Blood - what tests should I take? Necessary tests for an appointment with a cardiologist What blood test is needed for a cardiologist.

What are tests? Tests are a confirmation or exclusion of a particular disease, about which an opinion was formed after a clinical examination of the patient. With their help, the doctor will find out what exactly is preventing your body from living and working normally, and what is the condition of its individual organs and systems.

So, what do these same tests say if there is pain in the heart area? The determination of enzymes contained inside cells is important in the diagnosis of diseases associated with myocardial damage. And depending on which and how many cells die, their values will change.

Biochemical blood test indicators:

ALT (alanine aminotransferase): up to 68U/l, when assessing the level of this enzyme, it is worth considering that it is contained not only in the myocardium, but to a greater extent in the liver, therefore AST and ALT are always determined together, which helps in distinguishing between damage to the heart and liver. The timing of ALT increases is similar to AST.

AST (aspartate aminotransferase): up to 45U/l, this enzyme is found in large quantities in the myocardium, and its increase, in most cases, indicates damage to cardiomyocytes - the muscle cells of the heart; An increase in AST in the blood serum is observed in myocardial infarction (95-98%) cases within 6-12 hours from the onset of the disease. The maximum increase is observed on days 2-4, and on days 5-7 the enzyme level returns to normal. There is a clear relationship between AST numbers and the size of the focus of cardiac muscle necrosis. Therefore, if the necrosis is less than 5 mm in diameter, it is possible to maintain the level of this enzyme within normal limits, which also must be taken into account.

LDH (lactate dehydrogenase) and its constituent fractions: up to 250 U/l, is considered a specific marker for AMI; an increase in the activity of the LDH1 and LDH2 isoenzyme, even with normal levels of general LDH activity, indicates the presence of minor necrosis in the heart muscle. With AMI, its level increases quickly on days 2-4, and normalizes only on weeks 2-3. LDH levels provide valuable information about MI throughout the course of the disease. Other fractions LDH3 and LDH4 are enzymes of the lung tissue, LDH5 - liver enzymes.

CPK (creatine phosphokinase) and the fractions that make up this enzyme: up to 190 U/l, creatine phosphokinase - is considered a specific marker (especially an increase of more than 10 times) in acute myocardial infarction. It increases in the acute period (in the first 4-8 hours from the onset of the disease), much faster than the activity of the above enzymes and is a marker for early diagnosis of AMI, especially the CPK-MB isoenzyme. After 8-14 hours, the CPK value can reach its maximum value, and normalization can occur after 3-4 days. Also, the CPK value may increase with myocarditis;

Troponin test: up to 0.4 µg/l. Troponin is a specific contractile protein that is part of the structure of the heart muscle and skeletal muscles. This test is a diagnostic marker for suspected acute damage to myocardial cells and is one of the key results in diagnosing “acute myocardial infarction”;

Myoglobin: 12-92 µg/l. A protein in muscle tissue involved in the process of cell respiration. If it appears in the blood, it is regarded as a product of the breakdown of the muscle tissue of the heart or skeleton, with the appropriate clinic, it may indicate necrosis (necrosis) of the heart muscle tissue, therefore it is also considered a specific marker of this pathology.

The indicators of ALT, AST, CPK, CPK-MB, LDH, myoglobin and troponin test closely correlate with the size of the necrosis focus in the heart muscle, and therefore have not only diagnostic, but also prognostic significance.

Acid phosphatase: 67-167 nmol/(s·l), increases in activity in patients with severe, complicated MI, mainly transmural;

C-reactive protein (CRP): up to 0.5 mg/l, its detection indicates the presence of a pathological process in the body, in particular inflammatory or necrotic. It belongs to the so-called “acute phase” proteins. A sharply positive reaction to CRP indicates the severity of the inflammatory process.

Sialic acids: 2.0-2.36 mmol/l, the content of sialic acids may increase with endocarditis, MI;

Electrolytes, are mainly represented by K+ ions (normal 3.6 - 5.2 mmol/l), Na+ (normal 135 - 145 mmol/l), Cl- (normal 100 - 106 mmol/l), Ca2+ (normal 2.15 -2.5 mmol/l). An increased amount of potassium in the serum may be accompanied clinically by cardiac arrhythmia, which is confirmed by an ECG. Atrioventricular blockade of the conduction system of the heart may develop, the syndrome of premature excitation of the ventricles, ventricular fibrillation, and such a serious disorder as cardiac arrest may develop. Therefore, patients with heart rhythm disturbances need to monitor the content of K+ ions in the body. On the other hand, a decrease in potassium in the blood can also lead to adverse consequences in these patients - myocardial hyporeflexia. A decrease in the level of sodium ions may be accompanied by the development of cardiovascular system failure, since the ratio of K+ and Na+ ions, as regulators of processes in the cell, is in constant interaction and a decrease in one leads to an increase in the other ion. Hyperchloremia occurs in patients with kidney disease and may also lead to the development of cardiovascular disease;

