I went to the hospital to check for coronary heart disease, but the doctor asked me to get on a "treadmill". Why?

Mr. Zhang is in his 50s and has been smoking for more than 20 years. He has high blood lipids, but his health has never been abnormal and he has not controlled it well. However, recently, when he has increased his activity, he always feels chest tightness, which will only be relieved after resting for a while.

He was worried that he had coronary heart disease, so he went to the hospital to check his heart. The doctor connected some equipment to him and asked him to run on a "treadmill". Later, Lao Zhang complained to Huazi that he would feel chest tightness and discomfort if he moved too much, so why did the doctor ask him to run?

1. Diagnosis of Coronary Heart Disease

Huazi told Lao Zhang that judging from his symptoms, it was possible that he had myocardial ischemia, which means that the coronary arteries supplying blood to the heart had atherosclerosis and were narrowed. If the degree of coronary artery stenosis is greater than 50%, it can be diagnosed as coronary heart disease .

The "gold standard" for diagnosing coronary heart disease is coronary CT and coronary angiography, but both of these examination methods are invasive, require the injection of contrast agents, have certain risks, and are expensive, which many patients cannot afford.

However, for people whose myocardial ischemia symptoms are not obvious and cannot be diagnosed, they need to exercise to stimulate the symptoms of myocardial ischemia and assist in diagnosis. This diagnostic method is the exercise treadmill test .

Why is running necessary to diagnose heart disease?

The exercise treadmill test refers to the patient exercising on a treadmill-like flat plate according to the program set by the doctor under the monitoring of blood pressure and electrocardiogram instruments. This is a simple, non-invasive and inexpensive examination method.

When exercising, muscles require more blood supply, which increases the workload on the heart. When the workload on the heart increases, oxygen consumption increases, and the muscles themselves also require more blood supply.

If the coronary arteries are narrowed and there is an insufficient supply of blood and oxygen, the myocardial cells will undergo anaerobic glycolysis, producing lactic acid, which will stimulate the cardiac nerves and cause feelings of chest tightness and pain, forcing people to rest and stop exercising.

3. What is the role of the exercise treadmill test?

Many people with coronary heart disease do not have any abnormalities in their routine electrocardiograms. Through the exercise treadmill test to stimulate myocardial ischemia, coronary heart disease can be initially screened out . People who have been diagnosed with coronary heart disease can also use regular exercise treadmill tests to evaluate the treatment effect and adjust the treatment plan.

Exercise can cause blood pressure to rise, but if blood pressure is too high during exercise, it may be an early sign of hypertension . By monitoring heart rate during exercise and the degree of heart rate recovery after exercise, it can be determined whether the cardiac sympathetic nerves are overexcited , whether the prognosis of coronary heart disease is good, and whether there is autonomic dysfunction .

4. Don’t “run” to check your body on your own

The exercise treadmill test is very simple. Just by running, you can assess whether there are any heart problems. However , it is not recommended for people with chest tightness, chest pain, and those at high risk of coronary heart disease to use exercise to check their bodies . If angina pectoris is induced and there are no corresponding treatment measures, it may be dangerous.

In addition, symptoms similar to angina pectoris may appear in the early stages of acute myocardial infarction. If you exercise at this time, it will further increase the burden on the heart and increase the risk of death.

In addition to acute myocardial infarction, uncontrolled heart failure, arrhythmia, pulmonary embolism, aortic dissection, aortic valve stenosis, hypertrophic obstructive cardiomyopathy, severe hypertension, active myocarditis, pericarditis, electrolyte imbalance and other diseases are contraindications for exercise treadmill test.

The exercise treadmill test is only suitable for performance in hospitals . After the doctor has ruled out contraindications, the exercise should be performed under close monitoring. If any danger occurs, there are complete rescue equipment to ensure safety.

To sum up, when you go to the hospital for a heart checkup, the "treadmill" that the doctor asks you to use is an exercise treadmill test, which is a non-invasive, low-risk, low-cost auxiliary examination method in cardiology. It is a common method for screening early coronary heart disease and protects your health. I am pharmacist Huazi, welcome to follow me and share more health knowledge.