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- What is the Echocardiogram
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What is the Echocardiogram
EchocardiogramThe Echocardiogram is a test that is used to visualize the structure of the heart and thus to study its hemodynamic performance, i.e. its ability to pump blood. Thanks to it can be diagnosed accurately diseases cardiac, congenital or acquired, and it allows you to classify them according to their intensity and origin. The test has the same basis as other ultrasound: the emission of ultrasound throughout the body that bounce and are collected with the same device.
It's a very young test, because it was invented in the 20th century, and can not name a single inventor of the technique, since during the last decades there have been many physicians who have perfected it and have expanded its use to many fields of medicine.
In Echocardiogram has special importance the Doppler technique, which was invented in the 1980s and allows you to see not only the cardiac structure, but also the exact speed of the flow of blood inside the heart.
There are several types of echocardiography depending on the technology used. They may be studies at a level, flow, and studies of two dimensions. Usually tend to carry out studies in two or three dimensions, with added flow study. Classic Echocardiogram uses Transthoracic via, i.e., the heart is seen through the holes of the ribs. A special type of echocardiography is the Transesophageal Echocardiogram, which is carried out through the esophagus with a probe. It provides more accurate data, but its implementation is complex, and so different, that is considered an independent test.
The doctor who performs this test is the cardiologist, who will be well trained to perform the technique correctly. It is not an expensive test, but its interpretation can be difficult sometimes, and must always be accompanied by a good full medical study using clinical interview and physical examination. It's a test completely safe, simple, and convenient to the physician and the patient. Today it is a test routine in many hospitals, including children.
When an Echocardiogram is doneThe Echocardiogram is useful when the following diseases are suspected:
Valvular heart disease: so called diseases of the heart valves. Basically, there may be two problems, that the valves are not open enough (stenosis), or that are not properly closed (shortcomings). In the valvular stenosis is seen as blood is unable to pass through a small hole. The valvular insufficiencies blood will go well, but then regurgitates the previous cavities. In both cases you will listen to a heart murmur.
Heart failure: when the heart is weakened by age, a heart attack, or other reasons, its contraction may be insufficient and does not pump blood properly. The Echocardiogram allows the study of the blood pressure within the ventricles and Atria, being a simple test for the study of this disease.
Cardiomyopathies: are diseases of the heart muscle itself. We can divide them into three types: dilated, Hypertrophic and restrictive. In the hypertrophic heart has more thickened muscle and is more potent than normal, but also relaxes worse and stored less blood. In the dilated it is able to store a lot of blood, but has weak and thin walls. The restrictive the heart is hard, you can not relax, but its force of contraction is normal.
Arrhythmias: Although arrhythmias are power outages of the heart and its study is based on other tests such as ECG or holter, Echocardiogram allows to see the mechanical manifestations of arrhythmias. For example, an atrial fibrillation we would see as the Atria have a constant tremor without reaching the contract at any time.
Endocarditis: heart valve infections can be studied by echocardiography. There are warts that can be attached to the valves and hindering blood flow.
Embolism: when embolisms happen anywhere in the body (for example, an Embolic brain stroke), must be an Echocardiogram to check the origin of thrombi in the heart, as it tends to be frequent.
Pericarditis and pericardial effusion: this test permits the study of the pericardium, a membrane that lines the heart to protect and lubricate it. Motives that may change are many, it tends to be by viral infections in young people and, in older people, it can occur in context of tuberculosis or cancer metastasis.
Congenital heart disease: the study of cardiac malformations has revolutionized thanks to echocardiography. Thanks to it, many newly born them can be detected structural alterations early, and be candidates for surgical repairs. Some of the most frequent congenital cardiopathies are tetralogy of Fallot, atrial septal defect (ASD), Ventricular septal defect (VSD).
Preparation for the EchocardiogramIf you are performing an Echocardiogram these are the issues you should keep in mind to go well prepared to test:
Duration: Echocardiogram takes about 10-20 minutes. This time is usually sufficient to study all parts of the heart.
Income: Echocardiogram can be performed in a hospital or outpatient center without income. After the test, which lasts a few minutes, you can return to your normal life.
Is necessary to be accompanied?: do not need to be accompanied.
Drugs: don't need to take any prior medication. Must be communicated to the doctor all medications taken regularly, especially if you take drugs for epilepsy, psychiatric illnesses, antiarrhythmics, relaxing muscular, antiplatelet, anticoagulant, or anti-inflammatory, but will never have to be suspended for testing.
Food: it is not necessary to remain in fasting prior to testing or after.
Clothes: you can go to the quote from the test with the same clothes every day. Perhaps will ask you you to discover its top of the trunk so study the heart easily, therefore, seeks to take a shirt or t-shirt that can be easily removed.
Documents: bring the steering wheel which shows the performance of the test. You have to carry the health insurance card and medical history on diseases to study, if you have them, although the doctor will already have it with him. It can give you a document after the test.
Pregnancy and breast-feeding: the Echocardiogram is not contraindicated in pregnancy or lactation. Some test data can be altered, since pregnancy modifies the physiological functioning of the heart.
Contraindications: do not exist.
The Echocardiogram is doneFirst, the doctor will assess if it may be useful to perform the Echocardiogram. To do this it will make you a series of questions about your day to day and your illness, and then you will explore, giving special importance to the auscultation of the heart and lungs. Then it will quote you one day for the test and you will explain the basic measures that you need to know to submit yourself to it. You won't need to sign any document, and Echocardiogram does not entail any risk to the patient.
When you arrive at the hospital and passes to the test room ask you you to discover the top of the trunk. You tumbarás on a stretcher looking up and the doctor will get you a gel in the chest - which can be a little cold-, and thanks to him the Ultrasound will easily reach the surface of the skin and can penetrate into the body.
Once you are ready they will support you in the chest a transducer, which is the transmitter and ultrasonic receiver that allows to visualize the heart, and has the size of a mobile phone. The doctor will move this transducer by sliding it into the skin of the chest, and sometimes by pressing a little against the ribs. It will look for holes through the ribs where the ultrasound can pass without problems.
Will be checking all the structures of the heart one by one: valves, Atria, ventricles, aorta, veins, etc. Of each of these parties shall make lengths, areas, and will consider the speed of the blood and the amount that passes through each place. It is a detailed study you need a previous training that can last for years.
As for the study you will not do anything. It may be that sometimes the doctor asks you inspires deep or that breath you anymore. It seeks to heed her instructions to facilitate the work.
After testing the transducer will be removed and they give you paper so that you clean the skin gel. You can then dress, pick up your things and leave. Sometimes they ask you to wait a few minutes until they drafted the report that you can give at the moment.
Complications of EchocardiogramThe ECHO does not have complications because a test is non-invasive, which does not represent any risk for people who are subjected to it. Anecdotally, have been sometimes described cases of allergies to the gel applied to the home, but are delimited and mild skin allergies.
Results of the EchocardiogramThroughout the test the doctor aims data that will be used later to write the report. At the same time that the test you can see these measurements, but it is virtually impossible to analyze them because it takes time and dedication to study the different parameters at the same time.
The cardiologist will analyze the different magnitudes. If they are increased or decreased, they may have a meaning. Few times a single datum is used to give a diagnosis, usually several altered measurements, together with the clinical history and pulmonary auscultation, are bringing the final diagnosis.
Within the report can come images of different parts of the heart. They are very difficult to interpret images, but a doctor is able to see the tiny changes that indicate structural heart disease. Another possibility is that they delivered you a CD with the videos of the study; This is especially useful to show the heart flow alterations, because with a fixed image, not even the specific moment when occurs, or their variations in time they can be seen.
You can go to pick up the results of the Echocardiogram to the cardiologist who prescribed you the test. On that date it explain the alterations that have been throughout the study. It may necessary to perform more tests that determine better diagnosis, such as an Transesophageal Echocardiogram or catheterization. The treatment options will explain you and will recommend you the most appropriate.
What is an abdominal ultrasound
Abdominal ultrasoundAbdominal ultrasound is a diagnostic test which, through the use of ultrasound waves, allows to observe organs and structures that are found within the abdominal cavity. In addition, it allows simultaneously interventions as drainage of abscesses or shots of biopsies, since it makes it possible to direct punctures to the precise areas of safely. You can also examine the flow within blood vessels through a special ultrasound called ultrasound-doppler.
The device that serves to make ultrasound is called ultrasound and emits ultrasound waves that are not detectable by the human ear. These waves are introduced into the body through a tube called a transducer, which moves over the body that we want to study. The waves are transmitted inside the body and bouncing create waves that differ according to the density of the fabric through, e.g. different fluids, bone or fat. These waves are picked up by the transducer and, through a computer generated images of the body that we are studying.
