Cardiovascular Check-up — Extended

The Extended Cardiovascular Check-up is a comprehensive assessment program combining laboratory tests, electrocardiography, echocardiography, vascular Doppler examinations, and a medical consultation.

The package allows assessment of the main metabolic and biological factors associated with cardiovascular risk, kidney function, and electrolyte balance, as well as the electrical activity and structure of the heart. Vascular examinations allow assessment of arterial circulation and identification of atherosclerotic or hemodynamic abnormalities in patients for whom these findings are clinically relevant.

The physician integrates the results with the patient's age, blood pressure, smoking status, personal and family history, and other individual cardiovascular risk factors.

Components

• Lipid profile – total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides

Allows assessment of lipid metabolism and identification of dyslipidemia. LDL cholesterol is one of the main modifiable causal factors of atherosclerotic cardiovascular disease.

• Lipoprotein(a) – Lp(a)

A cardiovascular risk factor that is largely genetically determined. Elevated levels are associated with a higher risk of atherosclerotic cardiovascular disease. Lp(a) measurement is useful for complementing cardiovascular risk assessment and is generally recommended at least once during adulthood.

• Glucose

Assesses blood glucose at the time of sample collection and contributes to the identification of disorders of glucose metabolism.

• Glycated hemoglobin – HbA1c

Reflects glycemic exposure over approximately the previous 2–3 months and is used to identify and monitor disorders of glucose metabolism.

• High-sensitivity C-reactive protein – hs-CRP

A marker of low-grade systemic inflammation. A persistent level >2 mg/L, in the absence of acute infection or inflammation, is recognized by the 2025 ESC/EAS guidelines as an additional cardiovascular risk modifier.

• Uric acid

Allows identification of hyperuricemia, which is frequently associated with arterial hypertension, chronic kidney disease, and metabolic disorders and is also relevant in patients treated with certain diuretics.

• Sodium and potassium

Assess electrolyte balance. Changes in the concentrations of these electrolytes may occur in cardiovascular or kidney conditions or in the context of certain treatments and may affect cardiovascular function.

• eGFR (CKD-EPI) + Serum creatinine

Assess kidney function. Chronic kidney disease is closely associated with cardiovascular risk and influences prevention and treatment strategies.

• 12-lead resting ECG

Assesses the heart rhythm and electrical conduction and may identify arrhythmias, conduction abnormalities, signs of ventricular hypertrophy, or other electrocardiographic changes.

• M-mode, 2D and Doppler echocardiography

Assesses the structure and function of the heart, including chamber dimensions, ventricular function, heart valves, and hemodynamic parameters. It is particularly relevant in patients with arterial hypertension, cardiac symptoms, ECG abnormalities, or suspected structural heart disease.

• Color duplex Doppler ultrasound of the extracranial and intracranial cervicocerebral vessels

Allows assessment of the anatomy and blood flow in the examined vessels and may identify atherosclerotic plaques, stenoses, or other vascular abnormalities.

• Bilateral color duplex Doppler ultrasound of the lower limb arteries with mapping

Assesses arterial circulation in the lower limbs and may identify stenoses, occlusions, and other abnormalities consistent with peripheral artery disease. It is particularly relevant in patients with symptoms or an increased risk of peripheral artery disease.

• Medical consultation included in the package – cardiologist/internal medicine physician

The physician integrates clinical data, risk factors, and investigation results and determines the need for preventive measures, monitoring, or additional investigations.

Role of the package

• identification of dyslipidemia and disorders of glucose metabolism;
• assessment of additional cardiovascular risk modifiers, including Lp(a) and hs-CRP;
• assessment of kidney function and electrolyte balance;
• identification of electrical or structural cardiac abnormalities;
• identification of subclinical atherosclerosis or peripheral artery disease;
• complementing cardiovascular risk stratification and determining an individualized medical management strategy.

Indications

• multiple cardiovascular risk factors: arterial hypertension, dyslipidemia, diabetes/prediabetes, obesity, smoking, sedentary lifestyle;
• family history of premature cardiovascular disease;
• elevated Lp(a) or significant dyslipidemia;
• intermediate or high cardiovascular risk when additional information is required to refine risk assessment;
• arterial hypertension and the need to assess target-organ damage;
• clinical suspicion of atherosclerotic disease;
• symptoms or risk factors for peripheral artery disease;
• need for an extended cardiovascular assessment as recommended by a physician.

Medical sources:

https://www.escardio.org/guidelines/practice-tools/cvd-prevention-toolbox/score-risk-charts
https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/dyslipidaemias
https://www.eshonline.org/esh-content/uploads/2025/12/2024-ESH-MASTERplan-Blood-Pressure_publication_2025-1-1.pd
http://https://academic.oup.com/eurheartj/article/45/36/3538/7738955
https://academic.oup.com/eurheartj/article/42/34/3227/6358713
http://https://academic.oup.com/eurheartj/article/45/38/3912/7741010