Probe with physical options in cardiology. Test with physical tests for diagnostics of ischemic ailments of the heart Test with control in a vice

The heart of the people is good enough to be able to compensate for the loss of life in their robot, that is, a lot of serious ailments cob stages there are no symptoms. I vividly, accurate diagnostic methods will help patients to immediately find ailments. In the midst of impotent young people, it is especially seen as such called nautical testimonies. Also, to whom the stench is recommended, the MedAboutMe distribution.

All types of anti-stress tests (stress tests) are based on one principle - strengthening the heart in the period physical activity... A great part of cardiological diagnostics is carried out in a calm camp, often not giving a picture of a breakdown in a robotic organ.

The stress test is overwhelmed by the fact that it helps you to get better at that stage, if you do not show any pain in the heart of a calm heart. Until then, such a sophisticated supplement helps the intelligence, how kindly people are to endure the physical development. To that, navantazhuvalny testi is an obligatory part of prophylactic conditions among people, whose professions are tied with an educator (pozhezhni, pilots, vodії and іnshi). Cardiological stress also helps athletes to correctly develop and effectively carry out training.

EHC for new assignments - the most popular stress test

The main test of this type is the whole electrocardiogram (EKG) with new assignments. Moreover, behind the type and triviality, the price can be achieved with the improvement of the situation. The main types are:

• Health and safety test (Step test, walking).

The simplest test, which is not a special possession. The patient is familiar with showing the EKG in a calm camp, at the time of the singing hour to rob the physical to the right (big on the ice, walking, sitting). There is one more electrocardiogram to be afraid of. In some cases, the EHC is carried out for the third time - after a dozen hours of delivery (for example, after 3 hours).

• Veloergometry (BEM).

Lyudin is engaged in a bicycle (a special bicycle ergometer, connected to a computer), at the same time it is possible to customize it in a different way and in a different way, all of which can be found in the set of diagnostics facilities. The EHC is familiar with the camp before the test, before the hour of the test, and when the physical adjustment is made.

• Treadmill test.

Vidrіznyayєtsya from the EEM team, which is carried out on the big road. Treadmill allows more precisely to reduce the cost of making it more flexible, and also nahil the canvases of the road. How easy it is to go through a child, treadmill is more beautiful, shards are not obsolete for growth and vogue.

The new tests, as I have already said, are carried out in a general manner for athletes and people of singing professions. It is also recommended that everything is perfect for extraordinary patients. The main indications before stress tests are as follows:

• viyavlennya ischemic ailments heart (ІХС) at the early stage.
• Significant arrhythmias in case of physical imbalances, as well as at a certain period of time.
• diagnostics early stages chronic heart failure (CHF).
• Revealing of hypertension in case of physical navantages.

Stress tests are important and for the assessment I will become children from the heart-and-heart problems. Diagnostics is carried out in the offensive conditions:

• Control over the camp of the sick heart with ischemic ailment of the heart or CHF.
• The designation of the portability of physical nurturing for people from the heart.
• Assessment I will become healthy people with an electrocardiostimulator.
• The assessment of the dynamics will become patients who have suffered myocardial infarction, in the process of treatment.
• period of operation, Estimation of rates of rehabilitation.

Prototype shown prior to the immobilisation test

The navantazhuvalny testimonies may be not safe for the patients of certain categories, since before they are carried out, it is necessary to recognize the cardiologist's recognition. Zaboroneni testimonies with navantazhennyam in such vypadki:

• Gostriy myocardial infarction, first 2 add the postponed attack.
• Thrombosis of glibular veins, thromboembolism of the leg artery.
• Unstable angina pectoris.
• Gosstri zapalennya heart - myocarditis, pericarditis, endocarditis.
• Artery stenosis.
• Tachyarrhythmias.
• Heart block.
• Arterial hypertension(Від 200/100 mm Hg. Art.).
• Hypertrophic cardiomyopathy.

In the process of carrying out the stress test, the patient is identified by visual cardiology. It is physically impossible to lean back, when the hour of diagnosis, the following symptoms are detected:

• Rizke pidvischennya arterial grip.
• Blіdіst or cyanosis shkіrnyh curves.
• Risky bill in the breasts, angina attacks.
• Strong arrhythmia.
• Vimiryuvannya EKG show, but my heart will take away the lack of sourness.
• Zapamorochennya, darkening in the eyes.
• Be stronger than self-respect.

