Non-Invasive Cardiology

ECG ( Electro Cardiography) :
Electrocardiography is a simple procedure which once understood is easy to interpret. ECG is a linear graph of the voltage fluctuations produced by the myocardium. The heart muscle possesses the property of automatic rhythmic contraction. The impulses that arise in the conducting system spread throughout the myocardium resulting in the excitation of the muscle fibres. This results in weak electric currents, which spread through the entire body. These can be recorded by placing electrodes at various positions on the body and connecting them to an electrocardiographic apparatus.

TMT (Treadmill test or Stress test):
Stress test of the heart is an established method of detecting the functional reserve of the heart. The basal ECG which is commonly used to diagnose ischemic heart disease may be misleading because it may be normal even with 50-75% of narrowing of the coronary arteries. Exercise increases the demands on the coronary blood supply which may be adequate at rest but inadequate during exercise and reveal ischemic changes.

2D Echo: Echocardiography (echo):
The use of ultrasound to examine the heart – is a safe, powerful, non –invasive and painless technique. The subject usually lies in the left lateral position and ultrasound jelly is placed on the transducer to ensure good images. An echo examination usually takes 15-20min. This test is use to detect whether the patient has myocardic infarction, valves.
 

Holter Monitor:
It is a 24hours ECG monitoring. The recorded is connected to the patient body, which he takes it home and gets it back after 24hours. The recorder is connected to the computer and ECG is analyzed for arrhythmia problems.

TEE (Trans Esophageal Echocardiogram):
The echo techniques described so far have used ultrasound directed from the chest wall – transthoracic echo (TTE). The oesophagus in its mid – course lies posterior to and very close to the heart and ascending aorta and anterior to the descending aorta. An echo technique exists for examining the heart with a transducer in the oesphagus – trans-oesophageal echo (TOE). In some countries, the abbreviation used is TEE. This uses a transducer mounted upon a modified probe similar to those used for upper gastrointestinal endoscopy and allows examination of the heart without a barrier to ultrasound usually provided by the ribs, chest wall and lungs. By advancing the probe tip to various depths in the oesophagus and stomach, manoeuvring the tip of the transducer and by altering the angle of the ultrasound beam with controls placed on the handle, a number of different views of the heart can be obtained.

DSE (Dobutamine Stress Echo):
Stress transthoracic echo aids in the diagnosis of ischaemic heart disease. It helps to localize the site and quantifies the extent of ischaemia by the demonstration of regional wall motion and thickness abnormality with stress which are not present at rest.
 

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