26.01.2017 10:11:01

Diseases of the cardiovascular system in medical practice are the most complex and dangerous, which most often lead to death, regardless of the patient’s age.

Over the past quarter century in Ukraine, mortality as a result of these diseases has doubled, which cannot but cause serious concern.

That is why it is necessary to constantly monitor the condition of your cardiovascular system and undergo preventive examinations with a cardiologist, especially if there are certain prerequisites for the occurrence of pathologies, for example, heredity, overwork, heavy physical activity, etc.

One of the main symptoms of heart disease is the appearance of pain in the heart area, which can have different strengths and directions depending on the heart disease and its severity.

The second characteristic sign of heart disease is shortness of breath, which occurs from circulatory failure.

The third sign of problems in the functioning of the heart is a rapid heartbeat, as well as interruptions in the functioning of the heart.

All of the above symptoms are signals to contact a cardiologist, who, in order to make an accurate diagnosis, will necessarily send the patient for additional examination, which includes certain tests.

What tests are done for heart disease?

It is also worth considering that many pathological processes in the cardiovascular system are asymptomatic. Therefore, even if you are not bothered by pain in the heart, shortness of breath, rapid heartbeat or arrhythmia, periodic visits to a cardiologist should be included in the list of mandatory preventive measures that will help maintain your health for many years.

As with any diseases of various organs and systems, timely diagnosis and competently prescribed effective treatment of heart disease will help not only cure certain diseases, but also prevent serious complications, improve the quality of life, prolong it and even save it.

For diseases of the heart and blood vessels, a comprehensive analysis is prescribed - a cardiac profile.

Cardiological profile: why is it needed?

Cardiological profile is a set of special blood tests that allows you to:

Assess risk factors for the development of heart and vascular diseases;

Identify early and hidden lesions of the cardiovascular system;

Identify the risk of developing atherosclerosis, coronary heart disease and heart failure;

Assess the likelihood of myocardial infarction.

Cardiological profile: indications

Indications for prescribing a set of cardiological tests are:

Vascular atherosclerosis;

Coronary heart disease;

High blood pressure;

Heart rhythm disturbances, including:

Stroke;

Arrhythmia;

Heart attack;

Tachycardia.

What tests are included in the cardiac profile?

- Troponin quantitative;

Potassium (K);

Lipidogram;

Coagulogram;

AST (AST, aspartate aminotransferase);

Creatine kinase (creatine phosphokinase, CK, CPK);

Lactate dehydrogenase (LDH).

What do cardiac profile indicators mean?

• Troponin can diagnose myocardial infarction. Troponin is a special protein found only inside cardiac muscle cells (cardiomyocytes); it is practically undetectable in the blood under normal conditions. However, if cardiomyocytes begin to die and collapse, and most often this happens due to the development of myocardial infarction, then troponin begins to penetrate into the general bloodstream, as a result of which its concentration in the blood increases hundreds and sometimes thousands of times. This feature has become a key factor allowing early or late diagnosis of myocardial infarction.

• NT-proBNP- brain natriuretic hormone is a protein produced in the left ventricle of the heart. Plays an important role in the diagnosis of heart failure. Blood test to D-dimer indispensable when examining patients for various thrombotic disorders. D-dimer is a small protein fragment that is formed as a result of the breakdown of fibrin (fibrin is a blood plasma protein. Fibrin serves as the structural basis of a blood clot - ed.). Elevated levels of D-dimer in the blood indicate the human body's tendency to form blood clots or other clotting problems.

• Potassium(K) is an important trace element in the human body. It takes part in the act of muscle contraction, normal heart activity, conduction of impulses along nerve fibers, metabolism and enzyme activity. Potassium deficiency leads to disruption of the cardiovascular system and can cause muscle weakness. Long-term potassium deficiency can cause cardiac arrest. Large doses of potassium cause cardiac paralysis.

• INR- this is an indicator purely for assessing the effectiveness and correctness of treatment with anticoagulants ( medications that reduce the activity of the blood coagulation system and prevent excessive formation of blood clots - ed.). Patients who are forced to constantly take blood thinners are required to monitor their blood clotting abilities. This is necessary not only to assess the effectiveness of treatment, but also allows you to select an adequate dose of funds. In the same way, a person can be protected from an overdose of anticoagulants, preventing the development of corresponding complications against this background. One of the modern methods of such control is INR (international normalized ratio).