Prior to the designated stress test, it is necessary to prepare, in order to eliminate the indicators, the indicators may be inaccurate. Especially the people from the heart and the Sudin are affected by them. For such patients, a drug can be recommended for a few days before testing, with a dose of medication, in the first place, beta-blockers are priced. The whole group of drugs is in an up-to-date rhythm of the heart; Everything can be strongly matched to the dough.

It is also necessary to deny accurate indicators:

• Chi is not є 3 years before the procedure.
• The day before the test, it is taken to drink and alcohol.
• For the most part, the selection of the races includes chocolate, kava and other coffee products, liquorice, gas, bananas.

Yak performed on the hunt test

All stress tests take place in three stages:

1. Record of tribute (EKG, EXO-KG, vimir arterial vise (AT) and іnshe) in the calm camp. It is important for that patient to come to the test early, to see before the cabinet, to give the heart a normal rhythm.
2. The main part of the testuvannya is navantazhennya. It belongs to the type of tests, it can be either physical or medication (the patient is injected with a special drug that sniffs the heart of the test in the physical mode). During the whole hour, in most test options, the EKG is known in 12 tests, and echocardiography and other methods of detecting ischemia of the myocardium (for example, the introduction of radioactive tests during the period of time) can be carried out. In the simplest tests, the data is known at once and the right is right.
3. The patient is given an hour to make decisions, so that the robot's heart will be changed again. Likewise, the dan can be restructed without interruption (from the end to the right with a stretch of 10-15 khilin) ​​- in the whole vipad likar I will take a picture of how the rhythm of the heart is reintroduced.

According to the type of testing, diagnostics can be made from 15 hvili to decile years. BEM and the thread are most likely to be close to 1 year.

The current cardiology of stress is a whole group of young people. Lower guidance is most popular, not ruffled by the description of the EKG for new options.

• test Martini

The simplest and quickest stress test, in any case, you can know for the EKG support, or the car is simply in the arterial grip and heart rate. Navantazhennya in this situation - tse 20 sit in 30 seconds. Kіntsevі vimіryuvannya is carried out two times - immediately by sending and after 3 minutes.

• cardiopulmonary test

One of the few is called a complex test for the task heart-vascular system, Lykar obstozhusche th dizzy system, Zokrem, to the robot legends. The test is carried out at the EKG at new installations - on a treadmill or veloergometers. A special mask should be worn for the patient.

• Stress echocardiography

To carry out the test, one should be standardly installed on a bicycle ergometer or big roads, or the indicators are not known for an auxiliary electrocardiograph, but for an additional echocardiography, which is based on the Doppler effect. Vvazhaєya more sensitive dough, nіzh EKG z navantazhennyam.

• Stress test with talin or other radioactive agents

As a result of the standard stress test, a small amount of radioactive speech is injected into the patient's roof (a healthy dose is not possible). In the middle of peace and at once the signs are being edited in the gamma cameras, on which one can see the change and purchase of speech. The process of additional assistance in assessing blood flow, the size of the coronary arteries and the quality of the heart muscle. Diagnostic value of food, lower at the EKG for new options (90% versus 70%).

• Pharmacological stress test

For some children, there can be no reason for their physical problems. In general, the heart is stimulated for additional drugs, the drug can be tested and correct the exact results.

Note: * - I will become / become ill, if anyone is guilty of a cardiopulmonary test.

Testing with physical navantazhennyam can be carried out on a weekly basis of the latest protocols, as well as the development of time, but in some of them the actions of growing upwardness to navantazhennya are transferred, in others it is too late. By the test of tests with step-by-step navantazhennyam є reaching the maximum stress of the heart-vascular system;

In the middle of the protocols with step-by-step growth, the protocols are more and more frequent, in which the growth of growth is done without interruption and smoothly, due to the transfer for the patient (good tolerance), so for the occasional (test) protocols, which transfer the steps of the need to replace.

