Stress echocardiography

In stress echocardiography, the patient is exposed to medication and wall movement disorders that occur due to the reduced supply of the heart muscle under this stress can be detected.

Is a myocardial scintigraphy of the heart useful?

Myocardial scintigraphy is one of the imaging procedures and is a nuclear medical examination that can be used to identify scars and undersupplied areas of the heart muscle. With its help, the metabolic activity of heart muscle cells can be depicted and a statement made about the vitality of the heart. The method is particularly suitable for showing the exact cause of a reduced metabolism in the heart muscle.

If the cause is a previous myocardial infarction, sufficient metabolism does not take place in the tissue either at rest or under stress. If the cause lies in the coronary arteries, the metabolism at rest is normal. Only under stress is a reduced metabolism detected due to the reduced blood circulation. Thus, a distinction can be made between a former heart attack and coronary heart disease.

Heart CatheterCoronary Angiography

Coronary angiography (heart catheter) represents the so-called “gold standard” in the diagnosis of coronary heart disease. It is currently the best and most efficient method for detecting coronary heart disease. The shape and form of the coronary vessels (coronary arteries) is examined by means of a catheter (a small tube that can be directed), usually advanced over the inguinal artery, and associated X-ray examinations with the administration of contrast medium.

Occlusions or constrictions of the cross-section of the coronary vessels can be detected, but this does not provide direct evidence of an oxygen deficiency (ischemia). If the degree of occlusion of an artery is over 90% or if wall movement disorders are visible in the X-ray image, it can be indirectly concluded that the associated supply area is undersupplied. Coronary angiography is used to confirm suspected coronary artery disease and to exclude or detect coronary heart disease in clinically ambiguous situations.

In addition, it is possible to immediately follow up the diagnostic with the therapeutic procedure: Balloon dilatation, i.e. dilatation of the narrowed or occluded vessel, or stent insertion to keep the coronary vessel open, are possible and the success of the intervention is monitored and documented immediately after the procedure by means of an X-ray image. Coronary CT angiography is based on the technique of computed tomography (CT). This means that images of an organ are taken layer by layer.

This technique uses X-rays and is performed in a CT tube. Angiography refers to a special imaging of the vessels. Using a contrast medium, which is particularly striking in CT, the blood flow situation of various vessels can be shown.

If the blood flow in a vessel is not continuous, this may indicate calcification, for example. The coronaries are the coronary vessels. A coronary CT angiography is therefore the specific imaging of the coronary vessels using computed tomography.