Lipid spectrum, is associated by the common man with the word "cholesterol". In this case, substances (lipoproteins of various densities, triglycerides) that are involved in the metabolism of cholesterol (CH) are determined (the norm in the blood is 3.1 - 5.2 mmol/l). In addition to the value of total cholesterol, an important indicator is the atherogenicity coefficient (norm up to 4), which shows the ratio of “good” and bad lipids involved in the metabolism of fats and cholesterol, and the threat of development or progression of atherosclerosis and all the ensuing consequences. An increase in the fractions of lipoproteins and triglycerides can be either a physiological condition (of a nutritional nature) or a pathological condition. Increased lipids are characteristic of widespread atherosclerosis, obesity that accompanies and causes arterial hypertension. But it would be more accurate to say that this disruption of the functioning of internal organs and intermediate links in the metabolism of lipids and triglycerides, expressed in an increase in the atherogenicity index, causes the deposition of cholesterol in vessels of various diameters, the deposition of “spare fat,” which leads to the above diseases. Therefore, with widespread atherosclerosis, in this blood test, you can see increased values of ß-lipoproteins and total cholesterol. At the same time, a decrease in phospholipid concentration can be seen. But it is also necessary to take into account that there are age-related fluctuations in blood fats.

Coagulogram- an analysis by which you can look at the “viscosity” of the blood, or in other words, whether there is a threat of blood clots, which can lead to the formation of blood clots with different localizations, which in turn can be complicated by pulmonary embolism, which causes instant death. Or, on the contrary, see how high the probability of bleeding is and whether it can stop on its own after surgery, for example, heart valve replacement.

Any analysis or research provides the doctor with additional information that helps to more accurately make a diagnosis, determine the stage of the disease, and prescribe treatment. Tests also help to monitor the course of the disease, the effectiveness of the prescribed treatment, and ensure the safety of therapy. But sometimes additional research is required to confirm or complement the results of past analyzes.

Fedorova Lyubov Alekseevna, doctor of the first category, therapist, cardiologist

26.01.2017 10:11:01

Diseases of the cardiovascular system in medical practice are the most complex and dangerous, which most often lead to death, regardless of the patient’s age.

Over the past quarter century in Ukraine, mortality as a result of these diseases has doubled, which cannot but cause serious concern.

That is why it is necessary to constantly monitor the condition of your cardiovascular system and undergo preventive examinations with a cardiologist, especially if there are certain prerequisites for the occurrence of pathologies, for example, heredity, overwork, heavy physical activity, etc.

One of the main symptoms of heart disease is the appearance of pain in the heart area, which can have different strengths and directions depending on the heart disease and its severity.

The second characteristic sign of heart disease is shortness of breath, which occurs from circulatory failure.

The third sign of problems with the heart is a rapid heartbeat, as well as interruptions in the functioning of the heart.

All of the above symptoms are signals to contact a cardiologist, who, in order to make an accurate diagnosis, will necessarily send the patient for additional examination, which includes certain tests.

What tests are done for heart disease?

It is also worth considering that many pathological processes in the cardiovascular system are asymptomatic. Therefore, even if you are not bothered by pain in the heart, shortness of breath, rapid heartbeat or arrhythmia, periodic visits to a cardiologist should be included in the list of mandatory preventive measures that will help maintain your health for many years.

As with any diseases of various organs and systems, timely diagnosis and competently prescribed effective treatment of heart disease will help not only cure certain diseases, but also prevent serious complications, improve the quality of life, prolong it and even save it.

For diseases of the heart and blood vessels, a comprehensive analysis is prescribed - a cardiac profile.

Cardiological profile: why is it needed?

Cardiological profile is a set of special blood tests that allows you to:

Assess risk factors for the development of heart and vascular diseases;

Identify early and hidden lesions of the cardiovascular system;

Identify the risk of developing atherosclerosis, coronary heart disease and heart failure;

Assess the likelihood of myocardial infarction.

Cardiological profile: indications

Indications for prescribing a set of cardiological tests are:

Vascular atherosclerosis;

Cardiac ischemia;

High blood pressure;

Heart rhythm disturbances, including:

Stroke;

Arrhythmia;

Heart attack;

Tachycardia.

What tests are included in the cardiac profile?

- Troponin quantitative;

Potassium (K);

Lipidogram;

Coagulogram;

AST (AST, aspartate aminotransferase);

Creatine kinase (creatine phosphokinase, CK, CPK);

Lactate dehydrogenase (LDH).

What do cardiac profile indicators mean?

Troponin can diagnose myocardial infarction. Troponin is a special protein found only inside cardiac muscle cells (cardiomyocytes); it is practically undetectable in the blood under normal conditions. However, if cardiomyocytes begin to die and collapse, and most often this happens due to the development of myocardial infarction, then troponin begins to penetrate into the general bloodstream, as a result of which its concentration in the blood increases hundreds and sometimes thousands of times. This feature has become a key factor allowing early or late diagnosis of myocardial infarction.

