Visions of Life: A Journey Towards Health and Wealth

Heart Disease and the Doctor's Exam

Some standard and simple exam techniques provide your doctor with the first clues to how well your heart functions and whether you have heart disease. During your visit, your doctor will listen to your heart, take your heart rate, and check your blood pressure.

Heart Rate

Your doctor feels your pulse in order to check your heart's rate, rhythm, and regularity. Each pulse matches up with a heartbeat that pumps blood into the arteries. The force of the pulse also helps evaluate the amount (strength) of blood flow to different areas of your body.

You can tell how fast your heart is beating (heart rate) by feeling your pulse. Your heart rate is the amount of times your heart beats in one minute.

To measure your pulse, all you need is a watch with a second hand.

* Place your index and middle finger of your hand on the inner wrist of the other arm, just below the base of the thumb. You should feel a tapping or pulsing against your fingers.
* Count the number of taps you feel in 10 seconds.
* Multiply that number by 6 to find out your heart rate for one minute (pulse in 10 seconds x 6 = ____ beats per minute)

When feeling your pulse, you can also tell if your heart rhythm is regular or not.

Heartbeat

Your doctor listens to your heartbeat with the aid of a stethoscope. The opening and closing of your valves make a "lub dub" sound known as the heart sounds. The doctor can evaluate your heart and valve function and hear your heart's rate and rhythm by listening to your heart sounds.

Blood Pressure

Blood pressure is the force or pressure exerted in the arteries by the blood as it is pumped around the body by the heart. It is recorded as two measurements:

* Systolic blood pressure. Pressure in the arteries during the period of the heart's contraction (the higher number).
* Diastolic blood pressure. Pressure in the arteries when the heart is relaxed, between heartbeats (the lower number).

Blood pressure is measured in millimeters of mercury (mm Hg), which refers to how high the pressure in the arteries can raise a column of mercury in a sphygmomanometer, a device for measuring blood pressure.

Normal blood pressure for an adult, relaxed at rest, is less than or equal to 120 over 80. The 120 is the systolic pressure; the diastolic pressure is 80. Blood pressure may increase or decrease, depending on your age, heart condition, emotions, activity, and the medications you take. One high reading does not mean you have high blood pressure. It is necessary to measure your blood pressure at different times while resting to find out your typical value.

Physical Exam

Your doctor can also tell about your heart's function by examining other parts of your body such as your eyes, arms, legs, and skin.

Blood Tests

Your doctor may recommend a blood test to check your cholesterol and other markers that may indicate heart disease.

Heart Disease, Electrocardiogram, and Specialized EKGs

An electrocardiogram (also called EKG or ECG) is a test that records the electrical activity of your heart through small electrode patches attached to the skin of your chest, arms, and legs. An EKG may be part of a routine physical exam or it may be used as a test for heart disease. An EKG can be used to further investigate symptoms related to heart problems.

EKGs are quick, safe, painless, and inexpensive tests that are routinely performed if a heart condition is suspected.

Your doctor uses the EKG to:

* Assess your heart rhythm.
* Diagnose poor blood flow to the heart muscle (ischemia).
* Diagnose a heart attack.
* Evaluate certain abnormalities of your heart, such as an enlarged heart.

How Should I Prepare for an EKG?

To prepare for an EKG:

* Avoid oily or greasy skin creams and lotions the day of the test. They interfere with the electrode-skin contact.
* Avoid full-length hosiery, because electrodes need to be placed directly on the legs.
* Wear a shirt that can be easily removed to place the leads on the chest.

What Happens During an EKG?

During an EKG, a technician will attach 10 electrodes with adhesive pads to the skin of your chest, arms, and legs. Men may have chest hair shaved to allow a better connection. You will lie flat while the computer creates a picture, on graph paper, of the electrical impulses traveling through your heart. This is called a "resting" EKG. This same test may also be used to monitor your heart during exercise.

It takes about 10 minutes to attach the electrodes and complete the test, but the actual recording takes only a few seconds.

Your EKG patterns will be kept on file for later comparison with future EKG recordings.

If you have questions, be sure to ask your doctor.

In addition to the standard EKG, your doctor may recommend other specialized EKG tests, including a holter monitor or a signal-averaged electrocardiogram.

What Is a Holter Monitor?

A holter monitor is a portable EKG that monitors the electrical activity of a freely moving person's heart generally for one to two days, 24-hours a day. It is most often used when the doctor suspects an abnormal heart rhythm or ischemia (not enough blood flow to the heart muscle).

It is a painless test; electrodes from the monitor are taped to the skin. Once the monitor is in place, you can go home and perform all of your normal activities (except showering). You will be asked to keep a diary of your activities and any symptoms you experience and when they occur.

What Is an Event Monitor?

If your symptoms are infrequent your doctor may suggest an event monitor. This is a device that, when you push a button, will record and store the heart's electrical activity for a few minutes. Each time you develop symptoms you should try to get a reading on the monitor. They are used for weeks to months, typically one month. This information can later by transmitted by telephone to the doctor for interpretation.

What Is a Signal-Averaged Electrocardiogram?

This is a painless test used to assess whether a person is at high risk of developing a potentially fatal heart arrhythmia. It is performed in a similar manner to the EKG, but uses sophisticated technology to look for heart arrhythmias.