Abdominal ultrasound allows to observe the abdominal organs such as the liver, gallbladder, pancreas, spleen, kidneys and bladder. It also allows to see the abdominal aorta and detect the presence of fluid between the various bodies. In women it allows to see the ovaries and uterus, and men the prostate; However, these organs are best performing an ultrasound vaginal in women or by transrectal via in men.
When should I do an abdominal ultrasound?The most common reasons why the realization of an abdominal ultrasound may be requested are as follows:
In cases of abdominal pain, suspected disease of the bile as a biliary lithiasis or an infection of the gallbladder (cholecystitis).
To rule out the presence of liver cancer, for example in patients with chronic hepatitis.
In the study of the pathology of the kidney, renal lithiasis, kidney infections (pyelonephritis), or kidney cancer.
In the study of pathology of the pancreas, such as pancreatitis or pancreatic cancer. However, sometimes the pancreas does not on ultrasound, it is an organ that is very deep. Therefore, for their study is preferred often the realization of a computed tomography (CT).
Suspected appendicitis when a TAC is not possible.
To study the presence of narrowness or abdominal aortic aneurysms.
For the study of pathology of the uterus or ovaries, or to follow the fetus in pregnant women.
To guide the needle in the puncture or to perform a liver or kidney biopsy.
To drain abscesses located in some organ of the abdomen, especially in the liver.
Preparation for the ultrasound of the abdomenIf they go to an abdominal ultrasound done to you these are the issues that you must provide in advance:
Duration: the test is performed in about 15 minutes. If you perform an intervention as an outlet of biopsies or drainage of an abscess can last more.
Entry: the abdominal ultrasound can be done on an outpatient basis.
Is necessary to be accompanied?: don't have to be accompanied by although it might help if it makes you feel more relaxed.
Drugs: is not necessary to take any prior medication.
Food: must be on fasting the 6-8 hours before the test. In case that will study the organs of the pelvis as the uterus or bladder of urine, should drink at least one litre of water in the hour prior to the test to have full bladder. This allows better observe the organs of the pelvis.
Clothing: you can wear any clothes you want, but it should be easy to remove to leave bare abdomen when they require it.
Documents: where the abdominal ultrasound as a guide of an invasive procedure, as taking biopsies or drainage of an abscess, should be informed consent, which is a role where they explain you what is the test and its potential risks. You should read it carefully and take it signed. You must take the wheel of the test request.
Pregnancy and lactation: are not contraindications for testing.
Other considerationsThere are no contraindications for the realization of an abdominal ultrasound, because ultrasound waves do not produce any effect in the organism.
Abdominal ultrasound is performedTo perform an abdominal ultrasound you will be asked you lay it face-up on a stretcher and let exposed abdomen. It is not necessary to change clothes. Medical radiologist in a room in semi-darkness will test generally to allow you to better view the images on the screen.
The doctor will put you a gel in the abdomen to increase the driving of the ultrasound waves through the skin. This gel can be rather cold. The doctor will pass the transducer parts of the abdomen, which does not usually cause any pain or discomfort, unless your doctor has to press something stronger in any particular area of the abdomen. The passage of ultrasound does not originate any discomfort. It is possible that you have to change something from stance to allow a better visualization of an organ. Where necessary the study of any blood vessel, the doctor will use the technique of the ultrasound-doppler in which you may hear an intermittent beep which corresponds to the blood flow of the studied glass. You will not notice any pain or discomfort.
After completing the test facilitate you a paper to clean any residual gel abdomen. This gel has moisturizing properties so there is no problem to leave it or extend it by the abdomen.
Ultrasound is a very safe test. Ionizing radiation are not used as in x-rays or CT. The ultrasound waves do not have any detrimental effect on the body, so the test can be repeated as many times as needed without causing any prejudice. It is extremely rare that gel that is used to improve the driving produces allergy skin. In cases of serious problems of coagulation, the passage of the transducer can cause a hematoma in skin, although this is extremely rare.
Results of an abdominal ultrasoundThe images obtained by the ultrasound can see and interpret immediately by the radiologist. However, the doctor often dictate a report that may take a while to be in writing. It should take into account that ultrasound is a dynamic test and interpretation of the images is done on the ultrasound screen. Static images that can be obtained on paper are less diagnostic value.
The results of abdominal ultrasound report will include data on bodies scanned and found finds. The type of discovery can vary greatly depending on the pathology and studied organ. Many times you can find tumors benign or malignant, signs that indicate various infections, including abscesses or inflammation in any organ, malformations or pathology of the biliary tract or urinary tract.
Can be found in relation to vessels that irrigate the various organs or abdominal aorta, thrombus, vascular infarcts (due to the blockage of an artery), aneurysm or bleeding. It is often necessary to repeat the test to see how evolve different injuries, either spontaneously or with treatment.
Abdominal ultrasound has two major limitations. One is the presence of gas in the intestines. The air does not properly transmit ultrasound waves, preventing correct display of the bodies which may be behind the bowel. Obese patients, as the bigger the amount of tissue that have to go through the worst waves of ultrasound are the images obtained.
It is advisable to go to pick up the result and not assume everything is normal because the results you are not delivered in a few weeks. The doctor has asked the test will give you the results and will indicate the need for any treatment or other complementary explorations.
What is the ultrasound-doppler
Doppler ultrasoundThe ultrasound is a technique based on the ultrasound that allows to study the soft organs from almost anywhere on the body. It is not, however, to study the solid as the bones organ, because ultrasound do not cross them. The same applies to gases, making it difficult sometimes to an abdominal ultrasound done correctly. Ultrasounds come out from the end of the ultrasound, collide against the organ to study and bounce to return at the end of the ultrasound where they capture.
One of the types of ultrasound is the ultrasound-doppler (or echo-doppler). This type of ultrasound scanners allow you to use the Doppler effect, which was discovered by the Austrian physicist Christian Andreas Doppler. The effect is that when an object moves away or is close to a person, the sound emitted varies in its frequency (i.e., is more or less serious or acute). It is easy to recognize this effect when approaching an ambulance, the sound will be sharper when it approaches as well as more intense.
Ultrasounds that bounce off the blood will be different depending on the direction and the speed of blood flow. When it nears the ultrasound frequency will be higher, and when child away. Thanks to these changes in the ultrasonic waves, ultrasound can be interpreted and assigned a specific color for each frequency. Commonly used colors Red, Blue and yellow.
It is a risk-free, fast test to perform, and comfortable for the patient. It becomes a forced and especially useful technique when thrombotic of veinsor arteries diseases are suspected. Also used routinely in ultrasounds during pregnancy and echocardiography. It has the same limitations as a normal Ultrasound: not can pass through bone, so it goes beyond the skull, or gas, so it does not study the lungs.
When doing an ultrasound-dopplerAn ultrasound-doppler is performed when you want to study blood flow in a particular place, as it can be directly the blood vessels (veins or arteries), but also the blood within the heart or other organs. The test can detect these problems:
Partial or complete blood vessel obstruction: any artery or vein may see reduced its light; one of the most frequent causes are arterial and venous thrombi . It is frequently used in deep venous thrombosis of the legs, as the technique of choice. It also serves to study cholesterol plaques in some arteries, such as the carotid arteries of the neck.
Heart disease: you can study the impact that has on blood flow the stenosis and valvular insufficiencies of the heart. In this way it serves complement to a normal echo because it allows to know the severity of alterations.
Fetal malformation: ultrasound study allows us to view a developing fetus malformations, but with the ultrasound-doppler we can see also the cluttered arteries and its weak walls. Known relations between an altered blood flow and the possibility of developing malformations.
Pre-eclampsia: pre-eclampsia is one of the most common complications of pregnancy that causes the woman's blood pressure to rise, too, and it is very serious for the fetus. Ultrasound-doppler allows you to advance the diagnosis of this disease by studying the blood flow through the placenta.
Fetal distress: at the end of the pregnancy the baby needs more contribution of oxygen and nutrients through the placenta because it is bigger. However, the placenta is older and the blood flow is decreased. The doppler ultrasound can detect when it's an untenable situation.
Venous varicosity: the venography is a technique that is not often used today, but is still useful to check the venous permeability in all respects and plan the surgery.
Surgery planning: in some special situations it is necessary to perform an ultrasound-doppler to study flow and blood circulation in the area that will be performed.
