Text/Lin Kun
Electrocardiogram will be included in the company's health examination items, and most people always think that ECG examination is ok, indicating that the heart is healthy. Is it true?/You don't say.
Jiang Guangxing, an attending physician in the Department of Cardiology, Affiliated Hospital of Taipei Medical College, said that the electrocardiogram (ECG) during physical examination often refers to the so-called "static electrocardiogram". This is an instant and short-term exam, and its results reflect the situation at the time of the exam. Therefore, if it is a paroxysmal heart disease or the severity of the disease is good or bad, it may not be revealed during the examination.
Electrocardiogram (ECG) examination mostly reflects symptoms, and it is often impossible to diagnose coronary heart disease, heart failure and arrhythmia by this examination alone. Therefore, although ECG has a certain reference and judgment function, it is also a good tool for screening heart diseases, but it cannot be used as the diagnostic basis of 100%.
A better method is to make a comprehensive and objective judgment according to the patient's own health status, combined with ECG and blood tests, so as to find out the crux rather than relying solely on ECG.
Jiang Guangxing said that we are most concerned about whether the patient has uncomfortable symptoms and special medical history. It is best to make a comprehensive judgment based on everyone's health background and ECG examination, so as to identify the possibility of heart disease. For example, using blood tests, we can further understand whether we have three so-called three high problems: hypertension, hyperlipidemia and diabetes, which can be used as a basis to distinguish the risk of cardiovascular disease. Or cooperate with the detection of myocardial enzymes as a reference to judge whether there is an acute heart attack.
What is an electrocardiogram?
Electrocardiogram mainly looks at the electrical signals transmitted by the heart. From the examination results, we can observe the changes of heartbeat and infer the changes of heart structure and function.
1. Heartbeat problem: including heart rate (whether the heartbeat is regular) and heart rate (whether the heartbeat is fast). From the electrocardiogram, we can see whether the heartbeat is regular and whether there is a special beating pattern. These changes reflect problems such as conduction disorder or failure to follow the normal path.
2. Reflect structural and functional problems: for example, common cardiac hypoxia, that is, different discharge patterns after cardiac tissue changes, and abnormal waveforms will be found from ECG. In addition, some other organ system problems, such as lung and metabolic diseases, may also be reflected in the changes of ECG.
When the ECG is abnormal, it indicates that the heart function is abnormal, which can be used to detect heart diseases, such as atrial or ventricular hypertrophy, coronary artery insufficiency, electrolyte metabolism imbalance and so on. However, some symptoms of heart disease (such as angina pectoris) only appear when the physical burden or * * * increases, which is difficult to explain.
Do high-order electrocardiogram if necessary.
Because ECG is an examination that shows the physical condition at that time and is in a calm state, there are still many problems that cannot be detected according to it. For example, patients with coronary heart disease may have normal ECG at rest, but they will show asymptomatic coronary artery lesions due to increased oxygen demand during exercise, so it is necessary to arrange another time to do higher-order ECG such as exercise ECG or 24-hour ECG.
◎ Exercise ECG: It has characteristics that ECG does not have, because the human body will have different reactions when it is active or stressed. Exercise ECG can evaluate the exercise tolerance of patients and the changes of ECG, heart rate and blood pressure during exercise, so as to know whether there is myocardial hypoxia or arrhythmia. During the examination, you should record the complete electrocardiogram and blood pressure on the running track, and then start exercising. Exercise should be gradually increased according to the standard exercise ECG process, and blood pressure and heart rate should be recorded.
◎ 24-hour ECG or long-time recorder: extending the examination time and evaluating the heart rate and rhythm of patients during the period of general daily activities, rest and sleep can not only establish a longer record, but also increase the probability of finding problems. During the examination, the examinee must wear a small instrument which is powered by battery and can record ECG signals. The medical examiner will ask the patient to record any particularly uncomfortable symptoms (such as headache, chest pain, nausea, asthma or dizziness). ) and what activities he was engaged in at that time. During the process, attention should be paid to avoid water contact with the instrument, and it is forbidden to take a bath, get wet in the rain or swim, so as to reduce strenuous exercise, so as not to sweat a lot and make the pipes attached to him fall off. After the end, the doctor will analyze the records with a computer to understand the heart rate and rhythm.
High-risk groups do imaging examination.
If you want to know more about your heart health, you can arrange a high-level examination. For example, some high-risk people who want to know the heart condition in advance will consider doing similar examinations, such as echocardiography in imaging examination, which can evaluate the structure and function of the heart, understand the size and contraction of the heart, and judge the activity of the heart valve.
Compared with other examinations, image examination is relatively safe, and there is no need for invasive examination with the help of equipment. In addition, it also includes nuclear magnetic resonance, tomography and other examinations, which are also high-level examinations. Tomography and magnetic resonance imaging can observe the finer structures of the heart (including blood vessels, etc. ) and judge whether there is a problem with its function, but the inspection cost is relatively high.
Ultrasonic cardiography
As long as the patient lies on the left side of the bed and remains calm, the inspector will place the ultrasonic probe on the chest and upper abdomen for inspection for about 15 minutes. The ultrasonic probe emits high-frequency ultrasonic waves and records dynamic images composed of reflected waves generated by the heart and vascular structures. However, the clarity of the image may be affected by the examination conditions, such as the posture, figure and breathing condition of the subject.
Including auscultation of heart murmur, shortness of breath or tachycardia, unexplained heart failure due to respiratory problems, arrhythmia with obvious conscious symptoms or enlarged heart, unexplained chest pain or angina pectoris, myocarditis or cardiomyopathy, etc. , are indications for echocardiography. These patients had better be examined by echocardiography.
nuclear magnetic resonance
It can be used to observe the structure of the heart, including heart valves and coronary arteries, and can also be used to find heart or lung problems.
Computed tomography
It is an important clinical examination instrument. It cuts the body structure into many small pieces through the image, and then analyzes whether there is any abnormality in the tissue structure by computer recombination technology. The finer the segmentation, the more accurate the examination results will be. There is no need to be hospitalized during the examination. You don't need anesthesia, and you can take pictures synchronously with your heartbeat by injecting contrast agent into peripheral veins. The examination time is only 10 minute, which can understand the degree of stenosis and calcification of cardiac blood vessels and predict the probability of coronary heart disease and the degree of coronary artery stenosis in advance.
Don't ignore heart disease because you are young.
Every exam has its own meaning and function. Different examinations can provide different information and make the most accurate diagnosis. If people want to know the extent of their heart condition, they should look at their own ideas, discuss with doctors and listen to their suggestions.
However, high-risk groups need to know about heart health earlier than the average person. High-risk group refers to people who have symptoms of heart discomfort and cardiovascular problems (including stroke and renal failure). ) and must follow up; Those who are not sick or have no obvious symptoms should be evaluated according to their personal health background; Others include people with "three highs" problems, the elderly, people with poor family constitution and living habits (such as people with smoking habits). As long as the more items meet, the higher the risk of heart disease, and the need for early examination to understand their own situation. As for how long to follow up regularly, suggestions should be given according to personal circumstances.