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"Doctor, I have already received electrocardiography. Why do I have to receive color Doppler ultrasound?""Is it a repeated work that both contrast examination and color Doppler ultrasound are done?" 

In the internal medicine outpatient, doctors often hear such questions from patients.Are there many investigations for cardiac examination?Are these investigations really necessary?Yes, they are necessary!Recently, a patient, Mr. Zhao (pseudonym), presented to the Department of Internal Medicine of Jiaxing Kaiyi Hospital, and his personal experience explained the importance of a complete cardiac examination to physical health. 

Mr. Zhao, 50 years old, developed symptoms of frequent tightness in chest and shortness of breath more than a year ago, especially after exercise.He presented to Jiaxing Kaiyi Hospital, and ECG showed abnormalities.Therefore, Lin Xuanzhi, chief physician of the Department of Internal Medicine, suggested that he should receive the cardiac color Doppler ultrasound, which showed "slightly thickened interventricular septum, less homogeneous echo, mild regurgitation of bicuspid and tricuspid valves", and he was preliminarily diagnosed with coronary heart disease.Subsequently, coronary artery CT angiography further confirmed that he had "soft plaque formation with severe lumen stenosis in the proximal and middle segments of the left coronary artery anterior descending branch".Based on this finding, doctor Lin advised immediate intervention to the patient and invited a cardiovascular specialist for consultation.

"Examination showed severe lumen stenosis, which means that the patient had very serious coronary heart disease, so immediate intervention is required.Fortunately, this patient came to the hospital in a timely manner, otherwise the consequences would be unimaginable."said Doctor Lin.As an important organ of the human body, the heart is so complex, and carrying out detailed cardiac examination is an essential means to find the lesion and effect a radical cure. 

So, what are the differences among various cardiac investigations?What are the respective roles?Doctor Lin said that to answer this question, the first step is to have a clear understanding of the internal structure of the heart."We can compare the heart to a house. The left and right atria, and left and right ventricles can be regarded as four rooms. Myocardial tissues surrounding the atria and ventricles are walls of the house. The aortic valve, pulmonary valve, bicuspid valve and tricuspid valve are doors and windows of the house. Cardiac vessels and cardiac electrical conduction system are water pipes and electric wire of the house, respectively." 

With a clear understanding the internal structure of the "house", Doctor Lin can interpret the roles of various investigations in detail. He said that cardiac color Doppler ultrasound can examine the "house structure and doors and windows", where we can know the structure, size, and pulsation of the heart and the flow of blood, which helps to diagnose coronary heart disease, cardiomyopathy, structural heart disease and other diseases; ECG is to examine the "electric circuit system of the house", that is, to examine whether the circuit of the heart is smooth, which helps to determine whether the patient has premature beats, atrial fibrillation and other arrhythmia problems; coronary artery CT angiography is to examine whether the "water pipes of the house" are smooth by injecting contrast agent into the cardiac vessels, so that the coronary arteries are "visualized", and then through computer imaging, we can check whether the vessels have stenosis...

After listening to Doctor Lin's detailed interpretation of the "Cardiac Structure and Cardiac Investigations", you must have a deeper understanding of cardiac examination.Finally, "heart disease is a big thing". As an important organ of the human body, the heart is closely related to people's life safety. If you have any discomfort in the heart, please seek medical attention in a timely manner, so as not to miss the best treatment time.