor. The cardiac monitor can be kept in a pocket or bag for transport. Or you might strap it to your body like a purse. It may also be worn around your waist.
- Go about your day. You can carry out the majority of your daily tasks while wearing the monitor.
- Keep a log of your activities and symptoms. Your technician will show you how to do this. Record symptoms include chest pain, irregular or skipped heartbeats, and shortness of breath. Note the symptoms' onset time and your current activities. Your doctor will evaluate your ECG changes with your symptoms and activity.
When you experience symptoms, a portable gadget called an event monitor is utilized to collect the electrical activity of your heart. For extended periods, it records the same data as an electrocardiogram (ECG). The majority of these gadgets may send the data they record immediately to your healthcare provider. This enables him or her to examine your heart's electrical activity while you are experiencing symptoms.
The electrical signal that starts your heartbeat is often started by a particular set of cells. In the sinoatrial (SA) node are these cells. The right atrium, the heart's upper right chamber, houses this node. The two lowest chambers of the heart, the ventricles, receive the signal immediately as it travels down the conducting system of the heart. The signal causes the adjacent areas of the heart to contract as it passes. This promotes synchronized cardiac contraction.
This electrical communication through the heart is analyzed using ECGs and event monitors. The diagnosis of several aberrant heart rhythms and medical disorders is greatly aided by these tests. Standard ECGs are not portable and only record the heart signal for a brief period.
Event Monitor Indications
Even though your ECG appears normal, a doctor may occasionally believe that you have an irregular heart rhythm based on your health information. Unusual cardiac rhythms can occasionally and briefly occur. If this is the case, a random ECG is unlikely to detect your irregular cardiac rhythm. A better choice for you might be an event monitor. In this method, you can monitor your heart's electrical activity whenever an irregular cardiac rhythm causes symptoms. If you wear the event monitor, it can help identify any irregular cardiac rhythms you may have. The type of aberrant rhythm you do have can be determined using the event monitor.
If your heartbeat is excessively fast, abnormally slow, or irregular, you might need to wear an event monitor. Your event monitor may be used to assess how effectively an abnormal heart rhythm treatment is going if one is already being given to you. For example, palpitations, you might need an event monitor to assess some types of transient symptoms. Your heart can seem to be pounding too quickly or skipping a beat. Other symptoms like fainting and dizziness could indicate that you require an event monitor.
Event Monitor Application
- The Event monitor will be installed by a qualified technician who will also show you how to record your symptoms while using it.
- The electrodes are first attached to your chest by the technician. To firmly place the electrodes, they can shave some hair off your chest if it is hairy.
- The technician assists you in putting the event monitor on and goes over how to take care of it after the electrodes are in place. The monitor can be hidden in a pocket or pouch, worn around your neck and shoulders like a handbag or camera, or linked to your waist.
- Wear the monitor when engaging in your normal activities, with the following exceptions: While wearing the monitor, avoid taking a bath, shower, or swimming. And avoid regions with high voltage, metal detectors, and strong magnets.
- You will hear from the technician how to keep a log of your activities and symptoms throughout the test. Maintaining an accurate diary is crucial. Write down the time of day they started and what you were doing in your diary if you experience symptoms like chest discomfort, shortness of breath, irregular heartbeats, or dizziness. The variations in your ECG obtained by the Event monitor will be matched to the notes in your diary.
The heart and adjacent blood vessels can be seen during echocardiography, sometimes known as an echo. It is a form of ultrasonic scan, which uses a small probe to transmit high-frequency sound waves that, when they reverberate off various body organs, produce echoes. While the scan is being done, the probe picks up these echoes and converts them into a moving image on a monitor.
Any doctor, including your primary care physician, who suspects you may have a heart condition may request echocardiography, whether they are a heart expert (cardiologist) or not. A cardiologist, cardiac physiologist, or highly skilled sonographer will often perform the test at a hospital or clinic. An electrocardiogram (ECG), a test used to examine the rhythm and electrical activity of your heart, is different from echocardiography despite having a similar name.
Depending on the probable heart condition doctors need to check, you may have a different type of echocardiography. They provide a complete line of echo testing:
- Transthoracic echocardiography (TTE). The most popular and least invasive type of echocardiography, transthoracic echocardiography is performed entirely outside of the body. A team member puts gel on your chest before scanning your heart with a handheld transducer.
- Intracardiac echocardiography (ICE). Imaging of your heart inside is obtained during intracardiac echocardiography, a more recent type of testing. This method is mostly used to monitor therapies that involve inserting catheters (thin, flexible tubes) into your arteries.
- Stress echocardiography. As part of a thorough stress test that purposefully raises your heart rate and blood pressure, doctors might need to do echocardiography. Two sets of photos are taken: one at rest and the other after using a stationary bike or treadmill to exercise. If your health precludes you from engaging in such physical activity, doctors will inject a drug that has an effect similar to exercise. Pharmacologic stress echocardiography is the name of this test.