Preparation for the ultrasound-dopplerIf you will perform an ultrasound-doppler , these are the issues that you must take into account:
Duration: the ultrasound-doppler takes about 15 minutes.
Income: is usually done on an outpatient basis, although it is not uncommon to do it yourself during a hospital admission or emergency.
Is necessary to be accompanied?: is not necessary. It's a comfortable and simple test. You accompany depends more on your state of health than the test itself.
Drugs: drugs that you take tend not to influence the outcome of the test. Anyway, always you must tell your doctor all the medicines that you take.
Food: you can eat and drink before the test without restrictions, although if you're in the emergency room it is better that you stay in fasting, because you don't know if the test will yield a result that need immediate surgical intervention.
Clothes: you can go with the same clothes every day. For testing you will be asked you to discover you the area to study, so try to be spacious and comfortable.
Documents: it is recommended to carry the personal medical history, although the doctor will already have it with him.
Pregnancy and breast-feeding: is a test that can be performed without problems in these two situations, and in fact is routinely performed constantly.
Contraindications: there are no contraindications for the test. Just remember that it is not useful in parts of the body are occupied by bone or air.
How the ultrasound-dopplerFirst, the doctor will perform a series of questions about your health and the symptoms by which consultations. Then perform a physical examination that expect to find signs in different equipment and systems. If the physician deems it appropriate it shall request an ultrasound-doppler , which help in diagnosing or confirm you initial clinical suspicion.
Make you test it is not necessary that you enter. Don't remain in fasting before, nor it is mandatory to go to a hospital accompanied by. If you are quoted for you test in a programmed way come with enough time to get quiet. Upon entering the room where the test will make you ask yourself you discover a part of the body to study. If it is a large portion you will be asked you here and will give you a batin's hospital. Once inside, you will see a monitor and a table where you tumbarás in the position that is most comfortable to study you.
The doctor that carry out you the test, usually a radiologist, will a cold gel on skin that is over the study area. Then apply the probe of the ultrasound on the gel and will push the skin. The probe is the size of a mobile phone and the doctor must press to get a sharp image of the vessels that want to study. It is normal that may result you a bit uncomfortable at first, both by gel cold pressure exercised by the specialist, but it is not painful at any time.
The doctor will perform various movements with the probe. It will rotate it, scroll, and pull on your skin; Thus, able to study blood flow in various directions. If required, it will put more gel. During the study, you will hear strange sounds, ultrasounds that are heard on the ultrasound monitor.
When you are done they will leave you paper to cleanse your skin gel and ask you that you get to dress. Usually not can tell you the results directly and you'll have to wait for consultation with your physician. If you are an emergency, or is your own doctor who makes you the test, you can see the results directly.
Complications of the ultrasound-dopplerComplications of this test has not been described.
Results of the ultrasound-dopplerUltrasound-doppler findings are obtained at the same time of it, but its interpretation must be done with caution. So often not can tell you the results directly and you have to wait to have it delivered them you another day. In emergency situations it may make a clinical judgment in the Act and communicate it to you immediately.
Multiple parameters of blood floware studied with this test. Its speed, direction, flow, etc. All of them are given in different units of measure. However, the normal values of these measures depend on the area of the body to study. What is a normal flow in the heart may be pathological in carotid arteries or other areas. Why the results should be studied thoroughly.
It is common that with results delivered any image, even if they do not you should not worry because it doesn't serve much. In the picture you will see typical shades of gray that are seen in a normal ultrasound, but with areas of colors. These colors represent the blood flow from red to blue. Red indicates that the flow goes in direction to the ultrasound probe (the more intense faster is), and blue that moves (the more intense more quickly moves away). White or yellow usually indicate a slow or more stable flow.
What is an EKG?
ElectrocardiogramElectrocardiogram (EKG or ECG) is a diagnostic test that assesses the rhythm and cardiac function through a record of the electrical activity of the heart.
The heart beats because it emit electrical signals that arise from the right atrium (in a structure called the sinus node) and are transmitted by a few specific routes which are distributed by all the heart, leading to the heart beat. This electrical activity may be collected through electrodes that stick in the skin, specifically in the front part of the chest and arms and legs.
Electrical impulses They are recorded in the form of lines or curves on a graph paper, which translate the contraction or relaxation of the Atria and the ventricles. This record is what is called electrocardiogram.
When do an electrocardiogram?There are many problems, both cardiac and non-cardiac, which alter the electrical currents from the heart and which can be diagnosed with an electrocardiogram. Usually ask for an EKG in the following situations:
If chest pain or other symptoms that suggest an angina pectoris or myocardial infarction.
In the event of suspicion of cardiac arrhythmias.
In the study of suspicion of other cardiac problems such as pericarditis (inflammation of the pericardium, a membrane that surrounds the heart), myocarditis (inflammation of the heart muscle or myocardium), problems of the heart valves, heart failure, etc.
In persons carrying pacemaker, to evaluate the performance of the device.
Some lung pathologies and lung embolism, in which a thrombus, which usually occurs in the legs, migrates to the lung and obstructs a blood vessel. This pathology can have a reflection in the heart and is suspected with an electrocardiogram.
In disorders of ions such as potassium, magnesium, calcium, etc, as its alteration is also reflected in an EKG.
Finally, calls an electrocardiogram before surgery to assess the function of the heart.
Preparation for an electrocardiogramThese are the issues that you must consider when you undergo an electrocardiogram:
Duration: the test is performed in about two or three minutes. Which takes more time is to place the electrodes on the chest, ankles and wrists.
Entry: test can be done on an outpatient basis.
Is necessary to be accompanied?: don't have to be accompanied by, although it might help if it makes you feel more relaxed.
Drugs: is not necessary to take any prior medication. You can take your usual medication.
Food: don't have to go on fasting.
Clothing: can wear the clothes you want, but something that is easy to remove because it will ask you to leave bare chest, ankles and wrists should be. Nor should carry metal objects (earrings, bracelets, etc.) because they will be asked to remove them during the test.
Documents: can take the previous reports with your health information.
Contraindications: there is no contraindication to the realization of an electrocardiogram.
Pregnancy and lactation: not contraindicate the realization of the test.
Other considerations: it is important to tell the doctor the medication that you are taking, as some medicines can cause alterations in the ECG. Not do exercise immediately before the test and be as relaxed as possible, because any movement can alter the registry should.
How is an EKG?The electrocardiogram (ECG) test is absolutely painless.
For its realization the person tomb is face-up on a bed or stretcher. If it does not tolerate being lying at all, will rise the headboard of the bed.
You will be asked you to detach from all metal objects carrying over (watch, bracelets, rings, earrings, coins, belts...), because that can alter the registry.
The technician will put six electrodes, such as patches or stickers, on the left front of the chest, one electrode on each ankle and one on each wrist. A small suction cups are used sometimes instead of stickers. If amputees or persons carrying a plaster cast, sticker is put on the part of the limb that allows it, or in the trunk, as close as possible to the tip. Sometimes it is necessary to clean with alcohol, or even shaving, the area where the stickers are put to facilitate conduction through the electrodes.
Finally, connect a few wires to the electrodes and these to the ECG device. Hard log collection a few seconds that should stay quiet and without talking, although he can breathe normally.
Many times, when patients are under observation or admitted, and it is necessary to carry out several electrocardiograms on the same day, can the stickers do not withdraw and use them in the EKG successive. This helps to compare electrocardiograms, because they have taken the record exactly at the same points. However, if he goes home be removed him the stickers immediately after the completion of the test, or you can withdraw them without problems.
Complications of an electrocardiogramElectrocardiogram test does not have any kind of complication. Do not pass electrical current through the body. If you have to shave the skin you may notice some small discomfort. On rare occasions, the stickers can give a small irritation on the skin or you may notice some discomfort to withdraw them. You can be a normal life after the race.
Results of an electrocardiogramThe electrocardiogram (ECG) is obtained in a few seconds. However, the interpretation of the record requires specific training and must be performed by a cardiologist, physician or trained medical personnel. Therefore, the test result can be one day after its completion.
Your doctor will inform you about the results of the electrocardiogram and will instruct you if it needs new revisions or performing other procedures. Not all the cardiac pathology are reflected in an EKG.
In the interpretation of the electrocardiogram, the specialist evaluates mainly:
Heart rate, which under normal conditions is between 60 and 100 beats per minute.
Heart rate, that when it is normal is known as sinus rhythm. It means that the heartbeat originated with normality in the sinus node and has followed the usual way by heart without interruptions or arrhythmias.
