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Which are the best tests for heart disease screening?

Which are the best tests for heart disease screening?

Introduction

Saif Ali Khan the famous Bollywood actor had once suffered a heart attack. Timely identification of symptoms, ensured that he received treatment for myocardial infarction. This condition is relatively more common among Indians, and is attributed to gene modification, obesity, smoking, and lifestyle. Heredity is another major factor, revealing that when parents have suffered a heart attack, the children are four times likely to have it. Let’s look at tests for heart disease and how these tests can help spot the risks before the condition worsens.

What are the common blood tests for heart disease?

One of the most common tests for heart disease is a series of blood tests. These are important tests that measure different substances in the blood, indicating possible risk of heart disease. The main tests include a combination of the following depending on the preliminary diagnosis, symptoms or medical history of patient. 

  1. Cholesterol levels – Blood tests assess four different types of cholesterol levels. This includes, Low-Density Lipoprotein Cholesterol, Total Cholesterol, Triglycerides and High-Density Lipoprotein Cholesterol. The values from these tests determine if you will have build-up of plaque in your blood, overall cholesterol in blood and presence of fat. These values help determine risk of heart disease.
  2. High-Sensitivity C-Reactive Protein – This test helps to identify inflammation in the body, which may pose a risk of heart disease.
  3. Troponin – This test indicates if a person has had a heart attack, by looking for Troponin, a protein released by damaged heart muscle.  
  4. Apolipoprotein B – Commonly known as the ApoB test, high levels indicate an increased risk of cardiovascular disease.

In addition to the above, other tests include, B-type Natriuretic Peptide, Homocysteine, Fasting Blood Glucose and Hemoglobin A1c, Lipoprotein-Associated Phospholipase A2 and Fibrinogen. These tests help in determining risk of heart disease, and help in formulating a suitable treatment plan.

How is heart disease diagnosis carried out?

Diagnosis of heart disease is usually carried out by relying on a combination of medical history, physical examination, and tests for heart disease. Many patients often undergo tests only when some symptoms have manifested or after suffering some major cardiovascular event. However, it is a good idea to opt for screening, as this will foretell possible future risk. Here are some of the tests used to diagnose heart disease.

  •   Your medical history – This will look at certain symptoms, and family history of heart disease, apart from risk factors and your lifestyle. For instance, you will be probed to check if you smoke, if you are physically inactive, your diet, and stress levels.
  •   Physical examination – These look for specific vital signs to check your heart rate, heart murmur and abnormal sounds from lungs. For instance, abnormal sounds from lungs may indicate heart issues. Examination also looks for signs of poor circulation, like swelling in the legs. 
  •   Tests – These include blood tests mentioned above, and Electrocardiogram to identify arrhythmias, and previous heart attacks. 
  •   Imaging – These tests such as Echocardiogram, Chest X-Ray, CT scan and Heart MRI are used to visualize the heart, functions and abnormalities. 
  •   Stress tests – These help to assess your heart’s response to physical exertion. 

In addition to the above, you are also likely to undergo other tests such as Coronary Angiography, Nuclear Cardiology tests, Lipid Panel etc. All of these tests help in correctly assessing your present risk of heart disk. This will also indicate if you need lifestyle changes, dietary modifications and medications to reduce your risk.

What tests are part of rheumatic heart disease diagnosis?

While the tests for heart disease and the tests for rheumatic heart disease may be broadly similar, there are specific tests and changes. This is mainly because of the reasons behind RHD. For instance, untreated or poorly treated strep throat or scarlet fever is a reason for rheumatic heart disease.

Diagnosis involves a combination of medical history, physical examination, and certain diagnostic tests. Lets take a look at only those tests that are different or apart from the tests explained in section above.