• Lipidogram(lipid profile) helps diagnose atherosclerosis and coronary heart disease.

• With the help coagulograms the level of blood viscosity is determined. An increased blood viscosity level indicates an increased risk of developing complications of hypertension, coronary heart disease, heart attack or stroke.

• Increase AST values, an intracellular enzyme involved in the metabolism of amino acids in liver tissue, heart muscle and other organs, shows an increased risk of heart attack.

• This is also indicated by the enzyme creatine kinase, which is a catalyst for the rate of ATP conversion. An increase in the activity of CPK-MB, an enzyme found in heart muscle cells, indicates an increased risk of myocardial infarction.

• Most active LDH(lactate dehydrogenase), a zinc-containing enzyme, is observed in the cells of the heart muscle, liver, and kidneys. LDH activity also increases sharply during acute myocardial infarction.

How should you prepare for a cardiac profile?

A cardiac profile is a comprehensive blood test for the content of certain enzymes. Blood for a cardiac profile is taken in the morning, on an empty stomach.

The day before taking blood, it is necessary to avoid alcohol consumption, as well as psycho-emotional and physical stress.

Diseases of the cardiovascular system are by far the most global problem in medicine, because they are the reason why the largest number of people die every year. Heart attack, heart failure, hypertension and stroke affect people of all ages. Even children nowadays suffer from such ailments from a very early age and learn what shortness of breath or pain in the heart area is. The reasons may be hereditary predisposition, unhealthy lifestyle, and even poor ecology. The most important point in treatment, on which the further prognosis of the outcome of the disease and the possibility of recovery depends, is timely tests.

What tests can detect problems with the heart and blood vessels?

It is worth noting that some stages of various diseases of the cardiovascular system can be completely asymptomatic. And only preventive visits to the doctor and his appointments for tests can identify the problem in time and take measures to eliminate it. Let's consider what tests need to be done first.

1. Lipidogram. This is a blood test taken from a vein in the morning on an empty stomach to check for high cholesterol levels.
2. Coagulogram. Needed to determine blood clotting time and identify problems such as blood clots.
3. Aspartate aminotransferase (AST). Such an analysis is required to detect changes in the activity of the AST enzyme involved in amino acid metabolism. An increase in activity several times is a sign of a pre-infarction state.
4. Creatine kinase. This is the establishment in the blood of indicators of the intracellular enzyme crest kinase, which acts as an indicator of myocardial damage.
5. Lactate dehydrogenase. This is also an enzyme that is present in the muscles of the heart, and enters the blood only when they are destroyed.

Thus, identifying and identifying some catalysts and anomalies in hematopoietic processes is very important and can save a person’s life.

The cardiovascular system, by ensuring a constant flow of blood, supplies all internal organs of a person with oxygen and nutrients every second, and therefore its importance is undeniably high. And that is why, when the slightest disturbance occurs in it, cascade reactions of failures are caused in all other systems, and therefore symptoms always appear. But how is the heart and blood vessels examined? There are many methods for this.

Inspection

When a patient first consults a therapist either for preventive purposes (physical examination) or with specific complaints, the specialist must necessarily examine the heart area and conduct simple studies of this organ and its branches. So, first of all, the doctor conducts a general examination of the patient, paying attention to his skin (with diseases of this system, pallor and even cyanosis, dense cold swelling, minor hemorrhages are possible), the condition of the visible mucous membranes (injection of the sclera, white coating at the root of the tongue) , development of the musculoskeletal system (hypotonia, weakness, dystrophy or, on the contrary, obesity), the nature of the pulse (its presence and synchronicity in both arms, conduction of the pulse into the neck veins). Next, the doctor must conduct an examination of the heart, such as percussion of its borders, which can reveal hypertrophy of individual chambers. It is imperative to auscultate it, counting the number of heartbeats, detailing its tones, rhythm, and possible pathological noises.

Anamnesis

Finally, blood pressure is measured because it is an important indicator of cardiovascular health. Next, the doctor must detail the complaints, because a complete examination of the heart includes a detailed medical history. Thus, diseases of the cardiovascular system are characterized by pain in the chest (often of a pressing, squeezing nature) or, more precisely, behind the sternum, shortness of breath (appears with increased physical activity normally, and in pathology - with a slight load or even at rest), and a feeling of what - “interruptions” in the functioning of the heart, manifestations of high blood pressure (headaches, dizziness, heaviness in the body). Be sure to find out the time of their appearance, the factors that provoke and eliminate them, and their intensity.