The axis of the heart. That is, if the heart is at its usual location with the tip pointing left. Some pathologies may change the axis of the heart to the right or excessively rotate it to the left.
Hypertrophy or growths of the Atria or ventricles.
Signs of lack of irrigation in the heart (ischaemia) which produce characteristic changes in some parts of the layout of the ECG.
What is the electroencephalogram (EEG)
Electroencephalogram (EEG)The EEG, electroencephalogram, or EEG, is a test that is used to study the functioning of the central nervous system, specifically the activity of the cortex of the brain. It essentially consists of using special electrodes register the electrical currents that form in the brain neurons, and that are the basis of the functioning of the nervous system. Thanks to it can be diagnosed alterations of brain electrical activity that suggests diseases such as epilepsy, narcolepsy or dementia, among many others. It is also an essential test to certify a death in a patient in a coma.
Since the 19th century were already performed experiments in which will detect electrical currents in the brain of monkeys, but was needed to open the skull for your study. Eventually, the electrodes improved and already detected brain activity through the skull. In 1920 the German doctor Hans Berger began his studies of electroencephalography in humans, which meant a revolution in the field of Neurology and Psychiatry.
This test may identify normal and pathological cerebral activity rhythms. Normal electrical waves depend on the State of wakefulness or sleep. Waves which are typically are:
- Vigil: Alpha rhythms, delta, beta and thetha.
- Dream: activity REM and non-REM (which is divided into 4 phases).
- Stimulus: alterations of the rhythms of the past when Visual, sound, painful or sensory stimuli.
When doing an electroencephalogram (EEG)Electroencephalogram (EEG) is a test that is used when the following conditions are suspected:
Epilepsy: this disease appears when a group of neurons begin to generate nerve impulses of an uncontrolled manner that spread throughout the brain. That leads to a seizure which can be detected with the realization of an electroencephalogram.
Dementia: dementia is a clinical diagnosis, every time described more alterations encefalograficas that help to classify them and so you can adjust to the best treatment that delay their advance.
Brain damage: the brain can occur for many reasons. Among the most common are strokes (or strokes) and head injuries. In those cases, there would be a part of brain without electrical activity that would be in the electroencephalogram.
Encephalopathies: encephalopathies are different from other brain diseases that in this case the brain is healthy, but there are external agents that modify its activity. We may find ourselves brain diseases, metabolic, toxic, inflammatory, etc. All of them can have manifestations on the electroencephalogram.
Psychiatric disorders: is used as a complementary test to qualify better psychiatric alterations of each patient. The EEG is also used in research to find a relationship between the biological basis of each disease and the psychological picture.
Coma and brain death: the electroencephalogram can help differentiate between these two States. In both cases the person is unconscious but breathing and their heart beats. In coma there is brain activity, but in brain death (is not what is known as 'flat electroencephalogram').
Preparation for the electroencephalogram (EEG)If they are going to perform an electroencephalogram (EEG) these are the issues that you must take into account before introducing you to the test:
Duration: electroencephalogram takes about 20-30 minutes. The only extra time would be the preparation and collection after the test. Sometimes must be an electroencephalogram during sleep (as in polysomnography), by proving it can last a night.
Income: the electroencephalogram can be in a hospital, with a unit of neurophysiology, without requiring the patient admission, so you will be able to test and then return to your normal life.
Is necessary to be accompanied?: do not need to be accompanied.
Drugs: don't need to take any prior medication. Should be communicated to the doctor all the medicines taken regularly and will decide which suspend or maintain, especially if you take drugs for epilepsy, psychiatric illnesses, antiarrhythmics, relaxing sedative or muscle.
Food: it is not necessary to remain in fasting prior to testing or after. You can not drink drinks with caffeine between 12-8 hours before the test (coffee or energy drinks).
Clothes: you can go to the quote from the test with the same clothes every day. The night before you will have to wash your head with your usual shampoo, but you should avoid conditioners, masks or other cosmetic products.
Documents: is essential to bring with you the steering wheel which shows the performance of this test. You have to carry the health insurance card and medical history on diseases to study, if you have them, although the doctor will already have it with him. It can give you a document after the test, keep it.
Pregnancy and breast-feeding: the electroencephalogram is not contraindicated in pregnancy or lactation. Although it is important that the doctor knows you are pregnant, because some biological constants are altered for itself during these stages.
Contraindications: is considered a safe test and has no absolute contraindications. However, it recommended caution in an EEG performed in people with severe seizures, since they may be triggered easily during the test.
How the electroencephalogram (EEG)First, the doctor will assess whether it may be useful to perform the electroencephalogram (EEG) and if so will quote you one day for the test and you will explain the basic measures that you need to know to put you to the test. Avoid drinks with caffeine (coffee, Coca Cola, energy drinks...) 12-8 hours before the test, and the day before its realization do not use conditioner, hair gel or other hair cosmetics in the area of the body that you go to study.
When you arrive at the hospital and go to the room where you someterás to the EEG ask you that you sit in a Chair. Then placed the electrodes in her head, which are adhesive patches that are glued to the scalp. They are between 16 and 25 sensors, for concerned it the entire head. So well they conduct electrical impulses used a hair gel, so hair is very viscous after the test, but it solves no problems after washing it. All electrodes have a cable that terminates in an oscilloscope that records all the electrical signals.
Once placed all the electrodes, they ask you that relax and remain seated with your eyes closed. Throughout the test you will be monitored by the physician or the technician electroencephalogram, may not stay in the room and go to an adjoining room with a window, thus will not affect the test. While you're relaxing resting brain electrical activity will be recorded.
To detect the brain electrical activity corresponding to external stimuli, they will make different simple sensory experiences . For example, to see what the response to Visual stimuli you illuminated with a flashlight several times, to sound stimuli used a beep that will vary in intensity and tone, and to the sensory stimulus directly touched parts of your body with different textures. Another stimulus that is frequently used is breathing fast and deep for a few seconds, that maneuver can trigger mild epileptic seizures in some people and modifies the brain electrical activity.
Once the test completes one electrode will be one. They will leave you a paper or cloth to remove excess gel thickness, although you will have to wash your hair later at home. Then you may have to wait until you give you the results, although not come analyzed by the doctor because you'll need more time.
Complications of the electroencephalogram (EEG)The electroencephalogram is a very little invasive test and does not usually pose any risk for people who are subjected to it. Some complications that have been described in relationship to it is that some of the electrodes can irritate the skin in people who have it especially sensitive, something not very common.
When you study the cerebral electrical activity against external stimuli can be triggered seizures in individuals predisposed to them. This is normal and in many cases are looking that they happen to be able to study, but in people with a history of very serious crises should assess whether it is worth the risk of appearing a new crisis.
Results of electroencephalogram (EEG)During the realization of the electroencephalogram (EEG) electrodes different capture electrical signals that are stored in a memory. At the same time that the test you can see these measurements, but it is virtually impossible to analyze them because it takes time and dedication to study the different parameters simultaneously.
The neurophysiologist or neurologist will analyze the pattern of electric waves recorded on the electroencephalogram. It is set in several parameters such as frequency, amplitude, and the morphology of the same. The frequency is the number of times that a wave is repeated in time, the width is the distance between the maximum and minimum point of the wave, and morphology is seen with the way that each type of wave. With those data can differentiate the rhythms alpha, beta, REM, caused by stimuli, etc.
You can go to pick up the medical specialist who sent you the test, results of electroencephalogram (EEG) will normally be a neurologist. On that date it explain the alterations that have been throughout the study. It may necessary to perform more tests that require further diagnosis, such as a CT scan or an MRI. After all, your health care provider explain your illness and what treatment options, among which will recommend you the most suitable option.
What is an electromyogram
ElectromyogramEMG is a test that is used to study the operation of the peripheral nervous system and the muscles that innervates. Thanks to it can be diagnosed accurately neuromuscular diseases , congenital or acquired, and it allows you to classify them according to their intensity and origin. The test essentially consists of register using special electrodes the electric currents that form in the nerves and muscles to produce contractions.
The ability that had the muscles to produce electrical currents, thanks to the study of muscles of the fish line was known since the 17TH century. But until 1890 failed to make the first record of muscle electrical activity by the doctor and French photographer E. J. Marey; Since then, the technique was perfected and in the second half of the 20th century were to develop tiny electrodes that could register the electrical activity of cell-to-cell.
With this test you can identify if the neuromuscular disturbances are due to muscle or nerve fibers. So it basically scans:
§ The amplitude of electrical currents.
§ The number of muscle fibers which contract.
§ The time it takes to shrink.