Protocols of new tests: the middle of the methods with step-by-step growth of tests, all the more often the protocols are developed, in which the growth of growth is uninterrupted and smooth (A), due to these tests for the patient (good tolerance for handiness) , if possible, there will be a pass before the protocols, as they transfer the steps of the pressure to the new option (B).

For tests with physical options, you can choose a quick view ergometer, for example, a bicycle ergometer or a treadmill test.

In vipadkah, if s klіnіchnoї abo NAUKOVO metoyu neobhіdne detail doslіdzhennya transport O2 i / abo efektivnostі Yogo utilіzatsії, held kardіopulmonalny navantazhuvalny test, the results yakogo traditsіynі pokazniki navantazhuvalnogo testuvannya mozhut Buti dopovnenі otsіnkoyu ventilyatsії, spozhivannya CHIN (O2vd) i vidіlennya vuglekislogo gas (CO2vid ).

Test with physical navantazhennyam widely used for diagnostics of obstructive lesion of the vintsevic arteries - the most common cause of the IXS; At the same time, the most common cause of obstruction is coronary atherosclerosis, which may occur to ailments without a previous history of ІХС, as well as to those with a progressive interruption of ІХС in cases of progression of coronary arteriosclerosis

You can change the EKG for an hour of physical nurturing for the sick on the ischemic ailment of the heart presented to the little one. Changes in the ST segment in case of myocardial ischemia: oblique depression of the ST segment is an indicator of stress-induced myocardial ischemia (A);

Horizontal or oblique depression of the ST segment with a depth of at least 1 mm from the isoline at the end of 80 ms from the point J to the QRS complex is an indicator of myocardial ischemia, provoked by the contractions. There are a number of reasons for which the test can be positive or negative;

Typical cardiological stress tests

Stress test for talent to be victorious in order to make sure that there is a lot of blood in the heart and how it changes in the presence of physical nurturing. It is also possible to be victorious when controlling the level of tension in patients who have suffered a heart attack if there are reasons for such symptoms, such as in the breasts and in the back. The first test is to run during the operation to assess the efficiency. In addition, it is possible to get up if there are any blockages of blood flow in the coronary arteries.

For an hour to the test, the patient walk along the big road to quiet feasts, until the end of the day will not become the maximum. When a patient is injected into a vein, a gamma camera, behind the help of a gamma camera, is spared to the heart. Iakshcho є impaired blood flow, (how to see it with ischemic ailments), scenes (images of the heart) will show in the display, in which reductions are accumulated talіyu. I will get to know the ailments.

Scanning with pyrophosphate technology is just one stress test, before an hour is spent on radioactive indicators. The whole test is carried out for confirmation and detection of a heart attack.

For 2-3 years before the test, a radioactive isotope Tc-99m (technical pyrophosphate) is introduced into the roof. Then, after an hour, a series of signs will be carried out behind the additional gamma camera. As soon as you trap an infarction, then a part of the heart becomes necrotic (vidmira). In cich cells and will accumulate an isotope. Purchase price and fix gamma camera.

The whole test is performed in order to convert, to pump blood more kindly to the heart. Pislya tsoo, the patient sees the physical development, the triviality of what is deed to improve.

Have great people obsyag vikidu blood before the hour of physical navantazhennya improve, and the sick wine can change. Likewise, there can be no damage to the ruins of the wall of a livy little louse. The whole test will show a picture of the robots of all the chambers of the heart.

There is one cardiological stress test. Win vikoristovuєtsya for the emergence of quiet areas of the heart, in any damage to blood circulation. The whole test is carried out for diagnostics of ischemic ailments of the heart, for reversing the effectiveness drug therapyі robotic heart transplant. Identical to the stress test with pyrophosphate technology.

Physiological basis of tests for stepwise growth of the heart-vascular test

On the first scabbards of the nasal test (up to 50% of the maximum navantage), the heart wikid grows for the rakhunok to increase the heart rate, so і VO; at a higher intensity, the increase in the increase in the heart wikid was zoomed over the increase in heart rate, such an adaptation mechanism allows for an hour of maximum stress to increase the heart wikid by 4-6 times.

To preserve the balance, we are important diagnostic values the test with the achievement of the maximum value for the test and the potent riser in the power of the latter, the quicker the accumulation of the folds, the change of the criteria for the test.

