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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Diagnosis and Tests

Finding out if you have an aortic disease usually involves a few simple and painless tests. Since the aorta is deep inside the body, doctors rely on technology to “see” it. The goal of diagnosis is to get a clear picture of the shape, size, and condition of your aorta and heart valves. Accurate diagnosis is the key to creating a treatment plan that keeps you safe and healthy.

The process often starts with a conversation. Your doctor will ask about your medical history and how you are feeling. They will listen to your heart and stomach with a stethoscope. From there, they might order imaging tests. These tests are not scary. They are the same kinds of scans used for many other medical reasons. By using sound waves, X-rays, or magnets, doctors can build a detailed map of your cardiovascular system. This section explains the common tests you might encounter and what they tell your doctor.

The Physical Exam and History

The first step in diagnosis is a physical exam. Your doctor will listen to your heart for any unusual sounds. A healthy heart makes a steady “lub-dub” sound. If you have aortic valve disease, the doctor might hear a “whooshing” sound, known as a murmur. This sound is caused by blood flowing through a stiff or leaky valve.

They will also feel your abdomen. If you have a large aneurysm in your belly, a thin doctor might be able to feel it pulsating. They will check your blood pressure in both arms. Occasionally, a difference in blood pressure between arms can be a clue that there is a problem with the aorta. They will also ask about your family. Knowing if your relatives had heart trouble helps them decide if you need extra testing.

  • The doctor listens for murmurs or unusual heart sounds.
  • They may feel your abdomen for a pulsating mass.
  • Checking blood pressure is a standard part of the exam.
  • Family history provides important clues about your risk.
  • Your description of symptoms helps guide the next steps.

Echocardiogram (Heart Ultrasound)

An echocardiogram is one of the most common and useful tests. It uses sound waves to create a moving picture of your heart. It is very similar to the ultrasound used to look at a baby during pregnancy. A technician puts some cool gel on your chest and moves a wand around. There is no radiation and no pain.

This test allows the doctor to see the aortic valve opening and closing. They can measure how well blood is flowing and if there is any leakage. It is the best way to diagnose conditions like aortic stenosis and heart valve disease. The test can also show the first part of the aorta as it leaves the heart. It tells the doctor if the root of the aorta is enlarged.

  • It uses sound waves to make a video of your heart.
  • The test is painless and involves no radiation.
  • It shows if the valves are opening and closing correctly.
  • Doctors can measure the speed of blood flow.
  • It helps determine if the heart muscle is thickening.

Transthoracic vs. Transesophageal

There are two ways to do an echocardiogram. The standard way is called transthoracic. This type of exam is where the wand is placed on the outside of your chest. It is simple and quick. However, sometimes the ribs or lungs block the view of the aorta.

If the doctor needs a closer look, they might suggest a transesophageal echo. For this test, you are given medicine to make you sleepy, and a small wand is guided down your throat. Since the esophagus sits right next to the heart, the ultrasound gives incredibly clear pictures. It is often used to look for tears in the aorta or to see the valve in great detail before surgery.

What the Echo Reveals

The echo gives your doctor many numbers and measurements. It tells them the size of your heart chambers and how thick the walls are. It measures the diameter of the aorta to see if it is stretching. It also grades the severity of any valve problems.

For example, if you have bicuspid aortic valve disease, the echo will clearly show that the valve has two leaflets instead of three. This confirms the diagnosis. The doctor uses these measurements to decide if you need treatment now or if you can wait and watch. It provides a baseline so they can see if things change in the future.

CT Scans and MRIs

If the doctor needs to see the entire length of the aorta, they will order a CT scan or an MRI. A CT scan is a special kind of X-ray that takes pictures in slices. It creates a detailed 3D model of your chest and belly. You lie on a table that slides into a doughnut-shaped machine. It is very fast and precise.

An MRI uses magnets to take pictures. It does not use radiation, which is beneficial if you need many scans over your lifetime. The MRI machine is a longer tube that makes loud clicking noises, but it takes excellent pictures of soft tissues. Both tests give exact measurements of the aorta’s width at every point. Such information is crucial for planning any repairs for an aneurysm.

  • CT scans provide a detailed 3D map of the aorta.
  • MRI uses magnets and avoids radiation exposure.
  • These tests show the exact size and location of aneurysms.
  • They help doctors plan surgeries or procedures.
  • You simply lie still while the machine takes pictures.

Stress Tests and Monitoring

Occasionally, your doctor needs to see how your heart performs when it is working hard. A stress test involves walking on a treadmill while your heart is monitored. If you cannot walk, they can give you medicine to make your heart beat faster. This test helps see if your symptoms, like shortness of breath, are definitely coming from your heart.

For people with aortic conditions, doctors are careful with stress tests. They want to see how your blood pressure reacts to exercise. If your blood pressure spikes too high or your heart struggles, it gives them valuable information. It helps them set safe limits for your daily physical activity.

  • You walk on a treadmill to raise your heart rate.
  • Doctors monitor your blood pressure and heart rhythm.
  • It checks if symptoms are linked to physical exertion.
  • It helps determine safe exercise levels for you.
  • Results help decide the timing of valve replacement.

Genetic Testing

Since aortic diseases can run in families, genetic testing is becoming more common. If you have a bicuspid valve or an aneurysm at a young age, your doctor might recommend a blood test to check your genes. This is not just for you; it helps your whole family.

If your doctor finds a specific gene change, you can also test your parents, siblings, and children. It allows them to get screened early, often before any problems start. Genetic counselors explain what the results mean in simple terms. Knowing your genetic makeup adds another layer of information to keep you safe.

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FREQUENTLY ASKED QUESTIONS

Does an echocardiogram hurt?

No, it is completely painless. It just involves a plastic wand moving over your chest with some gel.

Ultrasounds are great for the heart, but CT scans see the whole aorta better, especially in the belly and chest.

The amount of radiation is low and considered safe for diagnostic purposes. The benefit of seeing the problem outweighs the small risk.

The exercise part usually only lasts 10 to 15 minutes. The whole appointment might take about an hour.

No, a blood test cannot show an aneurysm. Only imaging tests like ultrasound or CT scans can see the physical shape of the aorta.

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