Initial examination by a cardiologist. How is an examination by a cardiologist carried out and do you need to prepare for it?

If you are concerned about weakness, malaise and shortness of breath, then you should probably make an appointment with a therapist. He, in turn, after listening to complaints and an initial visual inspection. He will redirect you to a more highly specialized doctor for advice - to a cardiologist.

Who is a cardiologist

According to the WHO classification, cardiac vascular diseases a lot is known.

A cardiologist is a general specialist. Engaged in the diagnosis and treatment of congenital and acquired pathologies of the heart and blood vessels.

A special role is given to prevention and conducting explanatory conversations with patients. This is done to avoid the development and recurrence of serious pathologies associated with the heart and blood vessels.

Cardiology is a broad field in medicine, so a cardiologist may have a narrower specialization:

angiologist with activities to identify and treat disorders heart rate;
an arrhythmologist involved in the restoration and preservation of the functioning of the cardiac organs;
cardiorheumatologist, who may require consultation if you already have heart disease. Or after suffered a heart attack, surgical intervention;
phlebologist, making an appointment with whom can become a vital necessity. For vasculitis, thrombophlebitis, varicose veins;
a cardiac surgeon who performs open (closed) heart surgery;
angiosurgeon - a vascular specialist.

Special activities include pediatric cardiologist- specialist in the structural features of the heart in children under 18 years of age. Able to quickly identify congenital (acquired) defects. Put accurate diagnosis and spend therapeutic effects, heart surgery if necessary.

What vascular pathologies does it treat?

The competence of a cardiologist includes the treatment of the following diseases:

heart failure (of any etiology);
arrhythmia;
ischemia;
stenosis of the aortic, tricuspid, mitral, pulmonary valve;
aortic aneurysm;
angina pectoris;
thrombophlebitis, thrombosis;
heart injury;
tumor;
atherosclerosis;
congenital (acquired) heart and valve defects;
bradycardia;
tachycardia;
hypertension, hypotension;
post-infarction cardiosclerosis.

The cardiologist is obliged:

promptly identify or prevent heart disease;
take measures to prevent the development of complications or secondary prevention(if heart disease progresses);
select optimal treatment methods with individual approach to each patient;
monitor the well-being of a patient who has undergone open (closed) heart surgery during the rehabilitation period.

Almost all heart diseases are associated with myocardial dysfunction. In case of suspicion, appearance unpleasant symptoms You cannot postpone visiting a cardiologist and undergoing diagnostics.

What symptoms should you contact a cardiologist for?

Today, problems with the heart and blood vessels are experienced not only by older people, but also by more at a young age(after 30 years).

You should contact a cardiologist if you experience:

blueness of lips, earlobes;
pallor of the skin;
swelling of the limbs;
puffiness of the face;
increased heart rate, heart rate over 100 beats/min;
shortness of breath that occurs even at rest;
pressure surges;
dizziness;
frequent headaches, especially after worries or overwork;
unreasonable addition of extra pounds;
stabbing, It's a dull pain behind the sternum, in the heart;
hypertensive crisis.

Mandatory consultation with a cardiologist is carried out for:

women at the stage of planning pregnancy, also in the early stages;
diabetics;
people suffering increased level cholesterol or overweight bodies.

The risk group includes patients whose immediate relatives have previously suffered from vascular and heart diseases.

Where does a cardiologist see, prices

You can make an appointment with a cardiologist at the municipal (district) clinic at your place of residence.

Contact the registry office and receive a coupon for the initial free consultation and diagnostics.

The best vascular cardiologists are hired on a paid basis in private clinics and cardio centers. The average price for the service costs -1200-2100 rubles.

What does a cardiologist do when seeing a patient?

The initial examination by a cardiologist begins with:

listening to complaints, disturbing symptoms;
collecting information about the patient;
Finding out whether direct relatives suffered from heart disease. Does the patient have a blood disease ( endocrine system). Hasn't it been discovered before? diabetes whether heart surgery was performed;
Availability bad habits, hereditary predisposition;
palpating the heart area, performing percussion or finger tapping;
listening to heart murmurs with a stethoscope;
measuring blood pressure with a tonometer;
detecting pulsations in the arm to obtain information about heart rate;
conducting electrocardiography, echocardiography.