Other Important Aspects

The heart examination also includes asking the patient what he associates with the development of his disease, thereby identifying risk factors. So, this could be a strong emotional shock the day before (the death of a loved one, stress at work), lifting heavy objects or performing difficult physical work. Symptoms also appear when weather conditions change. Heredity is also an important criterion, because most diseases (diabetes mellitus, arterial hypertension, tend to be transmitted to the next generation. As a rule, a correctly collected anamnesis provides 50% of the patient’s clinical diagnosis. After talking with the patient and examining him, the doctor must refer his ward for a heart examination. One should remember the anatomy and physiology of this organ.

A little about a normal heart

So, it is, roughly speaking, a pump consisting mainly of muscles and a complex system of blood vessels. Inside it there are four chambers that communicate with each other in a strictly defined way and ensure constant movement of blood. And in order for the heart itself to continuously contract and relax, its tissues contain conductive structures through which a nerve impulse passes, thereby causing alternating tension in the muscles of each chamber and the opening and closing of the valves between them. Therefore, all methods of examining the heart can be aimed either at visualizing the anatomy of this organ (ultrasound, Doppler mapping, computed tomography, chest radiography, radioisotope methods) and directly at the arteries and veins (probing of the great vessels, angiography, coronary angiography), or at examining the condition its conduction system (electrocardiography, bicycle ergometry), or to auditory its tones and noises (phonocardiography).

Echocardiography

As you can see, the examination of the heart must certainly be detailed, detailed, and not lose sight of anything. Because damage to the cardiovascular system can be either a manifestation of an independent disease or a consequence of the pathology of another system. If we talk about visual ones, the first thing that comes to mind is Echo-CG, or, as it is also called. What the device shows during this important study can be guessed logically. By penetrating the ultrasound deep into the tissues and returning them back, an image appears on the screen that allows you to evaluate the structure of the heart, the size of its cavities, the condition of the valves and great vessels. Plus, this method is non-invasive and does not involve radiation, and therefore can be used even by pregnant women, lactating women and children. Although more effective, it still cannot replace ultrasound as a diagnostic tool.

Benefits of Ultrasound

At different stages of gestation, a woman periodically undergoes an ultrasound of the heart for the fetus, which shows a patent ductus arteriosus, stenosis of the ostia of vessels, prolapses or valve insufficiency, the condition of the interventricular and interatrial septum and other congenital malformations. Another important advantage of this method for the patient and the medical institution is its relative cheapness, the possibility of it being carried out on an outpatient basis, the short duration of the study, as well as the instantaneous acquisition of images and interpretation of all data. That is why ultrasound of the heart is so popular for diagnostic purposes.

What does vascular examination show?

In obese people, as well as patients with diabetes, the most common lesions of the cardiovascular system are atherosclerotic lesions of blood vessels, as well as hyalinosis of their walls. Therefore, it is so necessary to examine the vessels of the heart, because only they nourish this important organ, and its work requires a colossal amount of energy and nutrient substrates. So, first, a catheter is inserted into the femoral catheter, through which the vessels are filled with a contrast agent, clearly visible on the X-ray screen. The most important method for atherosclerosis and ischemic myocardial disease is a coronary examination of the heart vessels. It reveals their passability, the correctness of their movement. Also, many operations on this important organ are carried out under his supervision.

Results

Thus, there are currently a lot of methods for studying cardiac and vascular pathology, but each of them has strict indications and contraindications, and therefore it is economically unrealistic and diagnostically pointless to carry them out to everyone. Therefore, the key link is a competent doctor who will carefully supervise the patient and prescribe him the necessary treatment or send him to a more competent institution.

Various heart and vascular diseases are the most common cause of death in all countries of the world; even cancer is not yet ahead of them in this sad ranking.

Various sources and professional medicine devote a lot of time and attention to the prevention of cancer; there are even vaccines for some tumors.

And the main problem of modern humanity - diseases of the cardiovascular system - do not receive the necessary level of attention, and their prevention especially suffers.

In order to start treatment on time, every person should know the signs of diseases of the cardiovascular system and promptly seek medical help if they occur.