§ While remain collapsed.
The doctor who analyzes such tests is the neurophysiologist or neurologist, and with that initial data can make a pretty close analysis of the origin of the alterations. It is not a very expensive test, but its interpretation can be difficult sometimes, and must always be accompanied by a good full medical study using clinical interview and physical examination. It must be performed by experts, and only when you go to be useful to determine a diagnosis or adjust a treatment. It is usually done on units specific Neuropsychological what's in hospitals and clinics.
Electromyogram is a safe, useful and simple to test, and today is a test routine in many hospitals, even in children.
When an electromyogram is madeElectromyogram is a useful test when the following diseases are suspected:
Neuropathies: non-inflammatory degenerative diseases of the nerve fibers are referred to as neuropathy. They are classified as they affect nerves single, multiple, or so patched all over the body. Its causes are many, may appear in the context of autoimmune diseases, diabetes or alcoholics.
Muscular Dystrophies: there are degenerative muscle diseases appearing since childhood. The muscle fibers do not have sufficient strength and degenerate into fat, this makes skeletal movements and even breathing was difficult. One of the most frequent Dystrophies is Duchenne dystrophy.
Myasthenia gravis: it is an autoimmune disease. In this case there is no involvement or of nerve fibers or muscle fibers, the damage occurs at the junction between ones and others, at the appearance of antibodies directed against the receptors of the electrical signals.
Carpal tunnel syndrome: the nerves that supply the hand allow their movement and their sensitivity. They go through a fairly narrow tube in the wrist, which sometimes can be too narrow and compress nerves, altering them. The cause is unknown although it has been associated with other diseases.
Lateral sclerosis Amyotrophic: is a congenital disease of the nervous system, of unknown cause and without treatment. Destroyed nerve fibers responsible for movement, from the spinal cord to the muscle.
Guillain-Barré Syndrome: is a disease of the nervous system associated with infections that trigger a reaction of the immune system not well known so far. People who suffer lost nervous performance from the feet upward, sometimes reaching hinder breathing. Resolved over time and often have a good prognosis.
Preparation for an electromyogramIf you are performing an electromyogram these are the issues that you must consider when ready to test:
Duration: electromyogram takes about 20-30 minutes. The only extra time would be the preparation and collection after the test, which in any case would be less than an hour. In winter, if you come from the street, the start of the test usually take a little longer because you have to do it with a proper body temperature.
Income: electromyogram can be performed in a hospital with neurophysiology unit without requiring admission, and then you can return to your normal life. The only modification required in life habits is not intense physical exercise the five days prior to the test.
Is necessary to be accompanied?: is not necessary to be accompanied.
Drugs: don't need to take any prior medication. Must be communicated to the doctor all the medicines taken regularly, and will decide which suspend or maintain, especially if you take drugs for epilepsy, psychiatric illnesses, antiarrhythmics, relaxing muscular, antiplatelet, anticoagulant and anti-inflammatory.
Food: there is no why stay in fasting prior to testing or after.
Clothes: you can go to the appointment with the same clothes every day, and perhaps ask you to discover the part of the body to study. Avoid creams and products of personal hygiene in that area of the body.
Documents: is essential to present the steering wheel which shows the performance of this test. And you also have to carry the health insurance card and medical history on diseases to study, if you have it, although the doctor will already have it with him. It can give you a document after the test.
Pregnancy and breast-feeding: electromyogram is not contraindicated in pregnancy or lactation, although it is not a test that is performed much in those situations, since some biological constants are altered for itself during these stages.
Contraindications: diseases of the blood coagulation have a relative contraindication, as electrodes are used in the form of thin needles that reach the muscle.
How an electromyogramFirst, the doctor will assess if it can be useful to get an electromyogram. If you see fit, I will quote you one day for the test and you will explain the basic steps you should know. You should avoid exercising the five days before and the day of the test don't get creams and lotions in the area of the body that you go to study.
When you arrive at the hospital and passes to the test room ask you discover the part of your body to study. They apply antiseptic products on the surface of the skin so clean of germs. Then placed sensors in the form of very fine needles that will pass through the skin to the muscle. This can be painful for some people, but it is no different than an intramuscular injection, and not to introduce any medication not rankles both.
The number of electrodes is highly variable, depends on the impairment of neuromuscular study, affected muscle, and the extension of the study. It varies from a single electrode to ten, in the majority of cases. All electrodes have a cable that terminates in an oscilloscope that records all the electrical signals.
Once all the electrodes placed you will be prompted that you make muscle contractions to study or to do certain movements, and the electrodes recorded electrical activity. They can increase discomfort when moving the muscles, but they are only a few seconds. Then will be the test Conversely, electrodes will be shock and will cause muscle contractions.
Once the test completes one electrode will be one. Sometimes it is necessary to press the point of puncture to prevent bleeding. The area will be cleaned again and they will be small dressings at the puncture points. Then you may have to wait for you give you the results, although not come analyzed by the doctor because more time is needed to do this.
Complications of electromyogramElectromyogram is a very little invasive test and does not usually pose any risk for people that is performed. Some complications that have been described in relationship to it is that some of the electrodes can irritate skin in especially sensitive people, something not very common. Bruised and bleeding may appear in people taking medications that alter blood clotting. Infections are extremely unusual, thanks to the use of single-use sterile needles.
Results of an electromyogramDuring the realization of the electromyogram different electrodes pick up electrical signals, which are stored in a memory. At the same time that the test you can see these measurements, but it is virtually impossible to analyze them because it takes time and dedication to study the different parameters.
The neurophysiologist will analyze the number of muscle fibers that is capable of activating a nerve download, with intense contract, there is a long latency from discharge until the contraction, and the duration of each contraction time. If the damage is in the nerve fibers the muscle contraction will not be altered, but the number of muscle fibres activated will be lower, because you will not get the nerve impulse to all. If the damage is in the muscle fibers it will be just the other way around, a correct number of muscle fibers will be activated but its contraction will be altered.
You can go to collect the results of electromyogram medical specialist who sent you the test, and which will normally be a neurologist. On that date it explain the alterations that have been throughout the study. It may necessary to perform more tests requiring more diagnosis, as for example a muscle or nerve biopsy. The treatment options will explain you and will recommend you the most suitable option.
What is the ELISA technique
ELISAELISA is an acronym that is known by enzyme-linked inmunoabsorción assay (in English enzyme-linked immunosorbent assay). This is a technique of laboratory that was designed by scientists Swedes and Dutch in 1971, which can detect small particles called antigens, which are usually fragments of proteins. Identification is specific, i.e., get that small segments of proteins stand out and can not be confused with each other.
To identify the antigens are molecules with two coupled components: an antibody (which binds to the Antigen specific) and an enzyme (which is activated and designates the Antigen-binding). Before the discovery of the ELISA radioactive molecules instead of enzymes, used to posing an unnecessary added risk in the laboratory and a higher cost.
Thanks to this technique have been able to perform scientific studies in fields such as biology, biochemistry, and medicine. At the hospital it is mainly used to identify germs aggressors who are found in the blood, urine, sputum, etc. The technique soon became widespread with the use of simple and inexpensive equipment that are used still today in many worldwide diagnostic centers.
The different types of ELISA are:
Direct ELISA: is the most basic form of the technique. It consists of collecting a sample study and place it in a well (small bowl) in front of a sample same but contaminated with the germ to study, and another sample which is known that there are no germ. Applies the antibody with the enzyme in three wells and compare the sample to study with the other two.
Indirect ELISA: it is similar to the direct ELISA, but in this case is first added an antibody without enzyme and then one with enzyme. In this way, the signal issued by the enzyme is much more powerful and test is more sensitive.
ELISA sandwich: in this case in the wells first an antibody is added and then the sample, so that antigens are already held in the bottom of the well. Then add the antibody with the enzyme. It is the most effective way of performing the test.
ELISPOT: it is a type of ELISA that allows to know quantitatively Antigen, even identifies the specific number of cells where is located.
When is an ELISAELISA you are recommended in all situations in which you want to detect antigens whose existence can be decisive for a diagnosis or to draw conclusions in a scientific study. Some of the most frequent situations where the ELISA is used are:
Diagnosed with HIV: is the first test that is performed to rule out HIV infection. It is a very sensitive test, so virtually all cases detected. However, may cause false positive results, which is usually repeat back an ELISA and confirmed with a Western-Blot.
Detection of antibodies against microorganisms: sometimes the Antigen to study may be another antibody. This situation occurs, for example, in the identification of antibodies against the bacillus of tuberculosis, among others.