It is important for patients to understand how an appointment with a cardiologist takes place. This makes it easier to carry out preparatory procedures and collection of necessary tests in advance.

What methods of vascular diagnostics does a cardiologist use?

For full examination, to clarify the diagnosis, the doctor prescribes laboratory and instrumental methods examinations by a cardiologist. And a list of procedures for vascular disease:

general analysis blood for creatinine, urea, liver enzyme levels. Allowing to identify the causes of complaints in patients, although it is not directly related to cardiovascular pathologies;
urine test (general) to obtain an estimate of the number of ESR, leukocytes, hemoglobin, erythrocytes. Thus, the predominant number of leukocytes is observed in pericarditis and myocardial infarction. And low hemoglobin - with oxygen starvation cardiac muscle and arrhythmias;
blood test for biochemistry to determine the amount of glucose (%). If you suspect the development of atherosclerosis, diabetes mellitus

Hardware research methods:

electrocardiography;
chest x-ray;
coronary angiography;
transesophageal electrical stimulation of the heart (echocardiography);
angiocardiography, cardiac catheterization;
sphygmography;
positron emission tomography;
Holter monitoring;
phonocardiography;
duplex scanning vessels.

Echocardiography is often performed to evaluate the effects of medications or exercise on the heart if the disease has already progressed.

Sometimes prescribed by a doctor daily monitoring over the work of the heart (blood pressure). With small portable devices attached to the patient's body.

How is the treatment carried out?

Vascular diseases require integrated approach to treatment. The most commonly prescribed medications are various pharmacological groups:

anticoagulants (Warfarin, Heparin) to prevent blood clotting;
drugs with nitrates (Nitromint, Nitroglycerin) to reduce myocardial ischemia and improve function coronary vessels;
antiplatelet agents (Ticlopidine, Aspirin) to prevent blood clots;
beta blockers (Atenolol, Propranolol) to minimize heart rate;
diuretics (Veroshpiron, Furosemide) to relieve swelling, normalize blood pressure in particular.

It is possible to prescribe cardiac glycosides, angiotensin 2 receptor blockers, and ACE inhibitors.

Under no circumstances should you take medications without your doctor's permission. To avoid the development of complications and deterioration of well-being. When applying for the first time, it is important for patients to understand what tests they need to go to an appointment with a cardiologist.

In severe, advanced cases, after a full examination, the doctor decides to perform surgery.

The choice of tactics must bear maximum benefit and reduce risks to the life and health of the patient.

Vascular surgeons are often involved in the procedures and perform operations. And subsequent catheterization of the heart cavity or large veins.

Options for performed operations:

balloon angioplasty;
stenting of large vessels, coronary arteries;
prosthetics mitral valve;
shunting of blood vessels to bypass the affected areas;
pericardiocentesis to eliminate cardiac tamponade;
transplantation as a rare procedure, but applicable in treatment birth defects children's hearts.

The need for surgery arises when the following diseases cordially - vascular system:

thromboangiitis;
thrombophlebitis;
vein thrombosis;
varicocele;
diabetic angiopathy;
varicose veins veins;
encephalopathy;
obstruction of the patency of the brachiocephalic vessels.

You can make an appointment with a doctor not only for diagnosis and treatment. But also obtaining information and valuable advice on the prevention of cardiovascular diseases.

Learn how to eat right and what lifestyle to lead. Preventing the development of complex diseases of the heart and blood vessels means:

eliminate negative habits (smoking, alcohol);
Avoid excessive intake of strong coffee, tea, and energy drinks;
suppress conflict situations, stress;
walk more fresh air;
conduct water procedures, massage;
dose sports, exercising 3-4 times a week;
improve your diet by including fish, nuts, lean meat, grains, fruits, and vegetables that are healthy for your heart and blood vessels;
fight weight because it is overweight lead to wear and tear of the heart and increased workload.

Cardiovascular pathologies account for over 50% of premature deaths in people from heart attack and stroke.

Therefore, doctors advise leading a measured lifestyle and periodically restoring peace of mind:

provide massage, art therapy;
do meditation;
do not strain the heart by forcing it to work harder;
Be examined by a cardiologist once a year. Especially with a hereditary predisposition to the development of heart disease. Or elderly men who are uninsured against the rapid development of stroke, myocardial infarction, or heart attack.