NT-proBNP- brain natriuretic hormone is a protein produced in the left ventricle of the heart. Plays an important role in the diagnosis of heart failure. Blood analysis to D-dimer indispensable when examining patients for various thrombotic disorders. D-dimer is a small protein fragment that is formed as a result of the breakdown of fibrin (fibrin is a blood plasma protein. Fibrin serves as the structural basis of a blood clot - ed.). Elevated levels of D-dimer in the blood indicate the human body's tendency to form blood clots or other clotting problems.

Potassium(K) is an important trace element in the human body. It takes part in the act of muscle contraction, normal heart activity, conduction of impulses along nerve fibers, metabolism and enzyme activity. Potassium deficiency leads to disruption of the cardiovascular system and can cause muscle weakness. Long-term potassium deficiency can cause cardiac arrest. Large doses of potassium cause cardiac paralysis.

INR- this is an indicator purely for assessing the effectiveness and correctness of treatment with anticoagulants ( medications that reduce the activity of the blood coagulation system and prevent excessive formation of blood clots - ed.). Patients who are forced to constantly take blood thinners are required to monitor their blood clotting abilities. This is necessary not only to assess the effectiveness of treatment, but also allows you to select an adequate dose of funds. In the same way, a person can be protected from an overdose of anticoagulants, preventing the development of corresponding complications against this background. One of the modern methods of such control is INR (international normalized ratio).

Lipidogram(lipid profile) helps diagnose atherosclerosis and coronary heart disease.

With help coagulograms the level of blood viscosity is determined. An increased blood viscosity level indicates an increased risk of developing complications of hypertension, coronary heart disease, heart attack or stroke.

Increase AST values, an intracellular enzyme involved in the metabolism of amino acids in liver tissue, heart muscle and other organs, shows an increased risk of heart attack.

This is also indicated by the enzyme creatine kinase, which is a catalyst for the rate of ATP conversion. An increase in the activity of CPK-MB, an enzyme found in heart muscle cells, indicates an increased risk of myocardial infarction.

Most active LDH(lactate dehydrogenase), a zinc-containing enzyme, is observed in the cells of the heart muscle, liver, and kidneys. LDH activity also increases sharply during acute myocardial infarction.

How should you prepare for a cardiac profile?

A cardiac profile is a comprehensive blood test for the content of certain enzymes. Blood for a cardiac profile is taken in the morning, on an empty stomach.

The day before taking blood, it is necessary to avoid alcohol consumption, as well as psycho-emotional and physical stress.

Cardiovascular diseases are widespread among our population, regardless of gender and age. In addition, they very often cause premature death. You can protect yourself by regularly taking the simplest tests. In this article we will look at what kind of examination you need to undergo in a particular case.

Symptoms of heart and vascular diseases

Very often, people do not pay attention to the presence of the symptoms listed below, attributing their occurrence to fatigue and other ailments. Of course, you shouldn’t rush headlong to a cardiologist if you find one of the described symptoms. But it would not be a bad idea to consult a doctor if these manifestations are observed over a long period of time and do not go away.

Pale and weak

Anxiety, fatigue, poor sleep can be symptoms of cardiac neurosis. Pale skin indicates anemia and vasospasm, and blue discoloration of the limbs, nose, cheeks, and ears indicates the presence of cardiopulmonary failure.

Edema

Kidney problems, which people blame for regular swelling at the end of the day, are not the only reason for enlarged lower limbs. This is due to a large amount of salty food, which affects both the kidneys and the heart. It becomes unable to pump blood, which subsequently accumulates in the legs and causes heart failure.

Dizziness, nausea, headache

The frequent occurrence of these symptoms may be the first “bell” of an approaching stroke, and also indicates an increase in blood pressure.

Dyspnea

One of the signs of heart failure and angina pectoris may be shortness of breath and a feeling of lack of air.

Cardiopalmus

If you have not been involved in physical activity and have not experienced emotional uplift, and your heart is “jumping out of your chest,” this sign may indicate a malfunction of the heart: impaired blood supply, heart failure, tachycardia, angina pectoris.

Chest pain

This is one of the surest signs of heart problems. Acute chest pain that occurs even at rest may be a sign of angina, which, in turn, is a precursor to coronary heart disease and myocardial infarction.

What tests are taken to detect heart and vascular diseases?

Oddly enough, to diagnose the state of the cardiovascular system, the doctor prescribes the most common laboratory tests: general and biochemical blood tests. Based on their results, one can judge the main processes occurring in the body.

Complete blood count (CBC): interpretation of results

It gives an idea of the level of hemoglobin, the number of leukocytes, red blood cells, platelets, erythrocyte indices, erythrocyte sedimentation rate (ESR) and other indicators. By deciphering the results of this seemingly simple analysis, the doctor can detect several disorders in the body at once:

decreased hemoglobin level(normal for men - 130-160 g/l, for women - 120-140 g/l) indicates kidney problems, anemia, internal bleeding may indicate;
increase in white blood cell count(the norm is from 4 to 9 x109 cells per liter) suggests the development of an inflammatory process;
decrease in red blood cells(the norm for men is 4.4-5.0 x1012/l, for women - from 3.8 to 4.5 x1012/l) - a sign of chronic inflammatory processes and cancer, and their increase indicates dehydration of the body;
lack of platelets(in men the norm is 200–400 thousand U/μL, in women - 180–320 thousand U/μL) leads to problems with blood clotting, and too much leads to the formation of blood clots;
big erythrocyte sedimentation rate(ESR) is a clear sign of an inflammatory process. The ESR norm for men is 1-10 mm/h, for women – 2-15 mm/h.

