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An echocardiogram is a safe, non-surgical procedure used to diagnose cardiovascular disease. Echocardiography is the most widely performed cardiac imaging study. Compared to other techniques, such as nuclear scintography, magnetic resonance imaging, and computerized axial tomography, echo offers many advantages. These include low cost, lack of radiation exposure, portability, and the opportunity to completely assess cardiac structure and function in a single examination. Echo is the most commonly performed cardiac imaging study. Like ultrasound tests of other organs, echocardiography utilizes high-pitched soundwaves to create two-dimensional images of the four heart chambers, the heart valves, the blood vessels supplying the heart, and the sack surrounding the heart. The soundwaves are emitted from a handheld transducer that is placed on the chest and directed at the heart and surrounding structures. Echoes bouncing off these structures are reflected back to the transducer, analyzed by the echocardiogram computer, and displayed on a monitor. These images, which were recorded on videotape in the past, are transferred to a computer where the cardiologist can review them. An echocardiogram provides valuable information concerning the heart's valves, the dimensions of the heart's chambers, and the movement of the heart's muscular walls. The cardiac echo can detect accumulation of fluid and abnormalities of structures surrounding the heart. Some of the more common diseases and symptoms that can be diagnosed and monitored by an echocardiogram include: cardiomyopathy; congestive heart failure; all congenital anomalies, mitral valve prolapse; mitral, aortic, tricuspid, and pulmonic insufficiency/regurgitation; stenosis and replacement; rhythm disorders (afib, aflutter, palpitations, etc.), murmur; endocarditis; pericardial effusions and transplant. Additionally, Doppler technology facilitates the analysis of blood flow patterns within the heart, which is important in the diagnosis of valvular heart disease. By providing this window into the body, the echo provides physicians with the knowledge they need to properly treat a problem. What types of echocardiograms are there? Transthoracic Echocardiography Transthoracic is the traditional echocardiogram that is performed by positioning a probe, called a transducer, on the outside of the chest wall while the patient is lying down. Soundwaves lack the ability to travel through air, so a clear, gel-like substance is placed between the chest and the transducer to provide a medium through which soundwaves can travel. The gel also helps to improve the contact between the transducer and the skin. The probe is placed in various positions on the chest to obtain different images of the heart. Transesophageal Echocardiography Although transthorasic echocardiography is usually sufficient for comprehensive cardiac assessment, in some patients, lung disease, obesity and other factors make image interpretation difficult. Additionally, some structures, such as prosthetic heart valves, thrombus (blood clot) within the heart, and some forms of congenital heart disease are best imaged using transesophageal echocardiography. In this test, the patient actually swallows a small ultrasound probe, and images are acquired through the walls of the stomach and esophagus. The test typically lasts for 10-15 minutes, and the patient experiences no discomfort. Stress Echocardiography Coronary artery disease remains the leading cause of death in the United States. Although coronary angiography is the gold standard for the diagnosis of coronary artery disease, several noninvasive techniques are also available. Stress echocardiography is a modification of a standard exercise treadmill test. In addition to electrocardiographic monitoring, two-dimensional echocardiographic images are acquired before and immediately following exercise. If a significant stenosis, or blockage, is present in a coronary artery, the portion of the heart supplied by that artery will contract poorly immediately following exercise. How is an Echocardiogram performed? The test is administered by a specially educated ultrasound technologist called an ultrasonographer. You will be asked to remove your clothing above the waist and all of your jewelry. You will be given a gown or sheet for partial covering during the test. The test requires that you be able to lie on your back and left side on a bed or table. Electrodes will be placed on your chest to record your heart rate. A small amount of gel will be rubbed on the transducer to improve the transmission and reception of the soundwaves. The transducer is placed firmly on the chest and moved slowly back and forth. The transducer emits soundwaves through the chest, where they bounce off the structures in the chest cavity. The echoes are transmitted to a computer monitor and digitally recorded for later viewing by a cardiologist. During the test, you may be asked to breathe slowly, hold your breath, or lie on your left side. After the test is competed, the gel is wiped off your chest. | ||||||||||||||||
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