The insidiousness of heart and vascular diseases is asymptomatic at first. Inaction can lead to disability and mortality. Diagnosis and treatment are carried out by a cardiologist.

If you are constantly worried about shortness of breath and pain in the heart. Then it's time to make an appointment with an experienced specialist.

Useful video: who is a cardiologist

Make an appointment with a cardiologist would not hurt many, since cardiovascular diseases are very common among the population of our country and significantly affect the quality and life expectancy. Preventing a disease is easier than treating it, so consultation a good cardiologist- guarantee that pathological changes will be identified on early stage and serious complications can be avoided.

Complaints from cardiac patients

At an appointment with a cardiologist it all starts with discussing complaints. The main group consists of shortness of breath, chest pain, interruptions in heart function, frequent and palpitations, swelling in the legs, cough. Patients suffering from dizziness and headaches in the back of the head, tinnitus, flashing “spots” before the eyes, patients with weakness, dizziness, patients with chest pain, etc.

Good cardiologist will discuss complaints with you in detail: if this pain syndrome, then what kind of pain is in nature (stabbing, pressing, squeezing, burning) and where it is localized. All complaints relate to such characteristics as duration, circumstances of occurrence (physical activity, emotional stress, at rest) and cessation (on their own or with the help of medications), how often they bother you. It is advisable that you be prepared in advance for such questions and think through your answers, remember your feelings, and find the names of the medications you took.

These complaints do not necessarily indicate problems in the cardiovascular system: chest pain may occur due to osteochondrosis in the thoracic region spine or with pleurisy, palpitations - due to increased function thyroid gland. This is why it is important to find in Moscow such cardiologist, who is not limited by the narrow framework of his specialization, but thinks more broadly in order to suspect the pathology of organs other than the heart.

The importance of medical history for a cardiologist

At an appointment with a cardiologist It is important to collect two anamnesis: illness and life. In the history of the disease, it is important to find out the following points:

How did the disease begin?
How the symptoms changed over time.
How often do exacerbations occur and under what conditions (during heavy physical activity, under stress, while drinking alcohol)
Have you previously undergone examination and treatment and what are its results?

When collecting a life history, attention is paid to heredity, previous diseases, especially acute rheumatic fever, streptococcal infections. In addition, it is important to find out the patient’s lifestyle and diet, the presence of bad habits, and professional history.

Examination and diagnosis at an appointment with a cardiologist

When examining the patient, pay attention to the color of the skin and the presence of edema. The area of the heart is palpated and tapped (this is how the boundaries of the heart are determined). Further one of the most important points– auscultation. With its help, the sonority of tones, the correctness of the rhythm are determined, and heart murmurs are detected. Then the doctor determines the pulse, not only in the hands, but also measures arterial pressure. Good cardiologist knows and always warns the patient that before this procedure you need to rest for at least 5 minutes, and 2 hours before it - not to smoke or drink coffee.

After examination, the doctor prescribes necessary examinations: biochemical analysis blood, blood sugar test, ECG, Holter monitoring, cardiac ultrasound, stress tests, chest x-ray. When the results become known, we can talk about the diagnosis and treatment regimen.

Do not delay your appointment if you suspect heart problems. hearts, hypertonic disease, diabetes mellitus have become much younger, because the sooner doctors can diagnose them, the greater the chance of a good prognosis. In our medical center in Moscow accepts cardiologist Georgy Karapetovich Antanyan is a highly qualified doctor with extensive experience. At our clinic you can undergo an examination, and at an appointment with a cardiologist Receive an individual treatment plan and recommendations regarding diet and lifestyle.

A cardiologist represents a narrow medical specialization. He deals with issues of diagnosis and treatment various diseases heart and blood vessels. They include inflammatory, metabolic, degenerative-dystrophic pathologies. During the initial appointment, the specialist conducts a clinical examination of the patient, which makes it possible to make a preliminary conclusion about the nature of the disease, as well as the degree functional disorders. Then the doctor determines further treatment and diagnostic tactics, prescribes additional objective research and prescribes appropriate therapy.