  • Medical history – Your history of strep throat or rheumatic fever will be assessed, based on symptoms.
  • Physical examination – This will include examinations to look for signs of arthritis or joint inflammation. Additionally, skin examination will also look for certain types of rashes that indicate the condition.
  • Diagnostic tests – This will include tests to look for streptococcal infection, for antibodies that indicate a recent strep infection. Similarly, ESR and CRP tests are also conducted to assess inflammation in the body.
  • Jones Criteria – This is a standard used to look for Rheumatic fever, such as heart inflammation, joint inflammation, involuntary movements, and outbreak of rashes

What tests are part of ischemic heart disease diagnosis?

Commonly known as CAD or coronary artery disease, this refers to the condition when there is reduced blood flow to the heart. This causes pain, difficulty breathing and possible heart attack. The tests for heart disease that indicate CAD or IHD are the same as the tests for most heart diseases, and include:

  •       Medical history.
  •       Physical examination.
  •       Vital signs.
  •       Diagnostic tests.
  •       Imaging tests.
  •       Stress tests.
  •       Cardiac CT for calcium scoring.

How does genetic testing help?

Genetic testing can be a major or important factor in determining present or future risk of heart disease.  As outlined in introduction, Indians are at higher risk of certain conditions, apart from inherited conditions. The best way to combat this is to undergo genetic testing that will unearth possible risks. Advanced genetic testing facilities are presently available in Tamil Nadu that offer a clear and comprehensive risk assessment from genetic components of heart disease.

The tests involve submission of saliva or blood sample that are analyzed. The reports and interpretation help cardiologists determine the element of risk. Based on the results, you may then be recommended medications, and lifestyle changes apart from dietary modifications. The tests will also help people rule out risk if the genetic assessment shows that there are no abnormalities.

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Is rheumatic heart disease a serious condition?

Is rheumatic heart disease a serious condition?

Introduction

Four out of ten global patients with rheumatic heart disease are from India. The diseases accounts for more than 1,20,000 deaths annually. It is more prevalent in the less developed states of India, due to poor primary preventive care. Here is a detailed look at the disease and other similar heart disease conditions.

What is rheumatic heart disease and what are the symptoms?

This is a condition wherein heart valves are permanently damaged as a result of rheumatic fever. Untreated or poorly treated streptococcal infection causes damage to the heart valve. For instance, strep throat or scarlet fever if left untreated or if poorly treated may cause rheumatic heart disease.

Rheumatic fever is an inflammatory disease affecting connective tissues in the heart, joints, skin, or brain. When the heart valves are inflamed, with scarring, this causes a narrowing of the heart valve. As a result, it becomes harder for the heart to function. This condition develops over years gradually, and may ultimately result in heart failure.

Why are some people in India at higher risk of rheumatic heart disease?

Some people are at higher risk because of untreated or undertreated strep infections. For instance, children with repetitive strep throat infections are at higher risk. 

Common symptoms of rheumatic heart disease

  • Difficulty breathing, especially during some physical activity or when resting.
  • Pain in the chest.
  • Abnormal swelling.

Diagnosis of rheumatic heart disease

Tests to diagnose rheumatic heart disease include:

  • Echocardiogram also known as echo.
  • Electrocardiogram – ECG/EKG.
  • Chest X-ray.
  • Cardiac MRI
  • Blood tests

What is cyanotic heart disease and what are the symptoms?

This refers to heart defects present at birth, causing reduction in oxygen levels. Cyanotic heart disease is also known as critical congenital heart disease or CCHD. Your body requires a steady supply of oxygen for normal functioning. This condition prevents the body from receiving the required oxygen. 

There are three types of cyanotic heart disease:

  1. Left heart obstructive lesions
  2. Right heart obstructive lesions
  3. Mixing lesions

Common symptoms of CCHD

Symptoms or indications of CCHD are typically visible in the first few weeks after birth, but are usually noticed at childhood. Common symptoms include:

  • Skin with bluish or purple appearance. 
  • Fast paced breathing, and heart rate.
  • Build-up of fluid in the lungs.
  • During check-up, heart murmur is noticed. 
  • Poor energy levels.
  • Low levels of oxygen.
  • Abnormally slow weight gain.
  • Difficulty breathing during activities

What is hypertensive heart disease and what are the symptoms?