Basic examination methods at home and careful attention to your well-being will help you see a doctor in time and begin treatment.

Main symptoms

Delay in seeking medical help when problems with the heart and blood vessels occur is due to the fact that the symptoms for most of these diseases are vague, they are confused with diseases of the stomach, lungs, or are not paid attention to them at all.

Even if a person understands that he has problems with the heart and blood vessels, he turns to the pharmacy for help, they sell him whatever they want, in the best case, the symptoms go away, but the cause remains and the disease progresses.

We list the main alarming signs, the appearance of which requires consultation with a cardiologist and additional examination methods:

Shortness of breath or feeling of lack of oxygen.



The appearance of shortness of breath when running or any other physical activity is a normal physiological mechanism that allows you to provide the body with oxygen when there is an increased need for it.

In diseases of the heart and blood vessels, a feeling of lack of air and rapid breathing appears in situations that previously did not require this; in other words, shortness of breath appears with moderate physical activity. In cases of severe heart failure, shortness of breath appears at rest and with little physical activity.

Attacks of lack of air at night.

When the body position changes from horizontal to vertical, such attacks decrease or disappear altogether. As a result, a person begins to gradually increase the size and number of pillows, and eventually begins to sleep while sitting.

Few people understand that this problem is associated with heart failure; usually such patients are brought by ambulance with a suspected attack of bronchial asthma or lung diseases. Indeed, these attacks can be called asthma attacks, only cardiac ones. This is how acute left ventricular failure manifests itself.

The appearance of edema.



There are many reasons for their appearance. Edema associated with heart disease first appears on the legs in the evening and gradually rises from bottom to top.

Patients often turn to doctors for help when swelling appears in women on the anterior wall of the abdomen, and in men in the scrotum area. It is clear that the appearance of edema in such volumes is associated with a severe form of heart failure and such patients are treated with great difficulty.

Pain in the chest area.

Real heart pain, described in classical literature as attacks of “angina pectoris”, can be called pain at a stretch; these sensations are more reminiscent of heaviness, squeezing behind the sternum.

They occur only during physical activity, go away after 5 minutes at rest, or disappear immediately after taking nitroglycerin under the tongue. Angina pectoris progresses over time, pain appears with less physical activity, and may eventually appear at rest. The disease appears when the heart vessels fail to cope, and a lack of oxygen occurs in the heart.

Pain in the heart area.

With vegetative-vascular dystonia they can be different. People are often very bothered by stabbing pains in the heart area, which as a result turn out to be osteochondrosis or other diseases of the spine. you need to pay attention to increased pain in the chest when turning and bending the body. Heart pain is not associated with body movements.

Headaches, nausea, spots flashing before the eyes, tinnitus.

All these complaints are characteristic of arterial hypertension. Increased blood pressure very often appears in people after 50 years of age and often goes unnoticed and is discovered during the manifestation of complications.

Therefore, all people, especially those with a hereditary predisposition, need to control their blood pressure levels starting from the age of 40.

Rhythm disturbances.

Feelings of irregular heartbeat are a reason to consult a cardiologist. In accordance with modern recommendations for the treatment of such conditions, drug therapy is used in all patients who experience interruptions in the functioning of the heart.

Important! In addition to irregular heartbeats, you should see a doctor if your resting heart rate is above 90 beats per minute or below 60 beats per minute.

How to check your heart function at home?

All people over 40 years of age, regardless of the presence of the above symptoms, need to monitor blood pressure levels, pulse rate and regularity.

Any affordable device is suitable for measuring blood pressure. Blood pressure must be measured while sitting, at rest, on both arms and only on the shoulder. If you have recorded pressure several times higher or lower than 110/70 – 140/90, you need to contact a cardiologist.

It is not difficult to measure your pulse at home; you must adhere to the following rules: measure at rest for 60 seconds. This will also help to detect irregular heartbeats, if any. In some cases, rhythm disturbances cannot be determined by the pulse. Some blood pressure measuring devices are also equipped with a pulse counting option.

What tests will help detect problems?

If you find the above complaints in yourself, or record changes in blood pressure or pulse, you need to contact a cardiologist to make an accurate diagnosis. The doctor will prescribe additional tests that will help make an accurate diagnosis.

