Medical history and diagnosis of cardiac symptoms

The diagnostic process for suspected heart problems starts with a detailed medical history and a comprehensive physical examination. Symptoms such as fatigue, shortness of breath and swollen extremities could indicate heart failure.

If symptoms are present, the treating cardiologist will take a specific medical history in order to determine the exact causes. He will have a detailed discussion with the patient in order to assess their state of health in detail. Important anamnesis questions include

What are the symptoms?
How long have the symptoms been present?
In which situations do the symptoms increase?
Is there a family history of heart disease?
Are you currently experiencing family or psychological stress?

Diagnostic procedures

Following the physical examination, the attending cardiologist may use additional diagnostic procedures. The cardiologist will first check basic vital parameters such as pulse, blood pressure, weight and height. In addition, an acoustic examination of the heart and lungs is carried out using a stethoscope in order to detect any abnormalities.

Non-invasive diagnostic procedures

Electrocardiogram (ECG)

The resting electrocardiogram (ECG) can be used to examine the heart rate, heart rhythm and the activity of the atria and ventricles. During a resting ECG, heart activity is recorded while the patient is lying down. To do this, electrodes are attached to the arms, legs and chest around the heart. The result is displayed in curves and used to diagnose or monitor treatment for the vast majority of heart diseases.

Long-term ECG

With the long-term ECG, the heart rate and heart rhythm are recorded for a maximum of 10 days. The extended recording period can make it possible to detect intermittent arrhythmias.

Various devices can be used for this purpose. A new generation of devices makes everyday life possible with almost no restrictions. (showering, doing sports, swimming). The evaluation and discussion of the examination results takes place in the cardiac clinic.

Exercise ECG

During an exercise ECG, the heart rate curves are measured while sitting on a bicycle ergometer.

The load is applied according to a previously selected, individually adapted load protocol.

The exercise usually lasts 8-12 minutes. The aim is usually physical exhaustion. Blood pressure, pulse, heart rhythm and frequency as well as performance and oxygen saturation are measured.

Ergometry (performance test)

Ergometry, also known as exercise ECG, measures physical performance while simultaneously monitoring various bodily functions using an electrocardiogram (ECG).

It is used to analyze and evaluate exercise-induced changes in heart and lung function.

No special preparation is required. Ergometry should not be performed on an empty stomach.

Spiro-ergometry

In spiroergometry, cardiac activity is recorded under stress in the same way as in ergometry, but additionally by measuring the maximum oxygen uptake with the aid of a well-fitting mask over the mouth and nose.

This type of examination is used to evaluate the integrative performance of the cardiovascular system and the lungs.

6-minute walking test

Another method of assessing a patient's exercise tolerance is to carry out a 6-minute walking test.

This is an easy-to-implement test that allows conclusions to be drawn about the course of the disease or the success of a therapy based on the distance covered.

Pulmonary function test

During the pulmonary function test, the lung and respiratory volume and the inhalation and exhalation rate are measured while the patient breathes into a spirometer via a mouthpiece.

This examination is carried out at our clinic, particularly preoperatively on patients who require intubation anesthesia.

24-hour blood pressure measurement

A 24-hour blood pressure measurement is used if the blood pressure behavior is to be recorded over a longer period of time in the patient's normal daily environment.

The blood pressure cuff is worn on the arm for the entire period and measurements are triggered at a predefined time interval. The evaluation and discussion of the test results takes place in the heart clinic.

Imaging HErz diagnostics

Imaging of the heart (known as cardiac imaging) comprises various modalities which are offered by our team of heart specialists in collaboration with our colleagues at the Hirslanden Radiology Clinic.

Heart ultrasound examination (echocardiography)

Echocardiography is a painless ultrasound examination of the heart from the outside. Ultrasound is used to assess the anatomy of the individual heart chambers, the pumping functions and the function of the individual heart valves as well as parts of the aorta.

Transesophageal Echocardiography (TEE)

Ultrasound examination via the esophagus (from the inside) is used for a more precise assessment of certain structures and, in particular, the heart valves. This ultrasound method often produces a significantly better image quality for the structures mentioned. The patient swallows a tube with an ultrasound probe. The anesthesia of the throat and a sedative medication (sedation, light anesthesia) enable a gentle examination that is not felt by the patient.

3D special echocardiography

For a three-dimensional representation and analysis of the heart, the entire heart is captured and displayed using special 3D echoes.

The 3D technique is used in particular in transesophageal echocardiography (TEE) for high-precision diagnostics of complex structures and for planning operations / interventions.

Myocardial scintigraphy (cardiac scintigraphy)

The special procedure of cardiac scintigraphy is used for the imaging analysis of the blood flow and vitality of the heart muscle, for example in coronary heart disease.

By simultaneously injecting radioactive marker substances, cardiac function can be studied at rest and under stress and areas with insufficient blood flow can be identified.

Cardiac computer tomography (cardio-CT)

Cardiac computed tomography is used for the non-invasive diagnosis of cardiovascular diseases, such as coronary or valvular heart disease.

Computed tomography of the heart produces cross-sectional images of the heart in which the calcification of the coronary arteries (coronary vessels) and the exact anatomy of the heart valves can be recorded. The result provides information about the patient's individual risk. This method is also used to plan interventions and operations for valvular heart disease

Cardiac magnetic resonance imaging (cardiac MRI)

The non-invasive diagnostic method of cardiac magnetic resonance imaging makes it possible to obtain a comprehensive picture of the anatomy and functionality of the heart, for example in the case of diseases of the heart muscle, without exposure to radiation.

Depending on the situation, the result also allows a statement to be made regarding the risk of cardiac arrhythmia or a heart attack.

Invasive cardiac diagnostics

In addition to cardiological functional diagnostics and imaging procedures, our specialists also use invasive methods to examine and treat heart disease.

Coronary angiography (catheter examination of the coronary arteries)

Coronary angiography is used for precise visualization of the coronary vessels and large arteries, for example in coronary heart disease.

Right heart catheter

The right heart catheter is an invasive examination of the right heart (right atrium and right ventricle) and the pulmonary circulation. With the help of this examination, various pressures in the heart can be measured and can therefore help in the diagnosis of various diseases.

The right heart catheter is performed, for example, in cases of heart valve defects in the right heart, myocarditis, suspected pulmonary hypertension, various congenital heart defects and cardiogenic shock.

Event recorder implantation

The implantation of an event recorder to record cardiac arrhythmias is used in the event of unconsciousness for which no causes have yet been found or for long-term monitoring of the heart rhythm. An event recorder is usually combined with remote monitoring. An ECG is automatically saved in the event of special events (unconsciousness, arrhythmia).

The procedure is performed under local anesthesia and is performed on an outpatient basis. The recorder is implanted under the skin in the area of the left rib cage through a small incision in the skin.