Diagnosis of hepatitis B: similar to HIV, the hepatitis B virus can be recognized easily by an ELISA blood.
Detection of fecal germs: some viruses can be detected in feces when they cause diarrhea; the most frequent are the rotavirus. Sometimes not detected the germ itself, they can identify toxins which produces the same, as it is the case with the e. coli
Detection of antigens in urine: is a very useful and simple test to identify germs that cause pneumonia. Respiratory infections bacteria become blood and from there to the urine, so they can be antigens easily identified with an ELISA, which orients the antibiotic treatment directly.
Preparation for an ELISAIf they are going to conduct a study using the ELISA technique, these are issues that you must take into account:
Duration: sample collection usually takes very little time, what it takes to be a blood analysis. It usually takes seconds or minutes. The results are slow quite a bit, usually several days. In emergency situations, you can perform an ELISA and the results in one hour approximately.
Admission: admission is never needed. Sample collection you do at the time. Also may be the case that made you the test during an entry to identify the cause of your illness, but in this case the reason for the income will be your state of health.
Is necessary to be accompanied?: no, just received a puncture when blood sample which must be, and is not usually very painful. You can go to the clinic, only walking or driving, and return the same way.
Drugs: don't need to take any prior medication. You should tell your doctor all medications you are taking at that time. Some medications can give false negative results of the test, for example if you take antibiotics and want to detect the germ causing the infection.
Food: you can eat normally, you don't have to go on fasting. But if the sample is blood it is frequent to seize the prick of Analytics to measure yourself with other parameters in blood (sugar, cholesterol, etc.), so it is best that you reports or directly stay in fasting if analytics is early.
Clothes: you can wear normal street clothes.
Documents: it is recommended to carry your health card, although most of the times is enough to you to take the wheel with which the doctor sent you proof.
Pregnancy and lactation: this test can be normally in either of the two situations. In fact, it is a test that is usually performed in periodic inspections of pregnancy established.
Contraindications: there are no contraindications. So just rating if it really is worth the test and the results would serve as something.
How an ELISAThe doctor will ask the analysis by ELISA when necessary and is the best diagnostic weapon to study your disease. To make it, first take you the sample on which the ELISA will be held.
According to the site of specimen collection is recommended to adopt one or other measures. For example, if urethral should not urinate in the two hours before; If a sputum it is best to pick it up first thing in the morning, and if it's a blood sample it is best to match a fever peak. But will those details you know the doctor before testing you, so you should not worry.
Once have collected you the sample to study you can make a normal life. While waiting the results you must not be nervous and you must keep your routine. So you know how ELISA we summarize the steps below:
Settles the sample collected in trays with small pools. To the side there will be wells for samples that are known are contaminated and free of antigens known.
Once you have placed the sample are added antibodies that detect antigens if available. At the other end of the antibodies are coupled enzymes.
If it is an indirect ELISA can be added other antibodies that detect previous antibodies; Thus expands the signal.
Is a washing the wells; antibodies that are not linked to antigens are thus eliminated.
A substrate, i.e. a chemical that reacts with enzymes of antibodies that are is added. When the metabolites are formed.
Finally, it measures the amount of metabolite that is using different techniques, such as spectrophotometry.
Complications of the ELISAThe complications of the ELISA are virtually non-existent. It is a safe test that does not entail risks for persons who are subjected to it. The only risk is to accept false as positive or negative results, and take wrong steps in this regard.
Results of the ELISAThe results of the ELISA can take several days since the sample is taken for study. To pick them up there to keep another appointment, since the documentation alone can not be interpreted by the patient. In consultation the doctor will be the most appropriate interpretation of the result. If you are admitted shall communicate them yourself during your stay in the hospital, or later if given medical discharge earlier. In case of an emergency consultation may give you results in less than an hour.
The ELISA is expressed in qualitative values, i.e. is positive or negative. Only the ELISPOT can provide quantitative results, but there is no standard limits for all studies. When the ELISA is positive it means that they have detected antigens in the sample collected, and therefore there are germs present. When it is negative, not have been able to detect antigens and considered that the sample is not contaminated.
Although it proves very effective may provide false positive or false negative results. In situations where the ELISA is critical and radically change the attitude of the doctor, it is usual to test two times in a row, or perform another to ensure the result. It is the case of the testing of HIV: diagnosis is crucial for a person, and that two consecutive ELISA and other equipment are more than it allows to confirm the diagnosis with much more reliability.
What is the barium enema
Barium enemaThe enema is a diagnostic test that studies a possible pathology of the colon (large intestine) through X ray. To do so, is introduced by the rectum a barium compound called contrast that fills all the light of the colon. This contrast is opaque to x-rays, hence the name of barium enema, and allows to draw the entire surface of the colon and diagnose various diseases. Sometimes this test is also called barium enema.
There are two kinds of enema:
Simple enemaAlso called "simple contrast", in which the colon is filled with contrast and draws possible pathologies that are in the light of the intestine.
Of double-contrast barium enemaThe barium enema of "double-contrast", in which the colon is filled with contrast, but then allowed to leave, staying only a thin layer over the intestinal mucosa. Subsequently, the colon is filled with air, which provides images of the mucosa of the colon of better quality than that obtained with the simple enema. Opaque double contrast enema is tolerated worse than the simple enema and takes more time, for this reason, sometimes the realization of the simple enema is preferred.
When doing a barium enemaThe most common reasons that the realization of a barium enema may be requested are as follows:
Identify and monitor the evolution of diseases that involve intestinal inflammation such as Crohn's disease or ulcerative colitis.
Detect intestinal diverticula or narrowing lesions. Diverticula are small sacs that can be found in the intestinal wall, and occasionally become inflamed resulting in a diverticulitis.
Also used as a colon cancer screening test, although currently the realization of a colonoscopy for these purposes is often preferred.
In Chagas disease, a parasitic disease common in America, which can be attended with pathology of the esophagus or colon.
To study the cause of intestinal symptoms such as changes in the bowel, weight loss, or anemia that may be caused by chronic bleeding by the intestinal mucosa.
On rare occasions you can use as a treatment of a bowel disease that usually occurs in children called intussusception. Occurs when a part of the intestine is folded over itself, which can cause intestinal obstruction. The force exercised by the contrast on this crease can make it disappear curing disease.
Preparation for the enemaThese are the issues that you must consider when you undergo a barium enema:
Duration: a simple enema is performed in about 30-45 minutes although barium is maintained within the intestine only about 10 - 15 minutes. The realization of an enema double contrast can take more than one hour.
Entry: the test can be done on an outpatient basis.
Is necessary to be accompanied?: do not need to be accompanied. However, sometimes it can be finished tired after the race, so it is recommended that someone take him home.
Drugs: for testing will need to clean the colon for 1-3 days before the procedure. They will give you instructions to do so by means of laxatives, which are administered orally or enemas. Diet to be followed during this period depends on the type of laxative that would provide. Generally we recommend a low residue diet, therefore, you should not eat foods such as potatoes, vegetables, fruits, or unfiltered juices during the three days prior to the test. These instructions may change according to the laxative to give to prepare for the test. If after taking laxatives, stool are not liquid and clear can recommend you put a warm water enema, and repeat the enema every 30 to 60 minutes until clean water ejects. This enema is sometimes replaced with a suppository. In any case, you will be given a sheet of instructions that must be followed strictly.
Food: in general will alert you to see in fasting, but you must follow the instructions of your doctor in this sense.
Clothing: you can wear any clothes you want to but it should be easy to remove.
Documents: should be informed consent, which is a role where they explain you what is the test and its potential risks. You should read it carefully and take it signed. You must take the wheel of the test request.
Contraindications: It should not do an enema in the following cases:
- In cases of diseases of the colon that can worsen if you perform an enema opaque, as for example a bowel obstruction, acute gastrointestinal bleeding, perforation of the colon, or a pathological dilation of the colon called toxic megacolon.
- In pregnancy, because technique is performed with x-rays, which may harm the fetus.
- Allergy or intolerance to contrast or to the solutions that are given as a laxative.
- Very debilitated people or that they can move properly during the scan.
- Pathology of the year that would prevent the introduction of contrast.
- People with a colostomy, i.e. when any pathology of the colon has been necessary to join the end of the colon to the abdominal wall.
Other considerationsIt should be noted the technician the possibility of having allergy to latex, because materials containing this substance during the procedure may be used.
It should be noted if you has made in recent days some other proof with contrast by mouth. In such a case, it would have to wait several days to completely remove this contrast to the test.