Biochemical blood test: what do deviations from the norm indicate?

Thanks to it, the doctor receives additional information about the functioning of the heart and blood vessels, since it provides results for a larger number of enzymes.

ALT (alanine aminotransferase) And AST (aspartate aminotransferase) They are always tested in pairs so that the doctor can see and separate the damage to the heart and liver. Their increase, in most cases, indicates problems with the muscle cells of the heart and the occurrence of myocardial infarction. ALT norm in women - up to 31 U/l, in men - up to 41 U/l. The AST norm in women is also up to 31 U/l), and in men - up to 35-41 U/l.

LDH - lactate dehydrogenase(for women the norm is 125-210 U/l, for men - 125-225 U/l) and CK-creatine phosphokinase and especially its MB-fraction (MB-CPK) increase during acute myocardial infarction. The laboratory norm for CPK is 10-110 IU, and CPK-MB isoenzymes are 4-6% of total CPK.
Myoglobin increases in the blood as a result of the breakdown of muscle tissue of the heart or skeleton. The norm for men is 19 – 92 µg/l (average – 49 ± 17 µg/l), for women – 12 – 76 µg/l (average – 35 ± 14 µg/l).
Electrolytes (K+, Na+, Cl-, Ca2+ ions) They also talk about many things: an increase in potassium content in the blood serum (normal 3.6 - 5.2 mmol/l) entails heart rhythm disturbances, the possible development of excitation and ventricular fibrillation; low K+ levels can cause decreased myocardial reflexes; insufficient content of Na+ ions (normal 135 – 145 mmol/l) and an increase in chlorides (normal 100 – 106 mmol/l) are fraught with the development of cardiovascular failure.
Cholesterol, contained in the blood in large quantities, serves as a risk for the development of atherosclerosis and coronary heart disease. On average, the norm for total cholesterol is considered to be from 3.61 to 5.21 mmol/liter, the level of “bad” cholesterol (LDL) should be in the range from 2.250 to 4.820 mmol/liter, and high-density cholesterol (HDL) - from 0.71 to 1.71 mmol/liter.
C-reactive protein appears in the body during an inflammatory process or tissue necrosis that has already occurred, since it is contained in minimal levels in the blood serum of a healthy person. The norm for children and adults is the same - less than 5 mg/l.

Coagulogram

The results of this analysis, which is sometimes prescribed in addition to the main ones, give the doctor an idea of the process of blood clotting, its viscosity, the possibility of blood clots or, conversely, bleeding. The table below shows the main indicators of this analysis.

Note that during pregnancy, the results of a coagulogram differ from the norms presented above.

A referral for a CBC, a biochemical blood test and a coagulogram is prescribed by the attending physician, and the results of the study can be obtained within 1-2 days, depending on the equipment of the laboratory.

How to protect yourself from heart and vascular diseases?

Getting rid of excess weight, which significantly increases the risk of developing diseases of the cardiovascular system, comes first. For normal blood circulation and to prevent the formation of blood clots, it is necessary to expose your body to physical activity every day. This does not mean going to the gym every day; initially, walking will suffice, increasing the distance every few days.

Following a diet reduces cholesterol levels in the blood and thereby has a positive effect on the condition of blood vessels. Fresh vegetables, berries and fruits, which contain antioxidants beneficial to our body, cleanse and strengthen the walls of blood vessels. For example, acids contained in fatty fish, walnuts and almonds fight vascular thrombosis.

Quitting the use of alcohol and tobacco will certainly be beneficial not only to the heart and blood vessels, but will also have a beneficial effect on the health of all body systems.

Tests for heart and vascular diseases: which ones to take, why and where?

Editorial opinion

Approximately 40–60% of all people in the world die from heart and vascular diseases. Against this background, it is simply impossible to dispute the importance of cardiology as a field of practical medicine.

Who is a cardiologist?

Many have heard that “cardio” means heart in Greek. People understood the importance of this organ for humans back in ancient times. Nowadays, the field of knowledge of a cardiologist is broader - it is not only the heart, but also blood vessels.

Cardiovascular diseases are a huge problem for humanity. Problems of this kind can be the consequences of diabetes, obesity, or be congenital. And if earlier the heart usually began to “become naughty” in people of retirement and/or old age, now many diagnoses have become “younger”. And now people sometimes die from heart attacks very young.

Modern cardiology makes it possible to cure or at least alleviate a lot of diseases of the cardiovascular system. And yet the rate of sudden or immediate death from cardiac arrest remains high. The reason is people’s lack of attention to their health.

In what cases do you consult a cardiologist?