A mandatory test that everyone needs is an electrocardiogram. It can be used to determine problems with rhythm, disturbances in the conduction of impulses in the heart and insufficient blood supply to the heart muscle. If there are long-standing problems that have led to changes in the size of the heart muscle, then this can also be detected during the study.

The most informative method is ultrasound of the heart; during the study, large vessels and changes in them are also clearly visible. With the help of this study, it is possible to determine almost all heart diseases: the exact dimensions of all sections and cavities, blood supply disorders in certain areas, the condition of the heart valves and large vessels.

If there are blood clots in the heart cavity, this will also be visible during the study.

To clarify a diagnosis such as coronary heart disease and determine the functional class of angina, bicycle ergometry is used. During physical activity on an exercise bike, an electrocardiogram is recorded; if the subject has angina, then changes in the heart will be recorded during pain.

A study such as Holter monitoring is an ECG recording over a 24-hour period.

When deciphering the daily ECG, it is possible to determine changes during physical activity and compare them with the sensations of the subject; all changes in the state of health are recorded in a diary, indicating the exact time of occurrence of the sensations.

This study is of particular value for determining rhythm disturbances, especially such as extrasystole or paroxysmal forms of atrial fibrillation.

There are no specific characteristic changes in blood tests for diseases of the cardiovascular system. There may be changes in blood tests for cholesterol and in the coagulation system. There are markers that can be used to determine the acute stage of myocardial infarction.

However, the presence of all these changes, both in analyzes and in examination data, does not necessarily mean a disease. All these studies can only be used as additional data and assessed in conjunction with complaints and medical history by a cardiologist.

The table shows some clinics in Moscow and St. Petersburg where you can check the heart and blood vessels, and the price for an electrocardiographic study of the heart is indicated.

Considering all of the above, if you decide to check your heart and blood vessels and determine the presence of serious diseases yourself, then you will be able to detect various symptoms in yourself, both directly related to diseases of the cardiovascular system and those reminiscent of heart disease. Only a doctor can make an accurate diagnosis, much less prescribe the necessary treatment.

What can they say laboratory tests for heart disease? Someone will say “nothing!”, and someone will say “a lot!” Each of the respondents will be right in their own way, both the one for whom the tests alone mean nothing, and the one for whom the data obtained mean everything! What are tests? This is only a laboratory explanation, or more precisely, confirmation of the thoughts of the doctor examining you about a particular disease, be it acute appendicitis, or an attack of angina. To a simple question from a patient - “What are my leukocytes?”, the doctor’s answer “10.1” can confuse you, since you know that with appendicitis, leukocytes are elevated, and 10.1x109 is higher than normal. In fact, this is what future doctors are taught at the university, first for six years, then for another year in internship, and then in advanced training courses, so that they also understand that tests are only a confirmation or exclusion of a particular disease about which an opinion has been formed after clinical examination of the patient.

All laboratory tests that are performed during pathologies of the cardiovascular system, namely in patients with heart disease, can probably be divided into different groups: studies that are done in a clinic and a hospital, a private medical center. The difference, in most cases, will be in volume and, most unpleasantly, in quality. The results in the clinics themselves may also differ: somewhere they do it using hardware, and somewhere the old fashioned way, by eye, somewhere they do 2-3 indicators, somewhere 5-8, and somewhere - for your money, whatever your heart desires. Even in hospitals themselves, the range of laboratory tests performed may differ: in specialized cardiology centers and hospitals providing emergency care to patients with heart disease, as a rule, a full list of laboratory items of interest is performed, necessary to clarify the diagnosis and determine further treatment tactics, while general hospitals will only standard set. And this is due not so much to the fact that doctors of the worst qualifications work there, but to the fact that today laboratory diagnostics are a very expensive part of the budget of any hospital. And the faster this blood test can be done and of better quality, the less blood is taken and the more data can be obtained, the more expensive it will cost. Alas, this is the reality of modern technology!

Before talking about the test results, I would like to note and draw your attention once again that the results of laboratory tests themselves, without a characteristic clinical picture, without instrumental data, sometimes taken once, do not mean anything. But, if, nevertheless, you are interested in the numbers on a piece of paper with the inscription “blood test...”, then not everything is so bad, and it turns out that you care about your health! And we will try to help you understand these mysterious numbers! So, what do these same tests say if there is pain in the heart area?