In addition, it is clearly established and victories in the available adjuncts of the contraindication to the test. In the region, it is important to establish the criteria for CLINIC PRACTICE So, as they can not be reluctant, in the development of the accelerated development, mothers of legal inheritance.

Bezpeka navantazhvalnyh tests

With a stretch of the last ten years, we systematically saw the data about the spiring of the rhizik and the corysti of the anti-tamper test at dear ones... As a result, there was a clear formulation of indications and proofs for carrying out tests with physical options, victories in the recommendations of the American Association of Cardiologists and the European Society of Cardiologists.

Testing the new option to look like a valuable tool is not only for the detection of induction in case of the new option of myocardial ischemia, but for the purpose of establishing the level of training of the patient until the ear of the program It is necessary to make sure that the heart rate is set, so that it will not allow for an aerial adjustment, and for the advancement of the potential development of the development from the hour of physical training such acceleration, as the induction of the rhythm of blood pressure

Shown for nasal dough is presented by food.

Among the great epіdemiological pre-sledges, the link between physical vitality and mortality was demonstrated; navantazhuvalny test is widely used to improve the level of portability of physical navantages, zoomed to ailments, for risik-stratified ailments from CHF.

Unimportant to the endless value of the class, navantazhuvalny testimonies to achieve the maximum navantazhennya can sing the development of unwelcoming pests. In the population of the country with ailments, who are recruited for testing, the rate of death<0,01% хворих, інші патологічні стани - у <0,05% хворих.

When a non-fatal test is performed in the first 4th stage of a chronic myocardial infarction, the incidence of fatal growth results is up to 0.03%, and a non-fatal myocardial infarction, because of the need for cardiac resuscitation, is 0.09%. dough with the maximum amount of food for the day; As it was seen in one day, during the analysis of +1286 cycle ergometry of serious acceleration, it was not revealed.

Absolutely rizik vazhkih uskladnen pid hour navantazhuvalnogo testuvannya Mauger Buti mіnіmіzovany at chіtkomu dotrimannі priynyatim kriterіyam vіdboru patsієntіv, retelnomu zborі anamnesis, detailed klіnіchnomu obstezhennі, bezperervnomu monitoring 12 kanalnoї EHC, AT i їh recording pid hour navantazhennya i cutaneous hvilinu (mіnіmum - kozhnі 3 xs ) bezposeredno write and end.

Unimportant on a small absolute number of serious acceleration in the process of new tests, it is possible to clean up, but the stench will be winicatious hour by hour in conjunction with the great number of viconuable doslidzhen. At the primitive, de test is carried out, it is guilty that everything necessary for carrying out a heart-legendary reanimation is available, including lines for providing uncomplicated assistance, a defibrillator and a set for intubation.

The phone of the emergency wiklik for help is guilty of being available as soon as it is available. needed unavailable help It was qualitatively and promptly, with the staff of the guilt, regular trainings were carried out with a heart-and-legendary reanimation.

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Physical tests - available, at least some inexpensive non-invasive methods for assessing the nature of pain syndrome in the chest and signs of myocardial ischemia.

A cycle test on a treadmill is the main method for clarifying the diagnosis of IXC ( standard methods the value of the portability of physical nurturing in patients with the establishment of or transferring the diagnosis of IXC). Їх it is possible to vikoristovuvati to assess the prognosis of the disease, diї drugs and efficiency of carrying out revitalized entries.

When testing with physical parameters, two types of signs of myocardial ischemia can be registered: clinical and electrocardiographic. When the test was carried out, it was not only the manifestation of angina pectoris, but also the swelling in the balls, but a special scale was assessed. It is necessary to know about the ailment scale before carrying out the procedure.

One superior EKG-sign of myocardial ischemia is a decrease in the ST segment of the horizontal or oblique type by 1 mm or more. Changes in the amplitude of the Q, R waves and especially T are nonspecific for ischemia of the myocardium, which cannot be seen as a reliable sign of a positive test. It is necessary to take into account that there is a horizontal decrease in the ST segment before the hour of probing with changes in the row of symptoms, in which case the ischemia of the myocardium (so called hypo-positive changes in the ST segment) may not be displayed. The very best sign of myocardial ischemia during the test with physical options - additional electrocardiographic (horizontally lower ST segment) and clinical (angina pectoris) manifestations.