- Transesophageal echocardiography (TEE). In some cases, anesthesia is used to help a unique ultrasound probe enter your mouth and travel down your esophagus. Because the esophagus and heart are close together and the sound waves do not need to travel through skin, muscle, or bone, doctors can take good images. For some cases, TEE is a superior option. They might also require a clearer view of a particular area of the heart. Additionally, pulmonary disease and obesity can interact with TEE.
By examining the heart's structure and that of the blood vessels around it, determining how blood flows through them, and evaluating the heart's pumping chambers, echocardiography can aid in the diagnosis and monitoring of some cardiac diseases. Echocardiography can assist in spotting:
- Damage caused by a heart attack, where the heart's blood flow was unexpectedly stopped.
- Heart failure occurs when the heart is unable to circulate enough blood at the proper pressure throughout the body.
- Congenital heart disease. birth abnormalities that interfere with the heart's natural function
- Issues with the heart valves, which are the valves that regulate the flow of blood through the heart.
- cardiomyopathy, a condition in which the heart's walls thicken or grow.
- An infection of the heart's lining known as endocarditis can affect the heart valves.
Your doctors can determine the best course of treatment for these diseases with the use of echocardiography.
You can get echocardiography as an outpatient procedure or as part of a hospital stay. Depending on your situation and your doctor's practice, the procedures may vary. Echocardiography typically happens through this process:
- Any jewelry or other things that can restrict the procedure will need to be removed. You might have hearing aids, dentures, or spectacles on.
- After being instructed to take off your clothes, you'll be handed a gown to wear.
- On the left side of a bed or table, you will be lying down. For support, lay a pillow or wedge behind your back.
- Your heart will be monitored during the process using tiny, sticky electrodes connected to an ECG monitor, which will record the electrical activity of your heart. The images shown on the echocardiography monitor will be compared with the ECG tracings, which document the electrical activity of the heart.
- The lights will be turned off so the technologist can see the images on the echo monitor.
- The technician will apply warmed gel to the patient's chest before placing the transducer probe there. As the technologist places the transducer to obtain the required image of the heart, you may feel a tiny pressure.
- The technician will move the transducer probe during the examination and apply variable pressures to capture images of various cardiac regions and structures. There shouldn't be any discomfort from the pressure behind the probe. If something changes, you must inform the technician.
You walk on a treadmill that forces your heart to work harder and harder during a stress test. The electrical beats of your heart are recorded using an electrocardiogram (ECG). Additionally, the doctor checks your blood pressure and keeps an eye out for symptoms like fatigue or soreness in the chest. A sign of coronary artery disease (CAD) could include abnormalities in blood pressure, heart rate, ECG, or worsening clinical symptoms. CAD is caused by fatty deposits (plaques) that limit the flow of oxygen-rich blood to the heart muscle.
Stress ECG Indications
A stress test, also known as a treadmill stress test or an exercise test, is used to determine how well your heart responds to stress. However, unlike stress echocardiography, a stress test just evaluates your ECG during the test. Stress ECG has its indications and uses, but it has lower sensitivity, specificity, and predictive value than Stress Echo for assessing ischemic heart disease (any stenosis of your coronary arteries).
The heart must pump more blood during exercise because as your body works harder, it needs more oxygen. Your heart muscle will receive less oxygen if any arteries supplying it with blood are blocked, and your ECG may change as a result. This denotes a positive result from the test. This test can identify any arrhythmia that can be present and caused by exercise.
Your doctor may order a stress ECG for additional reasons, such as determining your fitness to drive, participating in a gym or a particular exercise regimen, or determining your risk of suffering a heart attack or having heart surgery. This test is performed for a variety of reasons.
Stress ECG Procedure
Electrodes are positioned on the patient's chest and connected to an electrocardiography (ECG) machine, which records the electrical activity of the heart, to carry out an ECG Stress Test, also known as exercise treadmill testing.
The patient works out by first moving slowly and then moving faster and uphill on a stationary bicycle or a treadmill. During the test, which usually comprises 10-15 minutes of exercise, blood pressure readings are taken. A medicine that causes the heart to beat rapidly, as it does during activity, may be injected into patients who are unable to exercise (called a pharmacological stress test).
The ECG collects the electrical signals that travel through each area of the heart during rest and exercise, as well as their strength and timing. A stress perfusion study, an echo stress test, and/or coronary angiography may be necessary for patients who undergo additional stress testing after experiencing an abnormal exercise stress test.
Non-Invasive Cardiology Salary
Non-Invasive Cardiologists make an average income of $165,000 in the US, with incomes ranging from $34,300 to $777,000. The middle 58% of Non-invasive cardiologists make an average salary of $164,980 to $368,940, with the top 87% earning $777,000.
For optimal results, prompt diagnosis and appropriate treatment are essential. You can rapidly examine, identify, and treat your cardiac patients with the use of complete, highly advanced, and non-invasive diagnostic imaging methods.