The Importance of Cardiac Diagnostic Tests. Interview with Dr. Massimo Uguccioni.

A healthy heart is essential for maintaining an overall well-being and ensuring a good quality of life. In addition to a healthy lifestyle, diagnostic tests play a crucial role in the prevention and monitoring of cardiovascular diseases. Thanks to increasingly advanced techniques, today we can detect potential issues and take appropriate measures to protect our heart.

Today, Dr. Massimo Uguccioni, an expert cardiologist, will help us understand the importance of cardiac diagnostic tests and the key differences between the most commonly used techniques.

Dr. Uguccioni, why is cardiac diagnostics so important?

Cardiac diagnostics is essential because it allows us to monitor our heart detecting potential issues even in the absence of evident symptoms. For patients with cardiovascular risk factors, these tests are an essential tool for preventing complications. Thanks to the various available diagnostic techniques, we can accurately analyze specific parameters and identify abnormalities, providing a foundation for timely and targeted interventions. This approach helps prevent the onset of serious conditions and improves the patient's quality of life.

What are the main diagnostic tests available?

Cardiac tests can be non-invasive and invasive, each playing a key role in the diagnosis and prevention of cardiovascular diseases. Some of the most commonly used non-invasive tests include the electrocardiogram (EKG), echocardiogram, Holter monitoring, stress echocardiography, and stress test. These tests allow for an accurate analysis of the heart function without the need for invasive procedures.

If the results of non-invasive tests are not sufficiently clear, invasive techniques such as coronary angiography or electrophysiological studies are used to identify issues such as coronary obstructions or arrhythmias.

Finally, blood tests can be extremely useful: altered levels of cardiac enzymes, cholesterol, blood sugar, or electrolytes like potassium and calcium, can provide valuable indications about potential heart diseases.

How is an EKG or an echocardiogram performed, and what are their purposes?

The electrocardiogram (EKG) is a fast and non-invasive procedure that involves placing electrodes on the patient's chest to monitor the heart’s electrical activity and rhythm. This test allows to detect abnormalities in the heart's rhythm, such as arrhythmias or signs of cardiac distress. Alternatively, the Holter test tracks the EKG for 24 to 48 hours, offering a more detailed view of the heart's rhythm during daily activities.

On the other hand, the echocardiogram uses sound waves (ultrasounds) to create moving images of the heart. This test allows for the analysis of the heart's structure and function, closely examining the walls, valves, and blood flow. It is particularly useful to identify malformations, structural defects, or issues with the heart's ability to pump blood. Unlike the EKG, an echocardiogram provides visual and detailed information, with the test lasting anywhere from 30 to 60 minutes.

What is the difference between coronary CT and coronarography?

A coronary CT is a non-invasive test that uses advanced computed tomography to obtain detailed images of the coronary arteries. This test allows to identify aneurysms, plaques, stenosis, and other vascular abnormalities with minimal risk for patients. Thanks to its synchronization with an EKG, a coronary CT can provide a precise and quick scan, making it particularly useful for an initial assessment or in the absence of severe symptoms.

Coronarography, on the other hand, is an invasive procedure that involves inserting a catheter into an artery, through which a contrast medium is injected to visualize the blood flow within the coronary arteries. This radiology test is considered the gold standard for diagnosing significant obstructions or narrowing of the coronary arteries, particularly in cases of advanced disease or severe symptoms.

In summary, a coronary CT is the ideal test for a preliminary, non-invasive investigation, while a coronarography is better suited for confirming diagnoses in complex cases or when timely intervention is necessary.

How does the stress test differ from the echocardiogram on exertion?

Both tests are crucial for detecting heart issues that may not be apparent at rest, but they differ in the type of information they provide.

The stress test is a common exam that involves progressively increasing physical activity, such as walking on a treadmill or cycling on a stationary bike, while monitoring heart rate and blood pressure. This test is useful for detecting abnormalities in the EKG that may indicate issues with blood flow to the heart, potentially causing symptoms such as chest pain or shortness of breath.

The echocardiogram on exertion, on the other hand, adds an echocardiographic component to the test. During exercise, echocardiograms are performed to observe how the structure and function of the heart respond to physical stress. This test is especially effective to identify obstructions in the coronary arteries that may not be detected at rest.

In summary, while the stress test focuses on monitoring the heart under stress, the echocardiogram on exertion provides a more comprehensive view combining blood flow analysis with detailed ultrasound of the heart.

Learn more about our Cardiology services at UPMC Salvator Mundi International Hospital.