Symptomless decrease in ST segment (more than 3 mm) per hour of testing with physical changes in patients with typical angina pectoris, or if they are transferred earlier, they look at the manifestation of the so-called painless ischemia of the myocardium. However, when such changes are re-structured for the first time, the patient is shown the implementation of additional methods of conditioning. Symptom-free ST segment decrease (in the horizontal type) in a patient with an unpermitted ІХС does not have the right to see the decrease in the manifestation of myocardial ischemia.

The sensitivity of the probes to the physical effects is not the same for the ailments due to the severe severity of the IXC (zokrem, you have to lie down at the stage of the coronary arteries). It has been shown that in case of severe only one coronary artery, the results of tests with physical changes are often negative (in 40-50% of patients), and it gives the right to eliminate the diagnosis of angina pectoris, albeit in any case. In ailments in patients with two or more major coronary arteries, there is a significantly greater correlation between the test data and physical tests and CAG results. Zbіg in cich vipads reaches 90% or more.

Sensitivity to the test with physical parameters is 70-75%, specificity - 60-80%.

The results of the test with physical parameters in the singing world lie in the scheme of conducting and victorious possession. Sensitivity of tests with physical options for detecting myocardial ischemia is true when carried out on a treadmill, but not on a bicycle speedometer. There are ailments in the first place because of the high tolerance of physical navantazhennya.

The diagnostic value of the test with physical options is often seen in the case of people and women. Changes at the EKG, related to the tests carried out in the absence of coronary pathology, are more frequent in women, less often in choloviks. Highly positive results probi z navantazhennyam, as pinned, it means in women with not a typical pain syndrome. In women, for adjusting the specificity of the diagnostic test, it is possible to increase the level of depression of the ST segment up to 2 mm, with a test it can be positive. The changes in the ST segment, as well as the restoration of these changes immediately in the decile indications with great efficiency, indicate a positive test result.

Given the innocence of innocently victorious negative placement before the tests were carried out for women. Otrimanі results and slіd obov'yazkovo look in the link z key manifestations, The nature of the attacks of angina pectoris, ІМ in anamnesis, in general, the manifestation of factors ІХС (we have cholesterol in the blood, chickens, tolerant to glucose and іn.).

In the Danish hour, there are two main types of physical navantages: on a bicycle gauge and on a treadmill. When a test is carried out on a bicycle ergometer, it is possible to change robots by a viconano patient without a second, while an assessment on a treadmill can be done bit by bit. When tests are carried out on a bicycle ergometer, it is easier to protect garnished quality records of the EKG, when vicoristanny treadmill for rejection of yakisnoy EKG is brought to vicoristovuvati special elektrodi. However, the quality of the test on the treadmill is more physiological.

When tests are carried out with physical parameters, follow-up visits are followed. In the first place of the assessment, I will become ill before the appointment and the appearance of possible proofs before the test. Note, tests are carried out, guilty but not baked necessary possessions for carrying out reanimation visits. Prototype testing before testing can be significant in terms of fallowness due to the fact that the test is carried out (in a special center or in the district polyclinic), as well as to carry out the qualifications to the personnel.

The main ones are shown before carrying out the nasal tests (recommendations of VNOK, 2004):

• differential diagnostics of ІХС and okremikh її forms;
• the value of individual tolerance to physical adaptation in ailments with the establishment of a diagnosis ІХС and a clarification of angina pectoris FC;
• assessment of the efficiency of medical, including surgical and rehabilitation, visits;
• examination of the primary care of CVD ailments;
• assessment of the forecast;
• assessment of the effectiveness of antianginal drugs.

Absolute contraindications prior to carrying out nasal samples (recommendations of the VNOK. 2004):

• state standard stage ІМ (2-7 days);
• unstable angina;
• damage to cerebral blood circulation;
• gostry thrombophlebitis;
• BODY;
• heart failure of FC III-IV for NYHA classification;
• the lack of legeneva is swirled;
• fever.

Pozdnyakov Yu.M., Martsevich S.Yu., Koltunov I.V., Urinsky A.M.

stable angina