Features of the initial consultation with a cardiologist

Consultation with a cardiologist takes place in medical institution. During the initial appointment, the specialist conducts a clinical examination, which includes:

Collecting anamnesis - clarifying the patient’s complaints, his subjective feelings(dizziness, headache, feeling of palpitations, lack of air), the connection of the symptoms of the disease with physical activity, physiological processes in the body, collecting information about past diseases, bad habits, allergic reactions.
Examination of the patient - the doctor carefully examines skin and visible mucous membranes, which makes it possible to determine possible violation blood circulation (characterized by the appearance of bluish staining of the lips, tip of the nose), heart area (development of visible deformation of the chest).
Palpation - palpation of the tissues of the heart area, determining the strength and amplitude of heart contractions.
Percussion - tapping the chest organs (heart, lungs, large vessels) to determine changes in their size.
Auscultation - listening to the sounds of the heart, large vessels, frequency and rhythm of heart contractions using a phonendoscope.

Based on the results clinical examination the cardiologist prescribes further objective diagnostics, including various techniques instrumental, laboratory and functional research. The main method for diagnosing heart pathology is an ECG, so sometimes it is necessary to do an electrocardiogram before your initial visit to a cardiologist.

How is a secondary appointment with a cardiologist carried out?

During the subsequent consultation, the cardiologist interprets the results of the additional objective diagnostics. Based on clinical examination data and analysis of the diagnostic results obtained, the specialist makes a conclusion about the nature pathological process, its nature, as well as the degree of functional disorders in organs of cardio-vascular system. This makes it possible to select the most optimal and effective treatment. Then, during subsequent consultations, the cardiologist evaluates the effectiveness of the prescribed therapy using a control clinical examination and additional diagnostics(ECG is most often used to monitor therapy in cardiology). If necessary, he can adjust the treatment and change the dosage medicines, as well as the mode of their administration.

A cardiologist is a specialist in a narrow branch of medicine who specializes in diseases of the cardiovascular system. His responsibilities include the prevention, examination, study and treatment of heart diseases. Typically, a cardiologist performs outpatient or hospital treatment with the help of medications and physiotherapeutic procedures. In rare cases, for particularly complex diseases, it is prescribed surgical intervention, which is carried out by a cardiac surgeon.

Diseases that a cardiologist specializes in

The range of diseases that are in the specialization of a cardiologist is very wide, since it includes pathological disorders in the functioning of the heart and the entire vascular system. Diseases include:

Cardiac arrhythmia.
Arterial hypotension.
Heart defects (acquired or congenital).
Hypertensive crisis.
Cardiosclerosis.
Myocardial dystrophy.
Circulatory disorders.
Neurocircular dystonia.
Heart and vascular failure.
Endocarditis.

In what cases should you contact a cardiologist?

Patients with heart defects should undergo mandatory examination by a doctor regularly. vascular insufficiency or hypertension. Also, consultation with a cardiologist is necessary if the following symptoms are observed:

A tingling sensation in the heart area for a long time.
Sharp, spasmodic pain in the chest.
Constant aching or stabbing pain, which is especially acute in the left half of the chest.
Feeling of heaviness in the chest.
A feeling of discomfort in the area of the left arm, shoulder blade or numbness of the limb, a feeling of “pins and needles”.
Rapid or slow heartbeat.
Shortness of breath (occurs even with minimal physical exertion).
Rare pulse (indicators reach a maximum of fifty beats per minute).
Swelling (which is especially acute on the lower and upper extremities).

Diagnostic methods used by a cardiologist

For precise setting diagnosis and a complete examination, a cardiologist may prescribe the following diagnostic and examination methods:

An appointment with a cardiologist begins with collecting anamnesis and asking the patient about troubling symptoms and other reasons for visiting.
Ultrasound examination of the heart.
Electrocardiogram, sometimes a 24-hour cardiogram is prescribed (monitoring the work of the heart for 24 hours using a special sensor).
Angiography.
Ultrasound examination of blood vessels.
Blood pressure control (daily monitoring and daily measurement).
Echocardiography.
Carrying out the necessary laboratory tests: general blood and urine analysis, for bilirubin, glucose, urea and others.
Genetic markers cardiovascular diseases.
Cardiorisk (checking the functioning of the heart during intense physical activity).

