How can you find out if everything is okay with your heart?

In a social context that tests our psyche and physique through the coronavirus pandemic we are just going through, people everywhere have become more attentive to one side of their existence, hitherto sometimes treated superficially or ignored - the state of health.

The possibility that the health condition will be affected due to the pandemic, has made more and more people aware that we have an essential role in maintaining, as unaltered as possible, the health condition. The essential role is played by prevention, followed by the active discovery of diseases that must be diagnosed in the early stages or before generating catastrophic accidents.

Of course, there are a multitude of organs involved in "devices and systems" in the human body with features related to prevention and active discovery, all being equally important in terms of a potential disease that by evolution can lead to death or permanent disability.

The heart needs more attention, and the recommended screening investigations to evaluate a possible cardiovascular disease must be in our attention. The diagnostic benefits of noninvasive imaging methods dedicated to the cardiovascular system are multiple and less well known, and are especially important because they do not presume that the explorer reaches the immediate vicinity of the explored site, as does classical coronary angiography.

Stopping or reaching insufficient oxygen or glucose in the heart muscle generates acute or chronic phenomena that can lead to what is known as a "heart attack" - heart attack.

Blood - a carrier of oxygen and glucose - reaches the heart through its arteries called coronary arteries, arteries that can "clog". "Clogging" of the arteries of the heart is a complex process, which occurs through a local phenomenon that occurs in the wall, very rarely by compressing the vessel outside the wall.

The most common mechanism by which the portion of the coronary artery through which blood flows - the vascular lumen - is narrowed or occluded / "completely clogged" is atheromatosis. Atheromatosis - this "disease of modern man" involves an abnormal deposition of lipids ("fats") in the walls of the arteries - oxygen-carrying blood vessels.

According to the above, it is logical that the arteries of the heart = the coronary arteries to be explored from two points of view - the condition of the lumen (the portion through which the oxygen-carrying blood circulates) and the condition of the arterial wall.

What non-invasive investigations can I do?

CT coronarography is the method that responds simultaneously to the above-mentioned goals, it allows the precise calculation of luminal narrowing (stenosis), as well as the evaluation of the thickness and composition of the arterial wall. This is possible using high-performance CT scanners, technically equipped to allow the acquisition of high-resolution images in short rotation times, with a large number of thin slices ("slices"). In addition to very good quality acquisitions, it is necessary to process data with advanced, highly technical medical software.

A retrospective CT scan, which results in a data set over an entire cardiac cycle, paves the way for a "STRESS" CARDIO-CT functional test, a useful investigation for establishing the resonance on the muscle of a coronary artery stenosis discovered in The first phase of the examination

Cardio - CT investigation, without the administration of the substance that induces pharmacological "stress", allows the identification of coronary stenoses, with the strictly anatomical evaluation of stenoses, without giving information about their hemodynamic significance.

However, there are numerous cases with intermediate coronary stenoses (about 50-70% of them) or in which the presence of calcified coronary plaques is found. Not all of these cases require stent implantation - a tool to dilate the narrowed portion of the coronary artery lumen. Thus, by administering a substance that causes increased blood flow to the coronary arteries ("pharmacological stress"), the area with significant stenosis can be identified and, thus, the decision to implant a stent or "bypass" surgery can be evaluated ( by-pass) of the arterial portion with narrowed / occluded lumen.

How can I check the condition of my heart muscle?

For a complete screening of the heart, after checking the arteries, it is necessary to check the condition of the heart muscle.

Magnetic resonance imaging (MRI), also known as nuclear magnetic resonance - "MRI", produces in cardiac exploration - cardio-MRI - several types of data sets that, depending on the sequences used, provide information about:

Contractility - "who" sequences, which are processed by special medical software, allow the calculation of ejection fractions of the ventricles and atria, the volumes of these cavities at the end of systole and at the end of diastole, as well as highlighting possible parcel disorders of cardiac wall motility by deformation studies. "foreigner";

Blood flow at the valvular rings of the major arteries - aorta and pulmonary artery - by 2D techniques to which the cutting-edge 4D Flow technique adds flow information to the cavities, intracardiac valvular rings - mitral and tricuspid - with the highlighting of possible communications abnormalities between the heart cavities. The 4D Flow technique offers the possibility to evaluate the malformations in the aorta - coarctations - of the resonance of the turbulent flow on the aortic wall in cases with stenoses or aneurysms, as well as a correct evaluation in time of the evolution of flows in patients operated in childhood for severe heart disease. malformations, such as Fallot's disease;

Myocardial tissue condition with assessment of increased water content / "edema", common to inflammatory pathologies (myocarditis) and ischemia, the presence of particular tissue types (fat) or materials (blood or blood degradation products) that are normally absent in myocardial level, by using the classical morphological sequences T2 FatSat, T2 *, T1, T1 FatSat or the avant-garde techniques of myocardial maps T2, T1 and "extracellular volume" (ECV)

Viability of a myocardial portion affected by an ischemia process - corroboration of data provided by T2 FatSat morphological sequences with T1 FatSat T1 images "blak blood" after intravenous contrast, allowing quantification of myocardial scar and its deference to areas of myocardium still viable, which through a correct and applied treatment in time can be saved from the evolution towards necrosis / fibrosis.

For patients with ventricular arrhythmia and suspected ischemic heart disease, a stress MRI investigation is recommended - a painless investigation that provides clear images for the diagnosis of myocardial ischemia. Stress MRI does not use radiation and is a non-invasive alternative to diagnostic visa coronary angiography that is both invasive and incomplete due to lack of functional data - respectively shows stenosis on the coronary artery but does not highlight its resonance - ie the presence or absence of ischemia - on myocardial territory tributary to the stenotic vessel.

Take care of your heart! Talk to a doctor and schedule the investigations you need.

Learn more about how to check heart health at home?