Cardiology is the medical specialty focused on the heart and the cardiovascular system. It involves the diagnosis, treatment, and prevention of conditions affecting the heart and blood vessels. These conditions include coronary artery disease, heart failure, arrhythmias (irregular heartbeats), and valve disorders. The field covers a broad spectrum, from congenital heart defects present at birth to acquired conditions like heart attacks.
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Before any surgery can take place, the medical team must have a precise “road map” of the problem. This is where diagnosis and testing come in. The journey usually begins with a visit to a primary care doctor or a cardiologist, who will order a series of tests to investigate the symptoms you are experiencing. These tests are designed to look at the structure and function of your heart and lungs from every angle. Understanding the anatomy is crucial for planning cardiothoracic surgeries, as the surgeon needs to know exactly where a blockage is or how a valve is damaged.
Patients often undergo several different types of tests. Some are simple and painless, done in a doctor’s office in minutes. Others are more complex and require a hospital visit. The goal of all these tests is to gather data. The doctors use this data to determine whether surgery is the most effective treatment or if medication can manage the condition. While the testing phase can feel long and tiring, it is the foundation of safe and effective treatment.
The most basic tool a doctor has is the physical exam. Your doctor will listen to your heart and lungs with a stethoscope. They are trained to hear abnormal sounds, such as a “murmur,” which sounds like a whooshing noise and can indicate that a heart valve is not closing properly. They will also listen to your lungs for crackling or wheezing sounds, which can suggest fluid buildup or airway obstruction.
Equally important is your medical history. The doctor will ask detailed questions about your symptoms: When do they start? How long do they last? What makes them better or worse? They will also ask about your family history and your lifestyle habits. This conversation gives the doctor important clues that guide which high-tech tests are needed next. Being honest and detailed here is very helpful for your care.
Technology allows doctors to see inside your body without making a single cut. These imaging tests are standard for diagnosing chest conditions. They provide pictures of the internal organs, showing their size, shape, and condition.
A chest X-ray is often the first test ordered. It is a quick, painless picture that uses a small amount of radiation to create an image of the chest. It can show if the heart is enlarged, which is a sign of heart disease. It can also reveal fluid in the lungs or masses that might be tumors. While it does not show fine detail, it is an excellent screening tool.
A computed tomography (CT) scan is a more advanced type of X-ray. It takes many pictures from different angles to create a detailed, 3D cross-section of the chest. This is incredibly useful for seeing the hardening of arteries (calcification) or examining the precise size and location of a lung nodule. It gives the surgeon a very clear picture of the anatomy they will be working on.
The heart works by generating electrical impulses that tell the muscle when to squeeze. An electrocardiogram, or EKG (sometimes called ECG), records this electrical activity. Small sticky patches called electrodes are placed on your chest, arms, and legs. These are connected to a machine that draws a line graph of your heartbeat.
An echocardiogram is essentially an ultrasound for the heart. Ultrasounds can show a baby’s heartbeat in real time, just as they can see a baby during pregnancy. A technician puts a cool gel on your chest and moves a wand-like device called a transducer over the area. This device uses sound waves to create a moving picture on a screen.
This test is critical for assessing the heart valves and the pumping strength of the heart. Doctors can measure the “ejection fraction,” which is the percentage of blood leaving the heart each time it squeezes. A low number indicates the heart is weak. They can also see if the valves are leaky or stiff. It is completely painless and has no radiation risks.
Sometimes, pictures from the outside are not enough. Doctors need to go inside the vessels to obtain the most accurate information. These tests are considered “invasive” because they involve inserting tubes into the body, but they are generally safe and done under sedation.
This is the most reliable method for diagnosing blocked arteries. A long, thin tube called a catheter is inserted into a blood vessel in the wrist or groin and threaded up to the heart. Dye is injected through the tube, and X-ray movies are taken. The dye makes the arteries show up clearly. Doctors can see exactly where the blockages are and how severe they are. This test confirms if a patient needs bypass surgery.
For lung conditions, if a mass is found, doctors need to know if it is cancer or something else. A biopsy involves taking a small sample of the tissue to look at under a microscope. These tests can be done with a needle through the chest wall or using a bronchoscope, a tube with a camera passed down the throat into the lungs. Knowing the exact type of cells helps determine the right surgery.
Preparation for these tests varies. For simple blood tests or X-rays, little preparation is needed. However, for stress tests or angiograms, there are specific rules. You may be asked not to eat or drink for several hours beforehand to prevent nausea. You might also need to stop taking certain medications, like blood thinners, temporarily.
It is important to wear comfortable clothing and to bring a list of your current medications. For invasive tests, you will need someone to drive you home afterwards, as the sedation can make you groggy. The medical staff will give you clear instructions following them closely ensures the tests go smoothly and the results are accurate.
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You are given local anesthesia to numb the area where the tube is inserted and sedation to help you relax. You might feel some pressure or a warm sensation when the dye is injected, but it is generally not painful.
For some tests, like an EKG, results are instant. For imaging tests like CT scans or echocardiograms, a specialist needs to review the images, which might take a day or two. Biopsy results usually take a few days.
The amount of radiation from a chest X-ray or CT scan is relatively low and considered safe for adults. The benefit of diagnosing a serious condition far outweighs the small risk from radiation exposure.
If you cannot walk on a treadmill due to arthritis or other issues, doctors can use a “chemical stress test.” They give you a medication that stimulates the heart to mimic exercise without you having to move.
For non-invasive tests like an echo or EKG, yes. For invasive tests like an angiogram or any test involving sedation, no. You must have a driver for your safety.
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