Diagnostics

The resting ECG is the basic examination in cardiology. The electrical currents in the heart are displayed graphically, so that a lot of information about possible structural and functional changes in the heart muscle can be derived. It is also essential for documenting the heart rhythm and detecting cardiac arrhythmias.

The long-term ECG is carried out using a small, portable ECG device that continuously records the heart's actions over a period of 24 hours to 7 days. This examination is of great importance in the detection of cardiac arrhythmias.

The exercise ECG reflects the electrical currents of the heart during physical activity and indicates the state of health of the heart during a stress phase. The great importance of the exercise ECG lies in the detection of pathological functional changes in the heart, which only become noticeable under stress in the early stages. In addition, the course of the pulse and blood pressure under stress is documented so that both cardiac arrhythmia and inadequately adjusted blood pressure can be investigated.

Performance diagnostics, for example before resuming a sporting activity or testing the current performance level, are additional information that this type of examination provides.

This examination is an intelligent further development of the classic ECG in that it displays the ECG three-dimensionally by attaching additional electrodes and linking it to artificial intelligence.

The large amount of additional information about the functional state of the heart means that this examination method not only provides information about blood flow, but also about possible inflammatory processes in the heart muscle.

Echocardiography, also known as “echo” for short, is an ultrasound examination of the heart, which is the most important imaging procedure.

This painless examination is carried out in the left lateral position and makes it possible to examine the functional state of the heart muscles, the heart valves, pressure values in the heart cavities as well as the thoracic aorta and the pericardium. The direction and speed of the blood flow through the heart cavities and the heart valves are displayed in color. This allows valve changes to be calculated and examined for their severity.

In certain situations, when the view from the outside is not optimal, the heart can also be examined from the side of the esophagus with a special probe using a so-called swallowing ultrasound examination, which is similar to a gastroscopy. This examination method is usually carried out by anaesthetizing the throat and giving a light “sedative injection” so that the patient is not aware of the examination, which only takes a few minutes.

In order to simulate the functioning of the heart muscles and thus the blood flow under stress, a drug can be infused into the vein at the same time as a classic echocardiography (see above), which causes the heart to beat faster and more strongly as if it were doing sport.

This examination method is an alternative to an exercise ECG and is particularly suitable for those patients who were unable to achieve a sufficiently high exercise level during the exercise ECG to be able to make a valid statement about the heart's blood flow and thus an existing coronary heart disease.

How well is your brain supplied with blood?

This question can be answered by an ultrasound examination of the vessels supplying the brain in the neck area. With the help of the “Doppler/duplex” method, the blood flow velocities in the direction of the brain can be calculated. It also provides important information about the condition of the inner layer of the blood vessels, which can be altered by dangerous calcium deposits (arteriosclerotic plaques), for example, and is a major risk factor for stroke.

Furthermore, by measuring the thickness of the inner lining of the vessel (intima), a very early procedure can be used to reliably diagnose the preliminary stages of vascular calcification (arteriosclerosis). This allows the development of relevant calcifications to be prevented in good time.

The measured parameters thus provide information about the current vascular health of the person. This examination is of crucial importance if risk factors such as increased blood lipid levels, high blood pressure, obesity, diabetes or nicotine consumption are already present.

Lung function testing (spirometry) is used to gather information about the functionality of the lungs by recording basic respiratory values. By measuring the respiratory volumes, resistances and respiratory flow rates, it is possible to determine whether breathing is taking place correctly.

This procedure can be used to diagnose diseases that are associated with narrowing of the airways, for example in patients with chronic obstructive pulmonary disease (COPD), as well as bronchial asthma and other changes in lung function, such as in smokers.

Polygraphy can be used to detect relevant breathing pauses at night. These are often associated with a considerable lack of oxygen in the body and can therefore cause lasting damage to the heart, brain and kidneys.

Our patients are given a device for this purpose, which they take home with them and put on for one night during one of the following nights after prior instruction. The parameters collected via the device are forwarded to us via an app and analyzed. Our patient therefore does not have to visit the German Specialist Medical Center again.

In mild cases, treatment with a supine position prevention or mandibular advancement splint is sufficient. In moderate or even severe forms of sleep apnoea, the patient should be seen in a sleep laboratory for adjustment to nocturnal mask ventilation.

Based on the so-called cardiovascular risk factors, i.e. laboratory parameters such as cholesterol (total cholesterol, HDL, LDL cholesterol), triglycerides, lipoprotein (A) or the long-term glucose value HBA1c, an individual risk profile for heart disease can be created.

Under specific drug therapies, these laboratory values are important in order to be able to prove the effect of medication and adjust it further if necessary.

Safety through regular checks.

To ensure that your implanted system is always optimally adjusted, regular checks and, if necessary, reprogramming are necessary.

The first priority is to check the electrical conductivity of the probes coming from the device (unit) and leading to the heart. These are surrounded by a layer of insulation, which can result from friction phenomena between the collarbone and the first rib through which the probes pass. In the advanced stage, the probe can also break at this poin

Abrasion of the insulation layer can become relevant relatively quickly within a few months. Checks at 6-month intervals are therefore recommended by the relevant professional associations. In addition, all systems provide important information about past cardiac arrhythmias, which are automatically saved.

This means that pacemaker follow-up not only involves checking the functionality of the unit (e.g. battery capacity) or the probes, but also provides information on new types of cardiac arrhythmia that have occurred over the past few months.

Services:

• Pacemaker checks and programming
• ICD checks and programming (implanted defibrillators)
• CRT checks and programming (resynchronization systems)
• Event recorder checks and programming