Give up bad habits, consumption of carbonated drinks, abuse of fatty and fried food. It is important to diversify your diet to provide your body with essential vitamins and microelements to maintain healthy blood vessels and normal functioning of the heart.
Make sure your weight is within acceptable limits to prevent the development of obesity.
Regularly take walks in the fresh air, walk, and do basic physical exercises.
Check blood pressure, monitor blood glucose and cholesterol levels.

A cardiologist is a doctor who diagnoses, treats and prevents inflammatory, metabolic and degenerative-dystrophic pathologies of the heart and blood vessels. The cardiologist also deals with the rehabilitation of patients who have suffered cardiovascular diseases or have undergone surgery on the heart and blood vessels.

You should contact a cardiologist if you experience discomfort, chest pain, frequent increases in blood pressure, or if other symptoms of cardiovascular pathologies occur.

What diseases does a cardiologist treat?

Cardiovascular diseases, which are treated by a cardiologist, can be classified into diseases of the circulatory system, including coronary, heart, artery, vein and heart attacks.

Most common problems problems that a cardiologist encounters are:

Congenital or acquired heart disease - damage to valves, septa, and myocardial vessels.
Coronary artery disease (CAD) is a pathology of the coronary vessels, due to which the heart does not receive the nutrition it needs.
Heart failure is the inability of the myocardium to provide the necessary quality of blood flow in the organs and tissues of the body.
Angina pectoris is one of the forms of coronary artery disease.
Inflammatory diseases of one or another part of the myocardium - carditis.
Disturbances in the rhythm of the heart muscle (arrhythmia) - pathological slowing of the pulse (bradycardia), pathological increase heart rate (tachycardia).
Violation of the abdominal structure, thoracic aorta– aneurysm.
Inflammation of the walls and blockage of blood vessels, most often veins lower limbs– thrombosis, thrombophlebitis.
Rheumatic carditis is damage to the muscles and valves of the heart due to a rheumatic attack caused by infection with streptococcal microorganisms.
Varicose veins, most often in the lower body and legs.
Vascular atherosclerosis – formation inside blood vessels cholesterol plaques and gradual narrowing of the lumen of blood vessels with impaired circulation.
Heart attacks and pre-infarction conditions.
Violation cerebral circulation- stroke.
Cardiomyopathy is a pathological weakening of the heart muscle.
High blood pressure - arterial hypertension(hypertension).
Reduced blood pressure – hypotension.

This is far from full list diseases and conditions that fall within the professional interests of a cardiologist, but these are the most common and dangerous.

Important! Any pathology of the cardiovascular system can significantly worsen the patient’s quality of life, negatively affect the condition of the entire body, and even cause death.

A cardiologist deals not only with identifying and treating CVDs, but also with their prevention. It identifies, evaluates and eliminates risk factors for pathologies of the cardiovascular system. He also gives recommendations regarding correction of the patient’s lifestyle.

You need to make an appointment with a cardiologist if the following symptoms occur:

Pain, discomfort in the middle of the chest, jaw, head, arms (left shoulder).
Difficulty breathing, shortness of breath, lack of air, suffocation.
Syncope – dizziness, fainting, presyncope.
Constant weakness, lack of strength, confusion, unconsciousness, chronic fatigue syndrome.
Numbness of any part of the body, including limbs and face.
Speech or vision problems.
Edema of the lower extremities.
Difficulty gait, problems with reaction and coordination of movements.
Increased pressure.
Any rheumatoid manifestations.
Heart rhythm disturbance.
Increased sweating, paleness, blue discoloration of the skin.
Fast weight gain.
Inability to do even mild physical activity, for example, difficulties while climbing one flight of stairs.
Elevated levels of glucose or lipids in the blood.

In this video, a cardiologist explains how to distinguish normal chest pain from that caused by heart problems:

Also, people who are at risk for diseases of the cardiovascular system should undergo regular examination by a cardiologist:

People over 40 years of age.
People who have systemic diseases, for example, diabetes.
People who have a hereditary predisposition to CVD.
People who smoke and/or regularly use alcoholic drinks, eat unhealthy, fatty and highly salted foods.
People with significant excess body weight, obesity.
People who lead sedentary image life, physically inactive.
People whose professional activity associated with constant stress, conflict or tense situations.
It is also mandatory for a woman to visit a cardiologist when planning to conceive or in the first trimester of pregnancy.

