Cardiological diagnosis, therapy and prevention

Cardiology deals with the clarification of heart complaints such as chest pain, heart rhythm disorders, shortness of breath, reduced performance and unclear circulatory problems.

In my practice, cardiological diagnosis is carried out in a structured, internal and guideline-oriented manner. Modern methods of ultrasound, ECG, blood pressure and vascular diagnosis are used.

The goal is not to collect isolated measurement values, but to provide a clinically meaningful functional classification of the findings – including individual risk assessment, therapy decision and prevention.

Medical responsibility and technical classification

This page is medically responsible for Prof. h.c. (RU) Dr. med. Wolfgang Kelling Specialist in internal medicine with a focus on cardiology and gastroenterology.

As part of my clinical work, I was active as a senior physician in an internal medicine department with an endocrinological focus for several years. This experience flows into the internal overall classification of cardiovascular findings, without an endocrinological focus or additional designation being carried out.

All diagnostic and therapeutic recommendations are made on a medical basis and take into account the individual situation of the patient.

Which cardiological symptoms are clarified

A cardiological clarification is particularly useful in cases of:

• Chest pain, pressure or tightness in the chest
• Heart stumbling, racing heart or irregular pulse
• Shortness of breath or reduced endurance
• Dizziness, tendency to collapse or fainting spells
• Persistent performance reduction without a clear cause

These symptoms can have harmless causes, but also be an indication of relevant heart diseases.

Cardiological examination procedures in my practice

ECG and rhythm diagnostics

The following procedures are used to evaluate heart rhythm and electrical heart function:

• Resting ECG
• Stress ECG (ergometry)
• Long-term ECG (24-72 hours)
• Control of modern pacemaker and defibrillator systems (ICD, CRT, CRT-D, LBB)
• Cardiosigraphy (3D vector cardiology with AI-supported analysis)

Blood pressure diagnostics

• Long-term blood pressure measurement over 24 hours for a realistic evaluation of the blood pressure profile in everyday life

Heart ultrasound - structural and functional evaluation

Heart ultrasound allows the evaluation of heart size, heart function and heart valves:

• Color-coded echocardiography
• 3D echocardiography
• Myocardial function analysis (strain)
• Stress echocardiography under stress, if necessary with contrast agent

Heart and vascular ultrasound

The following are used to evaluate the vessels:

• Ultrasound of the neck arteries (carotid sonography)
• Ultrasound of the peripheral arteries
• Aortic screening for aneurysm diagnosis

Vascular sonographic diagnostics are carried out in my practice initially in full. Further invasive diagnostics or interventional therapies are carried out in specialized centers with which we have been well networked for years.

Laboratory-based internal cardiovascular diagnostics

In addition to apparatus diagnostics, a broad internal laboratory basic diagnostics is usually carried out during the initial contact. Metabolic, renal and liver functions are crucial for cardiovascular risk assessment, therapy decision and course control.

Depending on the clinical question, the following are determined, among other things:

• Heart markers
• Extended lipid profile, including lipoprotein(a)
• Inflammation markers
• Blood sugar and metabolic parameters (e.g. fasting glucose, HbA1c)
• Kidney function parameters (e.g. creatinine, eGFR)
• Liver function parameters (e.g. transaminases)
• Further laboratory chemical parameters as part of the internal overall clarification

Targeted genetic examinations are only carried out in cases of clear medical indication.

The laboratory findings help to make therapeutic decisions safely - for example, when it comes to blood pressure and lipid therapy, assessing vascular risk, and selecting and dosing medications, taking into account kidney and liver function.

Cardiovascular risk factors and prevention

Cardiological prevention is particularly useful in the presence of risk factors such as:

• Smoking
• Arterial hypertension
• Diabetes mellitus
• Lipid metabolism disorders (especially LDL or lipoprotein(a) elevation)
• Familial predisposition (heart attack or sudden cardiac death)
• Lack of exercise, chronic stress or sleep disorders

Prevention serves the early detection of risk and realistic assessment, not the unnecessary medicalization.

When a timely cardiological clarification is recommended

A timely examination is particularly indicated in cases of:

• Newly occurring chest pain
• Heart racing, pauses or new irregular pulse
• Persistent reduced endurance after viral infections (including COVID-19)
• Familial accumulation of heart attack or sudden cardiac death
• Known risk factors such as high blood pressure, diabetes or dyslipidemia

Medical classification instead of actionism

Not every striking measurement value means a heart disease. And not every normal finding explains complaints completely.

The goal of cardiological diagnosis is to create security, realistically assess risks and provide a reliable basis for further decisions.

I take the time for a calm, thorough and understandable cardiological clarification.

In the case of primary vascular complaints, see also the page Angiologie Baden-Baden-Vascular diagnostics and therapy.