|
During auscultation (the process of using a stethoscope to listen to the heart), the physician will carefully evaluate several distinct factors, such as the loudness, frequency, configuration and timing of the patient’s murmur with the heartbeat. Each characteristic is matched to established guidelines.
If a patient exhibits symptoms of heart disease along with the discovery of heart murmurs, or if certain murmurs point to a more serious underlying condition, further diagnostic tests will be done. These tests may include:
- Echocardiogram. This test uses sound waves to create a picture of the heart, allowing the physician to determine the thickness and/or dilation of the various heart chambers. According to 2006 guidelines issued by the American College of Cardiology and American Heart Association, echocardiography is the standard for discovering the cause of a murmur.
- Doppler echocardiogram. This test is very effective, precise and noninvasive. It can show whether a murmur is the result of a significant medical problem. This ultrasound test provides images that indicate the direction and speed of blood flow, as well as the cause of a murmur (such as a heart defect).
- Electrocardiogram. This standard and fairly inexpensive test records the electrical patterns of the heart. It can reveal a number of problems with the heart. It may be performed first, but the echocardiogram is considered the best test to evaluate the cause of a murmur.
- Chest x-ray. This test may be done to assess heart size, calcification of valves and other information.
- Blood test. One or more tests may be administered if the physician suspects inflammation of the heart or valves endocarditis.
- Cardiac catheterization. During this test the physician examines the heart's hemodynamics (the pressures and motion of blood flow through the heart). Blood samples will also be taken and a coronary angiogram, including a coronary arteriogram, will be performed. Prior to the test, the physician will inject a special dye (contrast medium) into the coronary arteries through a catheter. This dye is visible under x-ray and allows the physician to precisely locate possible blockages of the coronary arteries. Following the coronary angiogram, the catheter may be moved into the left ventricle and a left ventricular angiogram will be performed. In some cases, an aortogram may be performed
Patients may also be asked to perform simple movements, such as standing suddenly, squatting or gripping an object tightly. These movements may change the nature of heart murmurs in predictable ways that help physicians better diagnose what kind of underlying is present. Medical professionals are well trained to diagnose murmurs and the extent of testing will be based on a careful assessment of many factors.
New technologies are being developed to better differentiate the types of murmurs. For example, electronic stethoscopes use computer technology to record and analyze heart sounds. Another innovation is in the field of telemedicine, where information gathered through electronic stethoscopes is sent as e-mail attachments. This can be useful in pediatric patients who may have murmurs that require further evaluation so the pediatrician can e-mail the information to a cardiologist.
|
/doctor_89.jpg "ulcerative colitis tips")