Preparing for initial consultation cardiologist includes the following points:

You need to remember and preferably write down everything related to the symptoms - when they first appeared, in which unpleasant sensations It is expressed how often it occurs, and what factors contribute to the appearance of disturbing signs.
It is necessary to prepare a list of all medications that the patient is taking (which pills help and why, who prescribed them, how effective they are).
If the patient has any medical documents(medical record or extract from it, research results) - take it with you to your appointment with a cardiologist.
On the eve of your appointment with a cardiologist, you should avoid procedures that may affect the diagnostic results. That is, do not visit the sauna, steam bath, do not take hot bath, do not drink alcohol or drugs that stimulate heart activity (unless prescribed by a doctor). And also reduce physical activity as much as possible, refuse sports and sex.
If possible, the day before the consultation you should measure your blood pressure - morning and evening.
Conduct hygiene procedures and wear loose, comfortable clothing, opaque underwear - the cardiologist will most likely ask the patient to remove outer clothing during the examination.

An appointment with a cardiologist begins with taking an anamnesis. The patient must answer all the doctor’s questions in as much detail and truthfully as possible and tell about his complaints and feelings. There are topics that the patient may not want to discuss, for example, facts about his smoking or excessive consumption alcohol. However, you cannot hide anything from the doctor, because this may affect the quality and effectiveness of treatment.

After talking with the patient, the doctor will conduct a physical examination:

Assess the condition and color of the mucous membranes and skin.
Examine the lymph nodes and thyroid gland.
Feels the abdominal area chest, will assess whether there are visually noticeable deformations in the heart area.
The doctor will measure your pulse and blood pressure and listen to your heart rhythm.
Measures the patient's height and weight to determine body mass index.

For further clarification clinical picture diseases, studies may be prescribed:

Blood and urine tests - general and biochemical.
Blood test for sugar and cholesterol levels.
Coagulogram.
Echocardiography.
Electrocardiogram.
Electrocardiogram with exercise (bicycle ergometer, treadmill test).
X-ray of the heart.
Ultrasound or Doppler ultrasound of the heart and blood vessels.
Vascular catheterization.
Daily blood pressure monitoring and/or ECG.

After the patient has completed all prescribed diagnostic procedures, the doctor studies the research results and gives a preliminary or final conclusion about the nature and nature of the pathology, as well as the degree of functional disorders of the cardiovascular system.

After this, treatment is prescribed. Typically, the diagnosis occurs at a secondary consultation, but this can also be done on the day of the first visit to the doctor.

Treatment methods used by cardiologists

Therapy for cardiovascular diseases is focused on conservative, that is, non-surgical methods. Among them is the appointment drug therapy, normalization of lifestyle, gradual increase in physical activity, introduction of diet and spa treatment, rehabilitation of patients.

Most often cardiologists prescribe complex therapy pharmacological drugs different groups:

Nitrate-based products improve the condition and function of coronary vessels and reduce myocardial ischemia. This is Nitroglycerin, Nitromint.
Antiplatelet agents – prevent blood clots. These are drugs based on aspirin and ticlopedin.
Anticoagulants - prevent blood clotting - Heparin, Warfarin.
Beta blockers - reduce heart rate - Atenolol, Succinate, Propranolol.
Calcium channel blockers - help lower blood pressure - Verapamil, Amlodipine.
Diuretics - reduce blood pressure and swelling - Furosemide, Veroshpiron.

In most cases, ACE inhibitors, angiotensin 2 receptor blockers, lipid-lowering, antiarrhythmic drugs, cardiac glycosides.

Important! Self-assign medications is strictly prohibited, as the condition may worsen and complications may arise.

A cardiologist is a doctor who deals with congenital or acquired cardiovascular pathologies. Considering that CVDs rank first in mortality and disability (48% of total mortality), and also that initial stages Such diseases are practically asymptomatic; periodic consultation with a cardiologist is required for absolutely all people. Cardiologists use both conservative and surgical methods treatment. Special attention These specialists focus on preventing the occurrence or recurrence of CVD.