General blood test indicators, common for men and women

erythrocyte sedimentation rate (ESR): 1 - 15 mm/h; in case of acute myocardial damage, it begins to increase, starting from the first three days, maintaining high values ​​for 3-4 weeks, rarely longer. At the same time, it is necessary to take into account its initial value, since in adults it is possible to increase ESR due to concomitant pathology. A return to normal indicates the end of nonspecific inflammation in the area affected by necrosis. As a result of the fact that ESR begins to increase during the first three days, remaining at this level in the future, and blood leukocytes at the end of the first week or from the beginning of the second tend to decrease, a kind of “scissors” is formed from these two indicators. An increase in ESR is also observed in acute pericarditis and cardiac aneurysm.

total white blood cell count: 4.0 - 9.0*109/l; in case of acute myocardial infarction (AMI), leukocytosis (up to 15-20*109/l) may be observed by the end of the first day. At the same time, some authors point to parallels between the level of leukocytes and the extent of necrosis of the heart muscle. And at the same time, leukocytosis may be absent in an areactive state and in elderly people. An increase in the level of leukocytes can be observed in acute pericarditis and cardiac aneurysm.

total red blood cell count: 4.5*1012/l; As a rule, with a decrease in red blood cells and hemoglobin, patients with chronic heart diseases develop cardiac complaints: chest pain, tingling, tightness.

hemoglobin level: 120 - 160g/l; reflects the saturation of red blood cells with a special protein - hemoglobin, which binds oxygen and participates in its transfer to tissues. With low hemoglobin levels, tissues, including the myocardium, experience oxygen “starvation”, against which ischemia develops, often, under existing conditions, leading to myocardial infarction (MI).

hematocrit 0.36 - 0.48; Based on this and the two indicators listed above, the degree of anemia can be determined. In case of acute anemia, a history of an aneurysm of the heart or aorta, and the presence of an appropriate clinic, one can think about rupture of this same aneurysm and bleeding. This is confirmed by performing an ECG, EchoCG;

platelets: 180 - 320*109/l; blood cells that are involved in stopping bleeding. An excessive amount of them can lead to blockage of small vessels due to the formation of blood clots, or, in combination with disorders of the blood coagulation system, to the formation of large blood clots, which can lead to more serious consequences, such as pulmonary embolism. A reduced amount is accompanied by increased bleeding;

« Blood formula", which indicates the relative ratio of other formed blood cells: plasma cells, young forms of leukocytes, basophils, myelocytes, band and segmented leukocytes, and also includes eosinophils, monocytes, lymphocytes. This formula, most often, is an indicator of the inflammatory process and the degree of its severity, or, as another option, blood disease. And on its basis, various intoxication indices (LII, GPI) can be calculated. In acute myocardial infarction, by the end of the first day there may be neutrophilia with a shift to the left. Eosinophils in AMI may decrease until they disappear, but then, as the myocardium regenerates, their number increases in the peripheral blood. An increase in neutrophils is also observed in acute pericarditis.

Biochemical blood test indicators

total protein: 65-85g/l, an indicator of the content of all proteins in the blood, a more detailed ratio of individual proteins that help in the diagnosis of heart disease is determined in the proteinogram;

bilirubin: 8.6-20.5 mkol/l, one of the indicators of liver function, in particular, pigment metabolism, and specifically for cardiac pathology, in its pure form, does not provide information for diseases of the cardiovascular system;

urea: 2.5-8.3 mmol/l, in most cases shows kidney function, and is always considered in combination with the following indicator - creatinine;

creatinine: 44-106 µmol/l, a product of protein metabolism, depends not only on the amount of protein in the body, but also on the speed of its metabolic processes;

The determination of enzymes contained inside cells is important in the diagnosis of diseases associated with myocardial damage. And depending on which and how many cells die, their values ​​will change:

ALT (alanine aminotransferase): up to 68U/l, when assessing the level of this enzyme, it is worth considering that it is contained not only in the myocardium, but to a greater extent in the liver, therefore AST and ALT are always determined together, which helps in distinguishing between damage to the heart and liver. The timing of ALT increases is similar to AST.

