Echocardiography

An echocardiogram is an ultrasound image of the heart. This method can help doctors diagnose a wide range of heart problems. Doctors use echocardiograms to diagnose heart problems, such as damage to heart tissue, enlarged heart chamber, hardening of the heart muscle, blood clots in the heart, accumulation of fluid around the heart, damage to the heart valves, and poor heart function. Echocardiography uses ultrasound to create an image of the heart called an echocardiogram (echo). This method is non-invasive and does not produce any radiation. Normally echocardiography does not have side effects. During the echocardiogram, the doctor can observe the following:

• The size and thickness of the ventricles
• Heart valve function
• The direction of blood flow through the heart
• Any blood clots in the heart
• Areas of the heart muscle tissue that are damaged or weak
• Problems with the pericardium, which is a sack full of fluid around the heart

Doctors also use echocardiography to check a person's general heart health, especially after a heart attack or stroke.

Uses of echocardiography

• Determine how the heart pumps blood
• Evaluation of abnormal electrocardiogram (EKG) of the heart causes
• Diagnosis of heart disease, including poor pumping or stiffness of the heart muscle, leaking or blocked heart valves, and enlarged chamber in adults
• Locating blood clots or tumors
• Assess heart pressure to diagnose a condition called pulmonary hypertension
• Identification of congenital heart defects in infants and young children
• Control of how to respond to various heart treatments such as heart failure drugs, artificial valves, and pacemakers

If someone suspects heart problems, their doctor will order an echocardiogram. Signs and symptoms that may indicate a heart disease include:

• Irregular heartbeat
• Shortness of breath
• High or low blood pressure
• swelling of the foot
• Abnormal ECG results
• Unusual sounds between heartbeats, known as heart murmurs

Types of echocardiograms

 

Doctors can order different types of echocardiograms, all of which use high-frequency sound waves. Common types include the following:

Transthoracic echocardiogram

The transthoracic echocardiogram is the most common type of echocardiogram test. The test involves placing an ultrasound transducer outside the chest, near the heart. This device sends sound waves to the heart through the chest.

Applying gel on the chest helps the sound waves to move better. These waves bounce from the heart and create images of heart structures on the screen.

Esophageal echocardiogram

An esophageal echocardiogram uses a thinner transducer that attaches to the end of a long tube. The person swallows the tube to insert it into the esophagus. This type of echocardiogram provides more accurate images of the heart than a traditional transthoracic echocardiogram because the "limb" view is closer.

Doppler ultrasound

Doctors use Doppler ultrasound to check blood flow. They perform this by generating sound waves at specific frequencies and determining the rebound of sound waves to the transducer. Doctors can use color Doppler ultrasound to draw the direction and speed of blood flow to the heart. The blood flowing to the transducer looks red, while the returning blood looks blue. Doppler ultrasound results can reveal problems with valves or holes in the heart wall and assess how blood moves through it.

Three-dimensional echocardiogram

The three-dimensional echocardiogram produces accurate three-dimensional images of the heart. Physicians can use three-dimensional echocardiograms to assess valvular function in people with heart failure, diagnose heart problems in infants and children, and perform valvular heart programming or structural intervention surgery to evaluate heart function in three dimensions, and also depict the complex structures within the heart.

Echocardiogram in the stress test

Your doctor may prescribe an echocardiogram as part of a stress test. Stress testing includes physical exercises, such as walking or running on a treadmill. During the test, your doctor monitors your heart rate, blood pressure, and electrical activity. An ultrasound specialist uses a travertine echocardiogram before and after exercise.

Doctors use stress tests to diagnose the following:

• Ischemic heart disease
• Coronary heart disease
• Heart failure
• Heart valve problems

Fetal echocardiogram

 

Doctors can use a fetal echocardiogram to investigate the heart of an unborn baby. This test is usually done around 18 to 22 weeks of pregnancy. Echocardiograms do not use radiation, so they are not harmful to the mother or fetus.

Preparation for echocardiogram

Echocardiograms are a low-risk, relatively rapid procedure that requires minimal preparation.
In cases where a health care professional takes an echocardiogram from outside the body, the individual does not need to prepare.

The doctor recommends people who receive an echocardiogram through the esophagus, to avoid eating or drinking anything for at least 4 hours before the examination. After local anesthesia, people can resume eating and drinking for about 1 to 2 hours after the echocardiogram.

How to do an echocardiogram

During the echocardiogram test, the person taking echocardiography lifts the clothes from the waist up. If they want to cover themselves during the test, they can wear hospital clothes. Then the ultrasound specialist instructs the person to lie on their back or to their left, on a table. They may inject a saline solution or stain the person's veins, which can be seen on an echocardiogram. The exact method depends on the type of echocardiogram. for example:

Transthoracic echocardiogram

If a doctor requests a Transthorax echocardiogram, the ultrasound specialist will apply a gel to the chest. Then moves the ultrasound transducer around the chest to get different images of the heart. During the test, the ultrasound specialist may ask the person to change position or take deep breaths. They may push the transducer into the chest to get a better picture of the heart.

Esophageal echocardiogram

During an esophageal echocardiogram, a person may receive a mild sedative to help relax the throat muscles and a local anesthetic to numb the throat reflex. As soon as the sedative effect remains, the doctor inserts a small transducer at the end of a long tube down the throat and esophagus until it reaches the back of the heart. Simultaneous ultrasound captures images of the heart. After first swallowing the probe, the person should not feel the transducer or tube in their esophagus.

After echocardiogram

Most people can return to normal activities after having a Transthoracic echocardiogram. People who have an esophageal echocardiogram may need to stay in a hospital or health clinic for a few hours after the examination. They may have a sore throat at first but should heal within a few hours to a day. People who received sedation before the test should not drive for several hours after the echocardiogram. Whenever a person takes sedatives, stomach contents can enter the lungs. To prevent this, the doctor asks the person to keep the stomach empty before participating in the test. Some people may experience low and high blood pressure or reduced oxygen supply to the heart during a stress test. In case of any complications during the test, the stress test is performed in a fully equipped medical center. The use of topical anesthetics, sedatives, and contrast agents may cause allergic reactions in some people. In some cases, contrasting colors can also cause the following side effects:

• Headache
• Nausea
• Anxiety
• Vision or audition problems

Interpretation of echocardiogram results

 

After the inspection, the ultrasound specialist will send the echocardiographic images to the doctor who requested the test. The doctor reviews the images and looks for signs of heart problems on the echocardiogram.