Newer diagnostic tests for a broken heart
Ah, February, and love is in the air.
No? Not for you? Well, even if you don’t have someone to share Valentine’s Day with this year, guess what? You still have a heart. And since I assume you’re not an octopus (they get three hearts), you have to take care of the one you have.
The heart is an amazing gift. Every day, though it’s a muscle no bigger than your first, it beats about 100,000 times, sending 2,000 gallons of blood through the 60,000 miles of blood vessels that feed your organs and tissues.
As durable is the heart is, things can go wrong with it, from leaky valves to weakness to heart attack. Our ability to find out what’s going on with a “broken” heart has come a very long way since the advent of the stethoscope.
Some cardiac tests have been around for decades. Willem Einthoven, a Dutch doctor, invented the first practical electrocardiograph (EKG or ECG) in 1895 and received the Nobel Prize for it in 1924. Cardiac catheterization was introduced in the early 1940s, echocardiography in the 1950s, and selective coronary angiography in the 1960s.
These tools are still in use — it’s not uncommon these days to have an ECG in your doctor’s office — but technological advances continue to refine heart diagnostics. Here are a few of the newer heart tests you may encounter if you’re being evaluated for a heart issue.
Cardiac magnetic resonance imaging (cMRI)
Chances are you’ve had an MRI on something, such as a sore shoulder or torn ACL. This medical imaging technique uses a magnetic field and computer-generated radio waves to create detailed pictures of organs and bodily structures.
A cardiac MRI does the same for the heart. It’s a noninvasive test that can be used to measure heart function, look at how blood flows through vessels and evaluate how much blood the left ventricle is pumping out to the body. It doesn’t require contrast dye or exposure to radiation, as CT scan would.
A cardiac MRI can help diagnose many different heart conditions, such as tissue damage from a heart attack, arterial blockages, problems with the aorta or heart inflammation. It usually takes 30 to 45 minutes, and only requires the patient to hold their breath for short periods. It takes place in an MRI “tube,” something that causes some folks to experience a bit of claustrophobia.
Stress echocardiogram (stress echo)
The stress echocardiogram has been around for a few decades, but it has evolved into a very useful diagnostic tool.
An echocardiogram, or echo, uses sound waves (ultrasound) to produce moving images of your heart. These images allow your provider to see the shape, size and of your heart and valves. In a stress echo, you may be exercising on a treadmill or stationary bike, or the stress may be induced with drugs.
Some of the conditions it can diagnose are:
• Cardiomyopathy, or difficulties with the heart pumping blood
• Congenital heart disease
• Heart failure
• Heart valve disease
• Pulmonary hypertension
It can also detect that the heart isn’t getting enough blood flow because of an arterial blockage, but it won’t detect the site of the blockages.
A stress echo lasts 45 to 90 minutes or so and, like the cMRI, it doesn’t require radiation or contrast dye.
Artificial intelligence in cardiology
Artificial intelligence (AI) isn’t so much a diagnostic test as it is a helping hand, and its presence is being felt in cardiology.
AI is the ability to make computers learn to solve problems by feeding it huge, complex data sets. The desired outcome is that decision-making, diagnosis and treatment can move ahead more quickly than if humans had to digest all of that information.
The Mayo Clinic is one place where AI tools are being applied in clinical practice to help people who have heart disease, or are at risk. “The clinic's AI cardiology team is applying these new approaches to early risk prediction and diagnosis of serious or complex heart problems,” according to the Mayo Clinic’s website.
Heart disease has been the leading cause of death in the U.S. 1950. We can all reduce our risk by controlling our blood pressure, not smoking, managing cholesterol, eating better and moving more.
Still, it’s good to know that technological advancements are improving the diagnosis of heart problems — even as we hope we never need them. If your doctor recommends certain tests, and you’re confused about what they are or what they do, take heart! A patient advocate can help guide you through the maze.
• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is available on Amazon. She is offering a free phone consultation to Daily Herald readers; call her at (312) 788-2640 or email teri@northshorern.com.