The obvious answer is when the heart hurts. However, cardiovascular diseases do not always cause pain. Human can:

experience difficulty climbing stairs or covering even relatively short distances;
sweating excessively and for no reason;
feel dizzy, suddenly nauseous, lose balance;
feel your heart enlarged, beating too hard.

The initial stage of many heart and vascular diseases is asymptomatic. This is why therapists recommend it annually, even if there are no complaints.

Other risk groups are people with high blood pressure (hypertension), diabetes mellitus, and rheumatoid diseases. And if real chest pain begins, even if it is not severe, you should contact a cardiologist as soon as possible.

How to prepare for your appointment

The most important thing is to collect specific complaints. It is best to remember exactly when any alarming signs appeared, in what situation (for example, during physical or emotional stress). It is also important to tell when and how relief came: did you have to lie down or did it all go away on its own?

Perhaps there are any additional medical documents? For example, you became ill on a business trip, and the local ambulance specialists did a cardiogram? The results of such and similar surveys can be very useful.

It is also advisable to know whether any of your closest relatives have or have had cardiovascular diseases. Hereditary factors are very strong here.

How does an appointment, consultation, examination with a doctor go?

The cardiologist gets his first opinion about the patient’s condition from simple tests: measuring pulse, blood pressure, and listening. In this way, the doctor finds out what to pay attention to. Then various examinations are prescribed: cardiograms, ultrasound, radiography of the heart, blood tests.

Such studies usually make it possible to determine the diagnosis. Sometimes the doctor prescribes additional referrals, for example, for vascular catheterization. This method is invasive, that is, penetrating.

using a simple tonometer, monitor your blood pressure (measure every day and record the readings of the device);
do not allow yourself to sit in one place, be sure to move, and in the fresh air;
combine fish, meat, cereals, vegetables and fruits, whole grain bread in your diet, limit simple fats and sweets;
do not smoke, eliminate alcohol as much as possible or completely;
From time to time, get your blood tested and check your sugar and cholesterol levels.

Chronic heart failure

Chronic heart failure (CHF) is a disease in which the heart is unable to pump enough blood to supply the body with oxygen. It can occur as a result of many diseases of the cardiovascular system, among which the most common are coronary heart disease, hypertension, rheumatoid heart defects, and endocarditis. A weakened heart muscle is unable to pump blood, releasing less and less of it into the vessels.

Heart failure develops slowly and in the initial stages appears only during physical activity. Characteristic symptoms at rest indicate a severe stage of the disease. As CHF progresses, it significantly worsens the patient’s condition, leading to decreased performance and disability. The result can be chronic liver and kidney failure, blood clots, and strokes.

Timely diagnosis and treatment can slow down the development of the disease and prevent dangerous complications. An important role in stabilizing the condition is given to a correct lifestyle: weight loss, low-salt diet, limiting physical and emotional stress.

Synonyms Russian

Congestive heart failure, heart failure.

Heart failure, congestive heart failure.

Clinical manifestations of heart failure depend on its duration and severity and are quite varied. The development of the disease is slow and takes several years. If left untreated, the patient's condition may worsen.

The main symptoms of chronic heart failure include:

shortness of breath during physical exertion, when moving to a horizontal position, and then at rest;
dizziness, fatigue and weakness;
lack of appetite and nausea;
swelling of the legs;
accumulation of fluid in the abdominal cavity (ascites);
weight gain due to edema;
fast or irregular heartbeat;
dry cough with pinkish sputum;
decreased attention and intelligence.

General information about the disease

By contracting, the heart ensures continuous circulation of blood through the vessels. Together with the blood, oxygen and nutrients are supplied to all organs and tissues, and the end products of metabolism, including fluid, are removed. This is achieved by alternating two phases: contraction of the heart muscle (called systole) and its relaxation (diastole). Depending on which phase of cardiac activity disrupts its functioning, we speak of systolic or diastolic heart failure.

Systolic heart failure is a consequence of weakness of the heart muscle and is characterized by insufficient ejection of blood from the chambers of the heart. Its most common causes are coronary heart disease and dilated myocardiopathy. More often observed in men.
Diastolic heart failure occurs when the heart muscle loses its ability to stretch. As a result, much less blood enters the atria. The most common causes: arterial hypertension, hypertrophic myocardiopathy and stenotic pericarditis.

The human heart can be roughly divided into right and left halves. Pumping blood into the lungs and saturating it with oxygen is ensured by the work of the right parts of the heart, and the left ones are responsible for delivering blood to the tissues. Depending on which departments fail to cope with their task, they speak of right ventricular or left ventricular heart failure. When the functioning of the left sections is impaired, shortness of breath and cough come to the fore. Right-sided failure manifests itself as systemic edema.

To select the necessary medications, it is very important to determine the mechanism of heart failure and its type.

Who is at risk?

The presence of at least one of the following risk factors is sufficient for the development of chronic heart failure. The combination of two or more factors significantly increases the likelihood of disease.

Patients at risk include:

high blood pressure;
coronary heart disease;
myocardial infarction in the past;
heart rhythm disturbances;
diabetes mellitus;
congenital heart disease;
frequent viral diseases throughout life;
chronic renal failure;
alcohol addiction.