How the enemaInitially it will instruct you to undress and put on a hospital gown. Be caught an IV if it is necessary to administer any medication. Lying on a stretcher back will take an x-ray of the abdomen. Then you will be asked you tipping aside and be introduced by year a well lubricated cannula where is will introduce him slowly contrast. The cannula can dispose of a small balloon at its end that swells to avoid that out the contrast. If you have discomfort you will be given painkillers intravenously. During the introduction of the contrast is recommended to breathe slowly and deeply to be relaxed. It is also recommended to do force with the year on the cannula. Above the table will have an x-ray tube called fluoroscope which take x-ray images of the procedure. These images will be visible by a similar to a television monitor.
During the test, you will be asked to change position several times so that the contrast is distributed throughout the entire colon. The stretcher can also be tilted slightly and a technician can be slightly tightened you abdomen to facilitate the movement of the contrast.
Imaging with contrast in the colon normally lasts about 10-15 minutes. Subsequently, you be removed cannula and leave out the contrast, for which it will provide him a wedge or allow you to go to the bathroom. Another x-ray is usually taken after the evacuation. If performed you the double-contrast technique, they can introduce air later and taken new images.
Unless indicate you otherwise, after the test you can return to eat and drink normally. It is recommended to drink plenty of fluids to recover losses by laxatives taken to prepare for the test. You can see that depositions are white or pink for 1 or 2 days after the race.
Complications of the barium enemaThe enema is a very safe test. Many patients referred to the most annoying thing is taking laxatives to clean the bowel. Sometimes you can see some intestinal discomfort as "cramping" due to the contrast, but they tend to be mild. Anal discomforts with the cannula may also have. These discomforts may be relieved by taking bath seat, or with the administration of an anesthetic solution after the procedure. During the test you can feel embarrassed by the procedure. There is no reason to do so. They are used to perform this test, doctors and technicians will try to be as comfortable as possible.
It is extremely rare that the procedure may cause serious complications. Sometimes, the contrast medium hardens in the colon and causes constipation or even, on rare occasions, an intestinal obstruction. So you should drink plenty of fluids and, if necessary, is you can put an enema or take some light laxative after the test. Sometimes, the contrast can irritate and inflame the lining of the colon on a temporary basis. The more serious and more uncommon complication is the perforation of the intestine by the pressure exerted by the contrast. This complication requires immediate surgery.
You should contact your doctor if after the test Note bleeding by the year, important constipation, abdominal pain, fever or any other symptoms that worry you.
Results of the barium enemaThe images obtained during the test can be seen immediately. However, their interpretation requires much expertise and is carried out by medical radiologists. This specialist will make a written report that will give you a few days of the test along with the radiographic images obtained.
In the report, the radiologist will inform found finds. Maybe it relates that the intestine is not well prepared, or that there are parts of the colon that has not been filled with contrast. In this case it indicates that the results may have limitations. The findings that are most frequently are narrowness of the intestine, polyps or masses in the mucosa of the colon, sacs in your wall (diverticula), signs suggestive of intestinal inflammation, or suggestive signs of pathology of the motility of the colon (e.g. typical of Chagas disease). In the event that the barium enema is used to treat an intussusception in children indicate the success of the procedure.
The doctor has asked the test will give you the results and will instruct you if it is necessary to other complementary examinations or to follow any treatment. It is especially important to take account of the discovery of masses or narrowness in the colon that may suggest the presence of a cancer. In this case, is usually to indicate the completion of a colonoscopy to take samples and confirm or rule out this diagnosis.
What is Ergometry
ErgometryThe treadmill test, also known as test effort, is used to study the functional response of the myocardium (the muscle of the heart) to physical exercise. Thanks to it can be diagnosed accurately situations of ischemia and lack of sufficient areas of myocardial blood flow. Normally this type of ischemia go unnoticed or can give (type angina pectoris) transient chest pain, dyspnoea or arrhythmia. The origin of this lack of blood supply is the presence of cholesterol plaques in the arteries that supply the heart.
The test essentially consists of using special electrodes register the electrical currents that form in the myocardial muscle contractions occur. When performing exercise cells involved in more metabolic activity and, if they do not have a sufficient supply of oxygen, may stop producing these electric currents or altered. The electrodes register is similar to the one of an electrocardiogram, but lasts longer and be seen progressive changes.
The person who is subjected to the stress test must be physical exercise during the test. Different very similar machines are used to measure the muscular effort that in many gyms. Two are mainly used: the stationary bike or the Ribbon slider to run. Begins with low intensity, and gradually increases to make sure that there is damage to the heart at any time.
It is not a very expensive test, but its interpretation can be difficult sometimes, and must always be accompanied by a good full medical study using clinical interview and physical examination. It must be performed by experts, and only when it will be useful to determine a diagnosis or adjust a treatment. It can be in cardiac units that exist in hospitals and clinics. The doctor who analyzes such tests is the cardiologistand with initial data from the treadmill test can be a quite approximate analysis of the affected area of the heart.
When a stress test is doneThe stress test is useful for detecting heart disturbances. Symptoms that can give heart pathology are mainly two: pain in chest and shortness of breath feeling. The test effort should be when the cardiologist suspects any of the following diseases:
Unexplained chest pain: especially when cardiac features such as feeling of pressure, lack of air, radiates to left shoulder, neck or wrists.
Worsening of angina pectoris: when an angina pectoris is stable there is to worry about because it just gives pain in situations of known efforts. If this change should be performed a treadmill test to detect changes in the gravity electric log.
After a heart attack: not all attacks it is necessary, but in some cases can help known after the residual damage that has been at the heart and rating other tests.
Study of arrhythmias: certain arrhythmias only appear during physical exertion and exercise testing can help to trigger them and detect them.
Study of valvular heart disease: certain alterations of heart valves, especially the stenosis, can cause increase in myocardial unless get you sufficient irrigation. The stress test would detect ischemia unnoticed.
Prevention of ischemic heart disease: adults with cardiovascular risk factors (diabetes, hypertension, high cholesterol, etc.) that have not yet done intense physical exercise ever and that will do it for the first time so intense (e.g., in a gym or a football team) should undergo a stress test that discard unnoticed ischemic alterations.
Preparation for the ergometryIf they are going to perform an stress test or stress test these are issues that you must take into account to be properly prepared to quote:
Duration: exercise testing takes about 20-30 minutes. The only extra time would be the preparation and collection after the test, which in any case would be less than an hour.
Income: ergometry can be performed in a hospital or a health facility without requiring admission, and then you can return to your normal life.
Is necessary to be accompanied?: is recommended, so you'll be more relaxed.
Drugs: don't need to take any prior medication. Should be communicated to the doctor all the medicines taken regularly and will decide which suspend or maintain, especially if you take drugs for epilepsy, muscle relaxing, antiarrhythmic, or psychiatric diseases. You should not take 48 sexual impotence medications prior to the test (as sildenafil and derivatives).
Food: should stay without smoking and fasting without eating or drinking, the 3-4 hours before the test. If it is too early in the morning consult your doctor if you should take some sugar to avoid a hypoglycemia. 24 hours before the test you can not take caffeine of any origin (coffee, tea, soft drinks, chocolate, energy drinks, etc).
Clothes: you can go to the quote from the test with the same clothes every day; Perhaps you will be asked you here the upper part of the body to place electrodes. It is comfortable, even sports footwear. Breast creams should be avoided to place the electrodes.
Documents: is essential to bring with you the steering wheel which shows the performance of this test. You have to carry the health insurance card and medical history on diseases to study, if you have them, although the doctor will already have this information. It can give you a document after the test.
Pregnancy and breast-feeding: the stress test is not recommended in pregnancy or lactation. It is not a test that is performed much in those situations, since some biological constants are altered for itself during these stages.
Contraindications: not to be able to walk or have some sort of disability prevents the test. Especially weak hearts, with advanced heart failure, must not undergo this test.
How ergometryFirst your doctor will assess if it may be useful to perform a stress test according to the symptoms that present, cardiac auscultation and the tests that you have made previously. If you see fit, I will quote you one day for the test and you will explain the basic measures that you need to know to submit to this. Remember not to take caffeine 24 hours before, and remain in fasting and without smoking four hours prior to the test.
When you get to the room where the test is done ask you discover the upper part of the body to put the electrodes to study. Electrodes that are placed are 10 around the chest, to detect each part of the heart. All electrodes have a cable terminated in a detector that records all the electrical signals, very similar to the electrocardiogram. They also placed you a cuff of the sphygmomanometer to measure you blood pressure and a Pulse Oximeter in any finger to measure blood oxygen level to you.
