Diagnostics

Echocardiogram or Ultrasound of the Heart

What is echocardiogram?

An echocardiogram is a painless, non-invasive diagnostic test that uses sound waves to create images of the heart. It provides valuable information about the heart’s structure and function, helping doctors assess heart health and diagnose heart-related conditions.

Alternative names for the test are:

  • Heart ultrasound
  • Heart sonogram

Who conducts echocardiogram?

Echo tests are performed by a specially trained technician (cardiac sonographer) in a variety of settings, including emergency rooms, operating rooms, hospital clinics, and hospital rooms. The test typically takes about an hour.

Why is an echocardiogram done?

An echocardiogram can be done for a variety of reasons, including:

  • To diagnose heart disease
  • To assess the severity of heart disease
  • To monitor the effectiveness of treatment for heart disease
  • To check for heart defects in newborns
  • To help plan surgery or other procedures on the heart

What are the different types of echocardiograms?

There are various types of echo tests available, and the doctor will provide more information on the specific test that is best suited for the patient’s disease condition:

  • Transthoracic echocardiogram (TTE): A transthoracic echocardiogram is the most common type of echocardiogram. It involves placing a small device called a transducer on the chest. The transducer emits sound waves that create images of the heart.
  • Transesophageal echocardiogram (TEE): A transesophageal echocardiogram involves inserting a flexible tube with a transducer attached (the transducer is the device that emits sound waves) into the esophagus, which is located behind the heart. This allows for closer and more detailed imaging of the heart’s structures, especially the backside, which is not easily visible from the chest wall. It is usually performed under sedation to make the patient comfortable during the procedure.
  • Stress echocardiogram: A stress echocardiogram is performed to assess the heart’s function during physical stress. It involves obtaining echocardiogram images before and after exercising on a treadmill. This helps doctors evaluate how well an individual’s heart responds to stress and detect abnormalities that may not be visible at rest.
  • Dobutamine stress echocardiogram: This is another form of stress echocardiogram. Instead of exercising, a drug called dobutamine is administered to simulate the effect of a vigorous workout on the heart. This test is performed when an individual is unable to exercise on a treadmill or stationary bike. It provides information about the heart’s response to activity and helps assess the risk of coronary artery disease (blockages in the arteries) as well as the effectiveness of cardiac treatments. During the procedure, a technician will attach EKG electrodes to the chest, and a nurse will insert an intravenous line (IV) into a vein in the arm to administer the dobutamine.
  • Three-dimensional (3D) echocardiogram: A three-dimensional echocardiogram provides a more detailed and realistic image of the heart compared to traditional two-dimensional echocardiograms. It uses advanced technology to create a 3D representation of the heart’s structures allowing for better visualization and assessment of its function.
  • Doppler echocardiogram: A Doppler echocardiogram measures the direction and speed of blood flow through the heart and blood vessels. It helps evaluate the functioning of heart valves and detects abnormalities like leaks or blockages. The Doppler technique uses sound waves to assess the movement of blood and can provide additional information alongside the standard echocardiogram.

Echocardiogram procedure

Before the echocardiogram, the patient is given the following instructions:

  • Not eating or drinking anything for several hours before the test
  • Taking off clothes from the waist up
  • Avoiding taking certain medications before the test

During Procedure

  • The patient will lie on a table while small metal electrodes are placed on the chest. These electrodes are connected to an electrocardiograph machine to monitor the heartbeat.
  • The room is dimly lit to help the technician see the video monitor clearly.
  • A gel is applied to the chest to assist in transmitting sound waves through the skin.
  • The technician may ask the patient to move or briefly hold a breath to capture better images.
  • A probe (transducer) is moved across the chest. It emits sound waves that bounce off the heart and create an “echo” that is detected by the probe.
  • The sound waves are converted into pictures displayed on a video monitor. These images are recorded for the doctor to review later.

Echocardiography is generally safe with minimal risks. Different types of echocardiograms have specific considerations, but complications are rare. Discomfort during a transthoracic echocardiogram and temporary side effects from medications during a stress echocardiogram are usually well-tolerated. The use of contrast dye carries a small risk of an allergic reaction, but doctors are prepared to handle it.

A transesophageal echocardiogram may cause a temporary sore throat and minor discomfort. Serious complications are rare, and the benefits of echocardiography in diagnosing and monitoring heart conditions outweigh the minimal risks.

Consult the doctor for any concerns or questions about the procedure’s risks and benefits.

References

  1. Echocardiogram. Available from: https://www.webmd.com/heart-disease/diagnosing-echocardiogram
  2. Mayo Clinic (2022) Echocardiogram. Available from: https://www.mayoclinic.org/tests-procedures/echocardiogram/about/pac-20393856
  3. American Heart Association. (2022). Echocardiogram available from: https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/echocardiogram-echo
  4. Echocardiogram. available from: https://www.healthline.com/health/echocardiogram

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