The diagnosis of chronic heart failure is made based on the medical history, characteristic symptoms and results of laboratory and other tests.

Laboratory research

There are most often no changes in the general blood test. In some cases, moderate anemia may be detected.
The erythrocyte sedimentation rate (ESR) may be elevated, especially when heart failure is the result of rheumatic heart disease or infective endocarditis.
A general urinalysis is important to diagnose renal complications and exclude the renal origin of edema. One of the possible manifestations of chronic heart failure is high levels of protein in the urine.
Total protein and protein fractions in the blood may be reduced due to their redistribution into the edematous fluid.
Blood glucose. Important for excluding diabetes mellitus as a risk factor for heart failure.
Cholesterol. high and low density lipoproteins. There is a clear relationship between elevated cholesterol levels and the development of atherosclerosis, coronary heart disease, and hypertension. High levels of cholesterol and lipoproteins in heart failure may indicate a more severe course of the disease.
Sodium and potassium in the blood. In chronic heart failure, their level in the blood serum can change significantly due to edema. Monitoring blood composition is especially important when prescribing diuretics.
Brain sodium

Cardiac examination

Often, a person who first feels any complaints from the cardiovascular system, upon initial treatment on an outpatient basis, immediately receives treatment, bypassing a full cardiological and related examination, which should include both instrumental and laboratory diagnostic methods.

Depending on the prevalence of clinical symptoms, three main groups of patients can be divided:

1. Patients with complaints of pain in the heart area

2. Patients with high blood pressure

3. Patients with rhythm disturbances, interruptions in heart function

Various combinations of clinical symptoms are also possible (rhythm disturbances and heart pain against the background of high blood pressure).

The minimum examination should include:

Examination by a cardiologist with detailed collection of complaints and physical examination (auscultation, percussion)

ECG (12-lead ECG, long strip ECG, cardiotopography, ECTG-60, ECG with isometric stress)

Ultrasound (ultrasound) of the heart, dopplerography of blood vessels, transesophageal ultrasound (often necessary for rhythm disturbances to exclude the presence of blood clots in the cavities of the heart), ultrasound of the kidneys, adrenal glands, thyroid gland

24-hour blood pressure and ECG monitoring (Holter monitoring)

Load tests (velergometric test, treadmill test, informational and pharmacological tests)

Consultations of related specialists (endocrinologist, gynecologist, ophthalmologist, gastroenterologist, neurologist, nephrologist, etc.)

Laboratory tests: biochemical blood test (glucose, electrolytes, lipid spectrum, cholesterol and other cardiac enzymes), determination of the level of certain hormones (thyroid gland, brain natriuretic peptide).

Heartache

The most common reasons:

Coronary heart disease (CHD)
Heart valve defects
Neurocirculatory dystonia (NCD)

A special role should be given to the differential diagnosis of pain in diseases of the spine (osteochondrosis).

An important role in the examination is given to ECG changes, including during stress tests and daily monitoring, as well as changes in biochemical blood tests (lipoproteins, triglycerides). If necessary, coronary angiography is performed to establish a final diagnosis and determine further treatment tactics. Treatment can be conservative (medication), endovascular (angioplasty and stent placement in the coronary arteries through the brachial or femoral artery), surgical (coronary artery bypass grafting with cardiopulmonary bypass or on-pump).

If spinal osteochondrosis is suspected, a consultation with a neurologist is required, who will determine the scope of necessary studies (CT, MRI, etc.)

High blood pressure

First of all, it is necessary to exclude the symptomatic nature of arterial hypertension (hypertension caused by diseases of specific organs). Such hypertension includes hypertension due to diseases of the kidneys and their vessels, tumors of the kidneys and adrenal glands, brain tumors, vascular diseases (coarctation of the aorta, other vascular pathology.) Endocrine causes of increased blood pressure deserve special attention, especially in women after 45 years.

If the cause of hypertension cannot be found (and this happens in approximately 95% of cases), such hypertension is considered idiopathic, or essential (is an independent disease), and requires treatment with special drugs. It is very important to understand that this disease requires systematic, often lifelong treatment. A very common mistake is the practice of taking antihypertensive drugs only to reduce high blood pressure, rather than taking them continuously and regularly. (See Guide to Lowering Blood Pressure.)

Rhythm disturbances, interruptions in heart function

Electrocardiogram (ECG) data play a key role in diagnosis. To find out the causes of arrhythmia, it is necessary to exclude organic causes (damage to the valvular apparatus of the heart) - for this, an ultrasound of the heart is performed - and coronary heart disease. Some arrhythmias may be congenital. A common cause of arrhythmia may be dysfunction of the thyroid gland, which requires a full endocrinological examination (consultation with an endocrinologist, determination of hormone levels in the blood). When establishing the cause and determining the nature of the rhythm disturbance, an electrophysiological study (EPS) of the heart may be necessary.

What do clinical blood test indicators indicate?

It is hardly possible to find a person who has not done a clinical (or general) blood test at least once in his life. This is one of the most commonly used tests for diagnosing various diseases; such a study, performed professionally, can tell the doctor a lot about the patient’s health status.