Once all the electrodes placed you will be prompted that you start to walk or pedal gently. The first few minutes will not do much physical exertion, only will be interested to know whether the registration of the electrodes is correct and meet the morphology of your usual electric log. Every three minutes you will be asked to increase the muscular effort. This can get walking or pedaling faster, increasing the resistance to the movement or tilting the treadmill as if it were a slope. In such a way that every three minutes will increase considerably the physical effort, reaching running and cycling intensity.
Throughout the test the blood pressure monitor cuff swell and compress you arm, you should not worry. Normal is that you sudes, even feel a slight tiredness. There are some symptoms that if they appear you should let the doctor know it and assess whether to continue with the test, are:
- Pain in the chest.
- Pain in the legs.
- Shortness of breath.
- Dimming of vision.
- Tremor, cold, or nausea.
When you are done the test you must not stop walking for 10 minutes. Thus the heart rate will decrease gradually. Every 15 minutes the nurse will measure you your vital signs and check that all is well. Once you check that all is well removed the electrodes one to one. Then you may have to wait until you give you the results, although not come analyzed by the doctor because you'll need more time.
Complications of ergometryErgometry test is non-invasive and does not usually pose any risk for people who perform it, because for that doctor previously selects suitable people to undergo the test. Some complications that can occur are fainting, severe chest pain, and shortness of breath attacks. It is very strange that you get to produce a full stroke or a malignant arrhythmia, and if it happens, the room will have the means to intervene quickly.
The stress test resultsThroughout the test the different electrodes pick up electrical signals that go to the electrocardiograph and are stored in a memory. At the same time that ergometry is performed these measurements can be observed, but it is difficult to analyse them thoroughly because it takes time and dedication to study the different parameters at the same time. Yes is can detect acute changes that put an end to the test.
The alterations that are sought in the electrocardiogram are typical of cardiac ischemia. These include:
• Peaked T wave.
• Widening of QRS waves.
• ST segment depression (elevation does not usually occur).
When they appear these alterations must relate to the figures of blood pressure, blood oxygen level and the intensity of the exercise carried out at the same time. Thus it will have an overall idea of the heart condition of the patient and the impact that can have on the quality and life expectancy will be valued.
You can go to pick up the results of the stress test to the doctor who sent you the test, and which will normally be a cardiologist. On that date it explain the alterations that have been throughout the study. It may necessary to perform more tests requiring more diagnosis as, for example, a cardiac catheterization. The treatment options will explain you and will recommend you the most suitable option for you.
What is the blood
BloodThe blood is the medical name given to the taking of blood pressure or, in more colloquial language, blood pressure. The blood, to be able to circulate through the blood vessels of the body, has to maintain a more or less constant blood pressure. Thus, it is able to go from sites of higher to lower blood pressure, for example, of the artery aorta to the liver.
To measure the blood pressure compares the blood pressure in atmospheric pressure. The difference between both measures will give blood pressure which, on the other hand, will have two values: the systolic blood pressure and diastolic. Systolic is the maximum value that corresponds to the heartbeat, when the heart pumps with force all the blood that can. The diastolic is blood pressure that remains as a minimum when it relaxes the heart.
This test is painless, harmless and tremendously useful, because blood pressure is altered in the presence of various diseases, and even maintain high figures is a disease in itself. It is used to measure a cuff or sphygmomanometer, which consists of two distinct parts: a sleeve that surrounds the arm and swells of air, connected with a hollow tube to a pressure gauge.
Classic monitors must be used with a stethoscopeto listen to the sounds of blood flow, but now there are also digital meters. Monitors that are sold in pharmacies can be placed in the wrist and, although they are less accurate, are simple to use by anyone at home.
When doing a bloodMake a blood to measure the blood pressure is useful when the following diseases are suspected:
High blood pressure: high blood pressure figures damage to organs of our body with the passage of time. The heart, kidney and retina are most affected, and the deterioration occurs without symptoms. Therefore it is recommended to measure blood pressure in adults once a year to detect high blood pressure.
Syncope and orthostatic hypotension: dizziness and the feathers are caused most of the time by decreases in blood pressure. It is normal that measure the voltage at a certain time does not serve to detect these low figures, and may need to make an ambulatory monitoring of blood pressure (a test which is known as map).
Pre-eclampsia: pregnancy blood pressure should be controlled to prevent eclampsia and fetal damage.
Pheochromocytoma: thus referred to a tumor of the adrenal glands that synthesizes hormones like adrenaline. This causes the blood pressure to rise punctually and tensional crisis occur. The measurement of blood pressure may be the first suspicion to diagnose it.
Aortic dissection: it is a very serious situation and urgent that the layers of the aorta artery are divided and are occluded many of its branches. Blood pressure may be altered and tends to be different in each arm.
Preparation for the bloodIf you will perform a blood for blood pressure , these are issues that you must take into account:
Duration: blood pressure does not mean long, figures can be seen in a minute.
Income: is a safe, painless, easy and fast. For this reason, there is no reason to enter you. It can be in the ambulatory, even at home.
Is necessary to be accompanied?: is not necessary to be accompanied.
Drugs: don't need to take any prior medication. Should be communicated to the doctor all the medicines taken regularly and he will decide which suspend or maintain, especially if you take medications such as diuretics, against epilepsy, to treat psychiatric diseases, antiarrhythmic, or relaxing muscle.
Food: it is not necessary to remain in fasting prior to testing or after. However, it is recommended not to drink coffee in the hours before, or not eating a meal that is particularly rich in salt from 24 hours before. You should not smoke an hour before the test.
Clothes: you can go to the quote from the test with the same clothes every day. You will be asked you to discover the arm you want to place the sleeve, so it is best that you take do not have very tight clothing that compress the arms.
Documents: does not require specific documentation, but it is always advisable to carry the health insurance card to the ambulatory, is required in case another test or an appointment with the doctor. You can point you the figures of blood pressure in a primer, or simply to communicate them to you.
Pregnancy and breast-feeding: blood pressure is not contraindicated in pregnancy or lactation. In fact, you must perform with some frequency during those periods.
Contraindications: there is no contraindication for a measure of blood pressure. There are situations where the measurement is not possible or you need a more accurate, as in units of intensive care (ICU) measurement.
How a bloodThe blood for blood pressure you can recommend your doctor or request it yourself. Either you must obsess you much with knowing your numbers of tension; Please note that it is rare that you change them in a short time, so the doctor will know better the frequency with which you have it to measure.
To measure you blood pressure you will not have taken coffee the previous hour, nor energy drinks or anything else with caffeine. You can not have smoked one hour before the test. You must be sitting quiet for a few minutes before measure you your blood pressure. Only this real blood pressure figures will provide. If these rules are not respected, you can alter the results and obtained erroneous figures.
When ready, the doctor or nurse will ask you to discover the arm where measured you the voltage. It is best that you take off clothes that cover the arm directly, because roll up you sleeves tends to compress the arm at the shoulder and you can also modify the blood pressure. Discovered once they placed you the cuff around the arm above the elbow.
They then inflated the sleeve, and it is normal that notes a strong pressure around your arm, and even some tingling in the hand (for compression of the nerves in the arm). The health that measure you the voltage will place the stethoscope in the front of the elbow (if it is a classic, non-digital monitor), to thus hear the blood flow. You will hear a few blows, as beats, which are called Korokoff sounds. When noise is detected the systolic blood pressure and when to end diastolic blood pressure is measured.
After making this measurement, the most appropriate would be to measure it minutes later. However, many times not turns to take because it almost always has the same value. It is appropriate to repeat it when the measurement supposed to start or change a medical treatment. It is ideal to repeat it in the other arm. If you think you are nervous or medical environment is uncomfortable, it is better you to tell that they take it into account.
The toilet will inform you what your blood pressure number. Depending on the value of blood pressure is recommended you return you to repeat in time or that you cites the doctor as soon as possible. Maybe everything is okay and you can forget in a long time.
Complications of the bloodComplications of this test are not known.
Results of the bloodThe results of the blood or blood pressure measurement are obtained at the time of the test. The toilet can instantly see your voltage values, and if you yourself are who take you it you can see the figures on the screen of your monitor.
Measurement of blood pressure He is expressed in millimetres of mercury (mmHg), as the atmospheric pressure. The reference values are:
The lower values are less important and should only be taken into account when you have symptoms of hypotension (syncope, for example). It is best to know your usual tension to compare it with the moment and certify that it is lower than usual.