AST (aspartate aminotransferase): up to 45E/l, this enzyme is found in large quantities in the myocardium, and its increase, in most cases, indicates damage to cardiomyocytes - the muscle cells of the heart; An increase in AST in the blood serum is observed in myocardial infarction (95-98%) cases within 6-12 hours from the onset of the disease. The maximum increase is observed on days 2-4, and on days 5-7 the enzyme level returns to normal. There is a clear relationship between AST numbers and the size of the focus of cardiac muscle necrosis. Therefore, if the necrosis is less than 5 mm in diameter, it is possible to maintain the level of this enzyme within normal limits, which also must be taken into account.

LDH (lactate dehydrogenase) and the fractions that make up this indicator: up to 250 U/l, is considered a specific marker for AMI, an increase in the activity of the LDH1 and LDH2 isoenzymes, even with normal levels of general LDH activity, indicates the presence of minor necrosis in the heart muscle. With AMI, its level increases quickly on days 2-4, and normalizes only on weeks 2-3. LDH levels provide valuable information about MI throughout the course of the disease. Other fractions LDH3 and LDH4 are enzymes of the lung tissue, LDH5 - liver enzymes.

CPK (creatine phosphokinase) and the fractions that make up this enzyme: up to 190 U/l, creatine phosphokinase - is considered a specific marker (especially an increase of more than 10 times) in acute myocardial infarction. It increases in the acute period (in the first 4-8 hours from the onset of the disease), much faster than the activity of the above enzymes and is a marker for early diagnosis of AMI, especially the CPK-MB isoenzyme. After 8-14 hours, the CPK value can reach its maximum value, and normalization can occur after 3-4 days. Also, the CPK value may increase with myocarditis;

troponin test: up to 0.4 µg/l. Troponin is a specific contractile protein that is part of the structure of the heart muscle and skeletal muscles. This test is a diagnostic marker for suspected acute damage to myocardial cells and is one of the key results in diagnosing “acute myocardial infarction”;

myoglobin: 12-92 µg/l. A protein in muscle tissue involved in the process of cell respiration. If it appears in the blood, it is regarded as a product of the breakdown of the muscle tissue of the heart or skeleton, with the appropriate clinic, it may indicate necrosis (necrosis) of the heart muscle tissue, therefore it is also considered a specific marker of this pathology. Already 2-4 hours after the onset of the disease, its concentration increases. The maximum concentration of myoglobin in the blood reaches 6-8 hours of AMI. Normalization of its level occurs after 20-40 hours. Based on the degree and duration of its elevated level, one can judge the size of necrosis and the prognosis.
The indicators of ALT, AST, CPK, CPK-MB, LDH, myoglobin and troponin test closely correlate with the size of the necrosis focus in the heart muscle, and therefore have not only diagnostic, but also prognostic significance.

Acid phosphatase: 67-167 nmol/(s·l), increases in activity in patients with severe, complicated MI, mainly transmural;

C-reactive protein (CRP): up to 0.5 mg/l, its detection indicates the presence of a pathological process in the body, in particular inflammatory or necrotic. It belongs to the so-called “acute phase” proteins. A sharply positive reaction to CRP indicates the severity of the inflammatory process.

sialic acids: 2.0-2.36 mmol/l, the content of sialic acids may increase with endocarditis, MI;

electrolytes, are mainly represented by K+ ions (normal 3.6 - 5.2 mmol/l), Na+ (normal 135 - 145 mmol/l), Cl- (normal 100 - 106 mmol/l), Ca2+ (normal 2.15 -2.5 mmol/l). An increased amount of potassium in the serum may be accompanied clinically by cardiac arrhythmia, which is confirmed by an ECG. Atrioventricular blockade of the conduction system of the heart may develop, the syndrome of premature excitation of the ventricles, ventricular fibrillation, and such a serious disorder as cardiac arrest may develop. Therefore, patients with heart rhythm disturbances need to monitor the content of K+ ions in the body. On the other hand, a decrease in potassium in the blood can also lead to adverse consequences in these patients - myocardial hyporeflexia. A decrease in the level of sodium ions may be accompanied by the development of cardiovascular system failure, since the ratio of K+ and Na+ ions, as regulators of processes in the cell, is in constant interaction and a decrease in one leads to an increase in the other ion. Hyperchloremia occurs in patients with kidney disease and may also lead to the development of cardiovascular disease;

serum glucose: 3.3 - 5.5 mmol/l, excess glucose levels, repeated in several tests, may indicate the development of diabetes mellitus (DM). The result of another analysis - glycosylated hemoglobin (HbA1c), allows us to assess the degree of compensation of carbohydrate metabolism in the patient over the past 3 months. This is important because in the case of initially diagnosed diabetes, 11% of people already have damage to the conduction system of the heart. And many patients don’t even know about it. Another complication of diabetes is damage to vessels not only of the main type, but also of small ones that directly bring nutrients to the tissues. In this regard, patients with high blood sugar need to undergo additional instrumental examination, primarily electrocardiography and ultrasound examination of the arteries of the legs.