Most often, people, independently receiving the results of a clinical blood test in the laboratory or listening to their interpretation from a doctor, do not understand what this or that indicator means and how it relates to their condition. Of course, the patient should not “replace” the doctor and try to diagnose himself, etc., based on the results obtained. The purpose of this article is to familiarize a wide range of readers with the main indicators of a general blood test, so that the terminology used by doctors when communicating with patients is not a “closed secret,” and the doctor and patient would better understand each other.

For a general blood test, blood is taken from a finger (or from a vein) in the morning on an empty stomach. It is recommended to avoid fatty foods the night before as this may affect your white blood cell count. Stress can also distort the blood picture - even a quarrel with someone on the way to the clinic.

To take the analysis, disposable sterile instruments are used. The laboratory technician who draws blood must work either in disposable gloves or rubber gloves, which are disinfected with disinfectant solutions after each blood draw, and which he changes as necessary.

Traditionally, blood is taken from the fourth finger of the left hand, which is thoroughly wiped with cotton wool and alcohol, after which an injection is made with a special needle into the flesh of the finger to a depth of 2-3 mm. The first drop of blood is removed with cotton wool soaked in ether. First, blood is drawn to determine hemoglobin and ESR, then to determine the number of erythrocytes and leukocytes, after which blood smears are made using slides and the structure of cells is studied under a microscope.

In addition, you need to take into account that each laboratory has its own “standards” for a general (clinical) blood test, so it is better to ask your doctor all your questions.

A general blood test helps a doctor of any specialty. Based on the results of a blood test (hemogram), the doctor can competently assess the condition of the body, make a preliminary diagnosis and promptly prescribe appropriate treatment.

So, A general (clinical) blood test shows:

number of red blood cells,
erythrocyte sedimentation rate (ESR),
hemoglobin content,
number of leukocytes,
leukocyte formula
and other indicators, each of which we will dwell on in detail.

Red blood cells also known as red blood cells. In humans, 1 mm³ of blood contains 4.5-5 million red blood cells. Red blood cells contain hemoglobin and carry oxygen and carbon dioxide. An increase in the number of red blood cells is a sign of diseases such as leukemia, chronic lung diseases, and congenital heart defects. Anemia (decreased number of red blood cells) can be caused by stress, increased physical activity, and fasting. If you cannot immediately determine the cause of the decrease in the number of red blood cells, then it is better to go to a hematologist and undergo additional examination.

A significant increase in the content of red blood cells may indicate erythremia (one of the blood diseases). In addition, an increase in the number of red blood cells (erythocytosis, polycythemia) is observed in acute poisoning, when due to severe vomiting and diarrhea there is a large deficiency of fluid in the body; with acidosis (due to metabolic disorders during exacerbation of certain diseases); loss of fluid for various reasons (heat, illness, heavy physical activity); with long-term cardiovascular or pulmonary diseases, when the body is not sufficiently supplied with oxygen and increases the number of red blood cells in an attempt to still deliver oxygen to the tissues; or when a person is in the highlands, when he no longer has enough oxygen.

Color index- its normal value for people of any age is 0.85-1.15. The blood color index is an indicator of the degree of saturation of red blood cells with hemoglobin and reflects the relationship between the number of red blood cells and hemoglobin in the blood. When its values differ from the norm, this generally indicates the presence of anemia. In this case, anemia is divided into:

— hypochromic — color index less than 0.85;

- hyperchromic - color index greater than 1.15.

However, anemia can also be normochromic - when the color indicator remains within the normal range.

Reticulocytes- These are young forms of red blood cells. Children have more of them, adults have less, because the formation and growth of the body has already been completed. An increase in the number of reticulocytes can be observed in anemia or malaria. A decrease in the number of reticulocytes or their absence is an unfavorable sign in anemia, indicating that the bone marrow has lost the ability to produce red blood cells.

Erythrocyte sedimentation rate (ESR) determines how quickly red blood cells settle in a test tube, separating from the blood plasma. In women, the ESR rate is slightly higher than in men; during pregnancy, the ESR increases. Normally, the ESR value in men does not exceed 10 mm/hour, and in women - 15 mm/hour. The ESR indicator may change depending on various factors, including due to various diseases.

An increase in ESR in a blood test is one of the indicators that makes the doctor assume that the patient has an acute or chronic inflammatory process (pneumonia, osteomyelitis, tuberculosis, syphilis), and an increase in ESR is characteristic of poisoning, myocardial infarction, trauma, bone fractures, anemia, kidney diseases, cancer. It is observed both after operations and as a result of taking certain medications. A decrease in ESR occurs during fasting, with a decrease in muscle mass, and when taking corticosteroids.

Hemoglobin- a complex iron-containing protein found in red blood cells - erythrocytes - of animals and humans, capable of reversibly binding to oxygen, ensuring its transfer to tissues. The normal content of hemoglobin in human blood is considered to be: for men 130-170 g/l, for women 120-150 g/l; in children - 120-140 g/l. Blood hemoglobin is involved in the transport of oxygen and carbon dioxide and maintains pH balance. Therefore, determining hemoglobin is one of the most important tasks of a general blood test.

