Stress ultrasound instead of bicycle test
The coronavirus has had a major impact on regular healthcare. Fortunately, medical progress has not stood still and there are many new developments. What new treatments are medical specialists looking forward to in 2021?
Menno Baars and Jacco Karper are both cardiologists and affiliated with HartKliniek, in Lelystad and Groningen respectively.
A woman’s heart is different from a man’s heart
“The very best news,” says Baars, “is that women’s hearts are really on the map in 2021. Thanks in part to pioneers such as Angela Maas and Janneke Wittekoek, we know that there are differences in all kinds of details between men’s and women’s hearts. In contrast to politicians, we do discriminate and that is good news, in practice especially for women. In the recent past, many vague complaints were attributed to the menopause. Now we dig deeper; we don’t stop until we find something.”
Stress echo instead of bicycle test
The old method of the EKG, in which patients had to cycle, no longer appears to be sufficient to detect abnormalities in the coronary vessels. “At HartKliniek we have therefore switched to stress echocardiography (DFE). This is a kind of echo on the chest”, explains Baars. “We send sound waves to the heart and, with a dobutamine infusion, we induce the heart to give a short, firm squeeze. We do this to virtually rule out oxygen deficiency as the cause of the complaints.”
If there are no severe narrowings in the coronary vessels, the problem often turns out to be caused by vasospasm and narrowing in the smaller blood vessels around the heart. Baars: “That applies to about 60 percent of the women, but also about 30 to 40 percent of the men. This is important to realize with typical complaints.”
Furthermore, according to Karper, there are indications that women may be able to manage with lower doses of heart failure medicines. This was recently revealed by a Groningen study.
In recent years, several new drugs and combinations of drugs have also been found, Karper knows. “I am thinking recently of the SGLT2 inhibitors, among other things. SGLT2 inhibitors are a kind of sugar water tablets. They appear to work well for patients with both diabetes and heart failure, but recent research shows that they also work well for patients with heart failure without diabetes.”
Sources):
- Plus Magazine