indicators of ASB (acid-base balance) have an indirect effect on the state of the cardiovascular system due to changes in homeostasis and are important, first of all, for specialists to correct the prescribed treatment;

proteinogram profile, is a spectrum of various proteins (albumin, α1, α2, ß, γ-globulins, albumin-globulin index) that are part of the blood, and under various conditions (acute myocardial injury, inflammation, burns, cancer, etc.) , their ratio may change, and even a pathological protein - paraprotein - will appear. Thus, an increase in α1 and α2-globulins occurs in patients with extensive myocardial infarction.

An increase in the amount of γ-globulin may be associated with excessive accumulation of cardiac antibodies in the body and precede the occurrence of post-infarction syndrome (Dressler syndrome). A long-term high content of α2-globulins (for a month) indicates a weak intensity of reparative processes in the necrosis zone, which causes a protracted course of MI and aggravates the prognosis of the disease.

lipid spectrum, is associated by the common man with the word “cholesterol”. In this case, substances (lipoproteins of various densities, triglycerides) that are involved in the metabolism of cholesterol (CH) are determined (the norm in the blood is 3.1 - 5.2 mmol/l). The number of deaths from coronary heart disease in recent years has increased from 5:1000 people with a total cholesterol level of 5.2 mmol/l, with 6.2-6.5 mmol/l - 9:1000 people, and 17:1000 with 7 .8 mmol/l. In addition to the value of total cholesterol, an important indicator is the atherogenicity coefficient (norm up to 4), which shows the ratio of “good” and bad” lipids involved in the metabolism of fats and cholesterol, and the threat of development or progression of atherosclerosis and all the ensuing consequences. An increase in the fractions of lipoproteins and triglycerides can be either a physiological condition (of a nutritional nature) or a pathological condition. Increased lipids are characteristic of widespread atherosclerosis, obesity that accompanies and causes arterial hypertension. But it would be more accurate to say that this disruption of the functioning of internal organs and intermediate links in the metabolism of lipids and triglycerides, expressed in an increase in the atherogenicity index, causes the deposition of cholesterol in vessels of various diameters, the deposition of “spare fat,” which leads to the above diseases. Therefore, with widespread atherosclerosis, in this blood test, you can see increased values ​​of ß-lipoproteins and total cholesterol. At the same time, a decrease in phospholipid concentration can be seen. But it is also necessary to take into account that there are age-related fluctuations in blood fats. Thus, in elderly men, the level of total cholesterol, triglycerides, and ß-lipoproteins is increased compared to those in middle age, but in old men, on the contrary, they decrease.

coagulogram- an analysis by which you can look at the “viscosity” of the blood, or in other words, whether there is a threat of blood clots, which can lead to the formation of blood clots with different localizations, which in turn can be complicated by pulmonary embolism, which causes instant death. Or, on the contrary, see how high the probability of bleeding is and whether it can stop on its own after surgery, for example, heart valve replacement.

Thus, if you look, there is a need for almost everyone seeking medical help to perform at a certain frequency, especially with chest pain, at least an ECG, on which heart disease will be suspected or determined, which will be confirmed after taking blood tests and their final confirmation. A good option for monitoring heart function is the Cardiovisor device, as it allows you to monitor the work of the heart at home and inform a person in advance about impending pathological changes in the functioning of the cardiovascular system. Thanks to the service, an impending pathology in the heart will be noticed in advance, which helps prevent complications that often do not go away without consequences for human health. Additionally, in terms of heart examination, it is possible to perform Echocardiography, AngioCT, angiography, radionuclide stress test (thallium examination), and functional tests.

But I would like to repeat it again, if sometimes you look at your tests, you can see so many diseases in yourself! But if we compare them with the clinical picture and data from instrumental studies, it turns out that perhaps this is just a variant of the norm...

Rostislav Zhadeiko, especially for the project.

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