What Are the Diagnosis and Treatment Methods for Heart Disease?

Early diagnosis of heart disease is the most critical step you can take to prevent life-threatening risks and improve your quality of life. When symptoms like chest pain, shortness of breath, or palpitations occur, it is essential to be evaluated without delay using the right cardiological tests. Problems identified in the early stages can be successfully managed with the innovative treatment methods offered by modern medicine.

• Echocardiography (ECHO) is a safe, radiation-free ultrasound of the heart.
• Rhythm and blood pressure Holter monitors catch hidden issues through 24-hour tracking.
• The stress test (treadmill test) evaluates the heart's blood supply in detail during physical exertion.
• Coronary angiography provides a definitive diagnosis of vascular blockages and allows for stent treatment.
• Pacemaker and ablation procedures are used for the permanent treatment of rhythm disorders.

What is Heart Disease and Why is Early Diagnosis Important?

Heart disease is a broad term for structural and functional disorders affecting the heart's muscle tissue, valves, vessels, or electrical conduction system. Serving as the body's engine, your heart beats an average of 100,000 times a day to deliver oxygen and nutrients to every organ. Even the slightest disruption in this flawless system deeply affects all bodily functions. Coronary artery disease, heart failure, rhythm disorders, and valve diseases are the most common conditions we see.

Early diagnosis quite literally saves lives when it comes to heart disease. Heart muscle cells are highly sensitive to oxygen deprivation, and once damaged, their capacity to regenerate is remarkably low. Thanks to regular check-ups and accurate diagnostic methods, narrowing in the vessels or irregularities in rhythm can be detected before they cause permanent damage. This way, the progression of the disease can be halted through lifestyle changes and appropriate treatments.

Symptoms and Risk Factors of Heart Disease

Heart disease does not always present with sudden, severe symptoms; sometimes, it can progress silently for years. Advanced age, genetic predisposition, smoking, diabetes, high blood pressure, and high cholesterol are the most prominent risk factors. People with a family history of heart attacks at an early age need to be especially cautious and undergo regular cardiological screenings.

While symptoms vary from person to person, a sensation of pressure, burning, or squeezing in the center of the chest is the most common warning sign. This pain often radiates to the left arm, jaw, or back. Shortness of breath brought on by exertion, unexplained fatigue, swelling in the ankles (edema), palpitations, and a feeling of faintness are also serious signals that must be taken seriously. Sometimes, even atypical complaints like stomach upset or back pain can herald a cardiological problem. You can explore detailed warnings on this topic in our article on hidden heart symptoms.

Diagnostic Methods for Heart Disease

When you visit the hospital, the answer to the question "which cardiological tests will be done?" depends entirely on the nature of your complaints and your physician's physical examination findings. The advanced technology devices offered by modern medicine allow us to examine the structure and function of the heart in intricate detail.

Echocardiography (ECHO)

Commonly abbreviated as ECHO, this is a safe, effective, and radiation-free diagnostic tool performed using ultrasound. Sound waves are used to obtain moving images of the heart. With an ECHO, the heart's structure, wall thickness, valve conditions, wall movements, the state of the pericardium (heart sac), and the dimensions of the major vessels exiting the heart can be easily evaluated. It is a painless, fast procedure that requires no prior preparation.

Transesophageal Echocardiography (TEE)

Known as TEE, this is an advanced imaging method performed using a special ultrasonic endoscope passed down into the esophagus. Because the heart sits just in front of the esophagus, this method yields much clearer and more detailed images. It allows for the close examination of heart valves, congenital heart defects (holes), and structural abnormalities. You must not consume food or water for at least 6 hours before the procedure. The throat is numbed with a local anesthetic spray, and the process takes about 10-15 minutes. Eating and drinking should be avoided for the first two hours after the test.

Blood Pressure and Rhythm Holter

A blood pressure Holter is a portable device used to diagnose hypertension and monitor patients experiencing blood pressure fluctuations by taking and recording measurements every 30 minutes. So, what does a rhythm Holter do? For patients experiencing palpitations, rhythm disorders, or fainting, electrodes are attached to the chest wall to record an ECG on a portable device for 24 hours. Patients should avoid excessive sweating, taking a shower, and passing through electromagnetic security gates while wearing it. After 24 hours, the device is removed, and any hidden irregularities in the heart rhythm are analyzed by the physician.

Stress Test (Treadmill Test)

Patients frequently wonder what a stress test, also known as a treadmill test, involves. This test is used for the early diagnosis of ischemic heart disease (blocked arteries). As the patient walks on a treadmill at a pace and incline that gradually increase at set intervals, their ECG and blood pressure are continuously monitored. The goal is to observe whether the heart muscle receives enough blood as the heart rate rises. It is recommended once a year for patients over the age of 45. If the stress test is positive, further investigations are initiated. Unless your doctor advises otherwise, certain medications (like Beta Blockers) may need to be stopped 48 hours in advance.

