MAGNITNO - REZONANSNAYA (MR) TOMOGRAFIYA. The basis of the method is the ability of atomic nuclei, placed in a magnetic field, radiate energy with a certain characteristic only this element, frequency. In research for medical purposes increasingly using hydrogen nuclei resonance radiation. In doing so, the signal intensity to a large extent depends on the water content in the examined tissue. Resonance radiation through a computer translates into high tomographic image. Perhaps study the entire body. Bone tissue is not delaying the signal. Resolution of about 1 cm

Unlike other existing methods of MRI, especially in modulating the nuclei of different elements, allows judged not only on structural change, but also the local chemical features (acidosis, the lack of certain enzymes, edema, ischemia, etc.). The study is noninvasive and is not associated with ionizing radiation.

The real diagnostic value method when examining patients with heart requires clarification. It provides information on anatomical, physiological and biochemical features of the heart, helps in recognition of vascular aneurysms, make for a picture of blood flow in large vessels and even the movement of drugs in them.

The disadvantages method, in addition to the extremely high cost of equipment include the inability to examine patients with metal implants and postoperative clip (which are heated in a magnetic field), in particular, patients with pacemakers, which function in a magnetic field can be violated.

KATETERIZATSIYA HEART AND ANGIOKARDIOGRAFIYA. Introduction rentgenokontrastnogo substance in the heart or blood vessels, followed by x-ray (perhaps with obtaining series rentgenogramm at short intervals) makes it possible to obtain quantitative information about important anatomical and physiological characteristics of heart and is widely used in the selection of patients for surgical treatment. To conduct the study requires special equipment and highly qualified staff, his serve in some specialized cardiological surgery and institutions.

Angiokardiografiyu always conducted simultaneously with cardiac catheterization, which in itself provides important diagnostic information. It helps determine the pressure in the cavities, to obtain blood for analysis directly from the heart chambers, and if there is special equipment - to determine Cardiac Output, for example termodilyutsii method, to comply vnutriserdechnoe elektrofiziologicheskoe study endomiokardialnuyu biopsy.

Below are some upper limits rules indicators obtained from cardiac catheterization: pressure in the right predserdii 6 mm Art. Art. (average), in the right ventricle 30 / 7 mm Art. Art., in the left 145/12 mm Art. Art. in the pulmonary artery 30/14 mm Art. Art., Shim pressure in the pulmonary artery branches 12 mm Art. Art. (average), Cardiac index 2,4-3,8 l min-1 m-2, arteriovenous difference in oxygen 3,5-5 ml / dl, pulmonary vascular resistance din with 250 cm-5.

Right-heart catheterization divisions technically easier, it is usually carried out through the subclavian vein. Under the supervision of X-ray catheter can be predserdie move to the right, the right ventricle, lung artery to branched 3-4 - th order (which is defined Shim pressure). Introduction contrast substance at various levels (that is, selectively) helps to understand birth defects defeat trikuspidalnogo heart valves and valve pulmonary artery, a blood clot in the pulmonary artery, constrictive pericarditis.

Left cardiac catheterization departments often carry out through the femoral artery with a catheter advance against the current blood on the left ventricle to the aorta. Angiokardiografiya reveals flaws and anomalies aorta (including the aorta aneurysm and sinus Valsalvy, to delaminate aneurysm, sub-and supravalvulyarny stenosis) and left-wing divisions of the heart, left ventricular aneurysm, of a blood clot, and a blood clot in the left predserdii mix. Suffice detail can be determined hemodynamic performance left ventricle, in particular faction release, end systolic and diastolic volumes, the shunt, the expression regurgitatsy etc.

Koronarografiya is widespread. Currently in our country carry out its increasingly patients with IBS set for a decision regarding the need and possibility of surgical treatment (aortokoronarnoe bypass or coronary artery dilatation cylinders). Through the catheter, introduced in femoral artery and advanced proximal directly in the mouth of each coronary artery impose 5-10 ml contrast substance. Multiple rentgenogrammy on film will give quite a complete picture of the anatomical features and patency of the coronary bed, the status of the collaterals. Introduction ergonovina during the study provides an opportunity to register a local koronarospazm vazospasticheskoy in patients with angina.

Koronarografiya - invasive procedures associated with some risk. During the procedure, and in the next 48 hours are possible embolism receptacles great circle, myocardial infarction and death of a patient. In imposing ergonovina risk increases. Introduction contrast substance may complicate anafilakticheskoy reaction worsen renal function. Radiation pressure higher than ordinary X-ray study. The frequency of severe complications in laboratories with strong experience in koronarografii amounts per share.

MEASURING SERDECHNOGO VYBROSA. Under cardiac output understand amount of blood, throws one of the ventricles in the heart unit of time (in emission standards from both ventricles same). This figure is expressed as a minute amount (MO - The volume of blood, heart ventricle emitted within 1 min), cardiac index (MO, calculated at 1 m2 of body surface) and systolic volume (volume of blood, emitted during sistoly ventricle). Cardiac release of a person calculated on the basis of indirect data. A study conducted in a substantive exchange and, if necessary - after functional loads.

Cardiac release along with other important parameters are now increasingly determined using echocardiography (more accurately - dopplerehokardiografii), as well as angiokardiografii, radioisotope techniques of cultivating an indicator.

Definition of cardiac output should be mainly in intensive care units for some hard myocardial infarction patients with unstable hemodynamics, as well as before surgery intervention.