This condition usually results from high blood pressure levels that have not been managed. This causes increased strain on the heart resulting in heart failure. Hypertensive heart disease develops over time causing one of many health issues.  For instance, when blood pressure is higher than 120/80 mmHg for a long time, it causes hypertensive heart disease.

People with hypertensive heart disease are exposed to higher risk of heart failure, acute coronary syndrome and possible sudden cardiac death. Outcomes of hypertensive heart disease include coronary artery disease and enlarged heart.

Common symptoms of hypertensive heart disease.

Symptoms include the following, but are noticed only after the disease has progressed considerably.

  • Pain in the chest.
  • Difficulty breathing.
  • Changes in heart beat rate.
  • Dizzy feelings.
  • Possible stroke.

What is atherosclerotic heart disease and what are the symptoms?

This refers to hardening of the arteries as a result of plaque build-up in the arteries over a period of time. Plaque comprises fat, cholesterol and other substances, restricting blood flow. Atherosclerotic heart disease symptoms are typically not noticed initially and are experienced at a later date, when the complications start manifesting.  

When the artery is blocked by more than half, symptoms maybe experienced in the body, depending on the location of the blockage. When the heart is affected, this may cause coronary artery disease. Symptoms include:

  •   Difficulty breathing. 
  •   Pain in the chest, back, shoulders. 
  •   Dizziness. 
  •   Heart beat changes. 
  •   Overall tiredness.
  •   Vomiting sensation. 

Causes of atherosclerosis include the following:

  • High LDL cholesterol and triglyceride levels.
  • Uncontrolled high blood pressure.
  • Smoking
  • Diabetes

What is congenital acyanotic heart disease and what are the symptoms?

This is a heart defect affecting flow of blood. For instance, a hole in the heart wall may be present at birth but will cause problems at a later stage in life. Congenital acyanotic heart disease refers to abnormal heart structure at birth, and is of two types:  

  • Cyanotic congenital heart disease – This involves heart defects that cause a reduction in the oxygen levels.
  • Acyanotic congenital heart disease – This involves heart defects, when the oxygen levels in the blood are enough, but are not pumped as desired.

Different types of acyanotic heart disease

Ther different kinds of acyanotic congenital heart defects include the following:

  •   Aortic stenosis.
  •   Atrial septal defect.
  •   Atrioventricular septal defect.
  •   Bicuspid aortic valve.
  •   Coarctation of the aorta.
  •   Patent ductus arteriosus.
  •   Pulmonary stenosis.
  •   Ventricular septal defect.

Common symptoms of acyanotic heart disease

Symptoms may be present at birth, but may not be noticed until issues begin to manifest. For instance, babies may have a heart murmur, if born with the condition.  These birth defects cause high blood pressure, pulmonary hypertension, and can eventually end up with heart failure. Symptoms typically include: 

  •   Feelings of breathlessness.
  •   Dizzy feelings.
  •   Overall tiredness. 

Causes of acyanotic heart disease and role of genetic testing

There is insufficient information about the reasons for congenital heart defects. However, studies suggest that this could be due to abnormal chromosomes or genetic reasons. Other issues such as sickness during pregnancy may also contribute to the causes. For instance, diabetes, blood disorders, drug abuse or viral infections may also be reasons.

Genetic testing has an important role in identifying, and mitigating the condition. Advanced genetic testing facilities in Tamil Nadu allow testing of blood or saliva sample to identify genetic components of disease. For instance, congenital defects at birth can be identified through genetic testing. Similarly, inherited conditions can also be identified through genetic testing. Based on the results, patients can seek advanced treatment to reduce the effects and future risk of complication

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