Coronary Angiography

How a heart angiogram is performed is one of the most common concerns for patients. Angiography is a procedure used to visualize the heart's blood vessels using special equipment. Thin catheters are guided to the heart through an artery in the groin or the wrist. By injecting a contrast agent (a special dye), any narrowing or blockages in the vessels are detected under X-ray. Patients are advised to drink plenty of water beforehand, and diabetic patients may need to pause certain medications under their doctor's supervision. If done via the groin, pressure is applied with a sandbag for 6 hours; if the wrist is preferred, a special compression band worn for 2 hours is sufficient.

Treatment Methods for Heart Disease

Following the diagnosis stage, the most appropriate treatment plan for the identified problem is determined using a multidisciplinary approach. When medication and lifestyle changes are not enough, interventional methods or surgical procedures come into play.

Balloon and Stent Procedures

If a severe narrowing is detected in the vessels during coronary angiography, it can be treated in the same session by inserting a balloon or a stent. A special balloon is placed in the narrowed area and inflated to open the vessel, followed by the placement of a stent—a tiny wire mesh tube—to prevent the vessel from narrowing again. Patients who receive a stent must strictly adhere to the blood-thinning medications prescribed by their physician; otherwise, the stent may clot, creating a sudden risk of a heart attack.

Pacemaker

Pacemakers are used to treat slowing or pausing in the heart's electrical system. Once the appropriate model for a temporary or permanent pacemaker is determined, the patient is taken into the procedure room on an empty stomach. Under local anesthesia, a small 5-7 cm incision is made near the collarbone, the device is placed under the skin, and the electrodes are guided to the heart. After the procedure, the patient is given protective antibiotics, and their arm movements on that side are restricted with a shoulder sling for a day. Stitches are removed within 10-15 days.

Electrophysiological Study and Ablation (EPS)

An electrophysiological study is performed in cases of unexplained fainting, sweating, and severe palpitations. Similar to angiography, this procedure involves entering through the right groin to map the electrical pathways inside the heart. Once the problematic area causing the rhythm disorder is identified, an ablation procedure (burning or freezing the tissue with radiofrequency energy) is applied in the same session to permanently treat the issue.

Complications and Risk Groups

If not diagnosed and treated in time, heart disease can lead to severe complications such as heart failure, heart attack, stroke, and sudden cardiac death. Those with uncontrolled diabetes, long-term smokers, and individuals struggling with obesity are in the highest risk group. Rhythm disorders can pave the way for blood clots to form in the heart, which can then travel to the brain and cause a stroke. To minimize these risks, paying attention to your lifestyle and staying under regular medical supervision is essential. For more information on prevention, you can read our article on how to prevent a heart attack.

When to See a Doctor?

Your heart health is far too valuable to leave to chance. If you experience any of the following symptoms, you should seek medical attention without delay:

• A sensation of pressure, squeezing, or burning in your chest, with pain radiating to the left arm or jaw.
• Severe shortness of breath that starts suddenly while resting or with mild exertion.
• Blacking out, dizziness, or sudden fainting (syncope) spells.
• Your heart beating so fast or irregularly that it feels like it might jump out of your chest.
• Cold sweats, nausea, and an unexplained feeling of extreme fatigue.

Especially if you are experiencing chest pain and shortness of breath at the same time, you should absolutely not try to drive yourself to the hospital; immediately call the 112 Emergency Call Center.

The Process at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi's Cardiovascular Surgery and Cardiology departments, the diagnosis and treatment of pediatric and adult heart diseases are carried out with a multidisciplinary approach. In our JCI-accredited hospital, advanced treatments such as coronary angiography, pacemaker implantations, ablation, bypass, and heart valve surgeries are meticulously performed by our expert staff.

With our 24/7 emergency department and fully equipped coronary intensive care unit, we are able to respond instantly to any cardiological emergency. To secure your heart health and undergo a detailed screening, you can reach us through our call center at 0850 811 34 00 or book an appointment via our website.

Frequently Asked Questions

How long does a heart angiogram take?

A diagnostic coronary angiography procedure takes about 15-30 minutes on average. However, if a narrowing is found in the vessel during the procedure and a balloon or stent application is performed in the same session, this time can extend to 45-60 minutes.

Who cannot undergo a stress test?

A stress test is not performed on patients with suspected acute (ongoing) heart attacks, severe aortic valve stenosis, uncontrolled dangerous rhythm disorders, or advanced heart failure. Alternative imaging methods are preferred for these patients.

Do I need to fast before an ECHO scan?

Fasting is not required for a standard (transthoracic) ECHO performed over the chest surface; patients can have this test done on a full stomach. However, for a TEE (Transesophageal Echocardiography) procedure done through the esophagus, the patient must abstain from food and water for at least 6 hours.

Can I use a mobile phone while wearing a rhythm Holter?

Yes, you can use a mobile phone while wearing a rhythm Holter device. However, to ensure the device's recording quality is not affected by electromagnetic waves, it is recommended not to hold the phone directly over the device or electrodes and to keep it at a slight distance while talking.

What should be considered after a pacemaker is implanted?

For the first few weeks following the procedure, the arm on the side where the pacemaker was implanted should not be moved excessively or raised above the head. The wound area must be kept clean and dry. Additionally, patients must avoid walking through electromagnetic security gates at airports or shopping malls and are required to show their pacemaker identification card to security personnel.

This article is for informational purposes only; please be sure to consult your physician for diagnosis and treatment.