Low hemoglobin (anemia) can be the result of large blood loss; a decrease in hemoglobin occurs when there is a lack of iron, a necessary material for the construction of hemoglobin. Also, low hemoglobin (anemia) is a consequence of blood diseases and many chronic diseases not associated with them.

A hemoglobin level higher than normal can be an indicator of many blood diseases, and a complete blood count will also show an increase in red blood cells. Increased hemoglobin is typical for people with congenital heart defects and pulmonary heart failure. An increase in hemoglobin can be caused by physiological reasons - in pilots after flights, mountain climbers, after significant physical activity, the hemoglobin level is higher than normal.

Leukocytes- These are the protectors of our body from foreign components. The blood of an adult contains an average of 4-9x10 9 leukocytes/l. White blood cells fight viruses and bacteria and cleanse the blood of dying cells. There are several types of leukocytes (monocytes, lymphocytes, etc.). The leukocyte formula allows you to calculate the content of these forms of leukocytes in the blood.

If leukocytes are found in increased numbers in a blood test, this may mean the presence of viral, fungal or bacterial infections (pneumonia, tonsillitis, sepsis, meningitis, appendicitis, abscess, polyarthritis, pyelonephritis, peritonitis), and also be a sign of poisoning of the body (gout ). Previous burns and injuries, bleeding, postoperative condition of the body, myocardial infarction, lung, kidney or spleen, acute and chronic anemia, malignant tumors - all these “troubles” are accompanied by an increase in the number of blood leukocytes.

In women, a slight increase in leukocytes in the blood is also observed in the period before menstruation, in the second half of pregnancy and during childbirth.

A decrease in the number of white blood cells, which a blood test can show, may be evidence of viral and bacterial infections (influenza, typhoid fever, viral hepatitis, sepsis, measles, malaria, rubella, mumps, AIDS), rheumatoid arthritis, kidney failure, radiation sickness, some forms of leukemia, bone marrow diseases, anaphylactic shock, exhaustion, anemia. A decrease in the number of leukocytes can also be observed while taking certain medications (analgesics, anti-inflammatory drugs).

Platelets- these cells are also called blood plates. They are the smallest blood cells. The main role of platelets is participation in blood clotting processes. In blood vessels, platelets can be located near the walls and in the bloodstream. In a calm state, platelets have a disc-shaped shape. If necessary, they become like a sphere and form special outgrowths (pseudopodia). With their help, blood platelets can stick to each other or stick to a damaged vascular wall.

A decrease in the number of platelets is observed in women during menstruation and during normal pregnancy, and an increase occurs after physical activity. Also, the number of platelets in the blood has seasonal and daily fluctuations. Typically, platelet monitoring is prescribed when taking certain medications, when a person has burst capillaries for no reason, has frequent nosebleeds, or when being examined for various diseases.

An increase in the number of platelets in the blood (so-called thrombocytosis) occurs when:

- inflammatory processes (acute rheumatism, tuberculosis, ulcerative colitis);

- acute blood loss;

- hemolytic anemia (when red blood cells are destroyed);

— conditions after removal of the spleen;

- observed during treatment with corticosteroids;

- some rarer diseases.

A decrease in the number of platelets (thrombocytopenia) is observed in a number of hereditary diseases, but appears much more often in acquired diseases. The number of platelets decreases when:

- severe iron deficiency anemia;

- some bacterial and viral infections;

- liver diseases;

- diseases of the thyroid gland;

- the use of a number of medications (vinblastine, chloramphenicol, sulfonamides, etc.);

- systemic lupus erythematosus.

Hematocrit- this is the proportion (as a percentage) of the total blood volume that is made up of red blood cells. Normally, this figure is 40-48% for men, 36-42% for women.

The volume of erythrocytes compared to plasma increases with:

- dehydration (dehydration), which occurs with toxicosis, diarrhea, vomiting;

- congenital heart defects, accompanied by insufficient oxygen supply to the tissues;

— a person being in high altitude conditions;

- insufficiency of the adrenal cortex.

The volume of red blood cells relative to plasma decreases with blood thinning (hydremia) or with anemia.

Hydremia can be physiological if a person immediately drinks a lot of liquid. After significant blood loss, compensatory hydremia occurs when blood volume is restored. Pathological hydremia develops when water-salt metabolism is disturbed and occurs with glomerulonephritis, acute and chronic renal failure, and with heart failure during the period of swelling.

Blood formula. The study of the leukocyte formula has important diagnostic value, showing characteristic changes in a number of diseases. But these data should always be assessed together with other indicators of the blood system and the general condition of the patient.

For various diseases, a combination of the following signs is looked at: the total number of leukocytes; the presence of a nuclear shift of neutrophils (the so-called “shift according to the formula to the left”, that is, the appearance of young, immature forms of neutrophils in the blood); percentage of individual leukocytes; the presence or absence of degenerative changes in cells.