What is Echocardiography?

An echocardiogram is a test in which ultrasound is used to examine the heart. Echocardiography not only provides single-dimension images, known as M-mode echo (allows accurate measurement of the heart chambers), it also offers far more sophisticated and advanced imaging. This is known as two-dimensional (2-D) Echo and is capable of displaying a cross-sectional "slice" of the beating heart, including the chambers, valves and the major blood vessels that exit from the left and right ventricles.

Common uses of Echocardiography

Transthoracic imaging is the most common type of echocardiography exam. It allows the doctors to view the heart from outside the chest without any discomfort to the patient. It does not require the patient to be sedated.

Echocardiography evaluates the size of the chambers of the heart, the dimension or volume of the cavity and the thickness of the walls. The appearance of the walls may help identify certain types of heart disease that predominantly involve the heart muscle. Echocardiography can also measure the severity of heart enlargement.

Pumping function of the heart can also be measured by echocardiography. The pumping power of the heart can be assessed to determine if it is normal or reduced.

If the heart is pumping poorly, it may be due to one or more isolated areas that are displaying depressed movement due to prior heart attacks (akinesia) or possibly another condition known as cardiomyopathy. In addition, echocardiography identifies the structure, thickness and movement of each heart valve. It can help determine if the valve is normal, scarred from an infection or rheumatic fever, thickened, calcified or torn. In cases of prosthetic or artificial heart valves, it can evaluate proper functionality.

The use of “Doppler” helps to identify abnormal leakage across heart valves to determine their severity. Doppler is also very useful in diagnosing the presence and severity of valve stenosis or narrowing.

Unlike echocardiography, Doppler follows the direction and velocity of blood flow rather than the movement of the valve leaflets or components.

Echocardiography is used to diagnose mitral valve prolapse (MVP), while Doppler identifies whether it is associated with leakage or regurgitation of the mitral valve (MR).

Low blood pressure can occur if the heart's function is poor, but may also be seen when patients have a reduced volume of circulating blood, as in cases of dehydration, blood loss or the use of diuretics. Usually the diagnosis can be made on the basis of history, physical examination and blood tests. However, there may be confusion when patients have a combination of problems. Echocardiography can be used to determine whether the inferior vena cava (IVC) is distended or increased in size in patients with heart failure and reduced in caliber when the blood volume is reduced thereby clearing up this confusion.

Other uses of Doppler or echocardiography include: congenital heart diseases, blood clots or tumors within the heart, active infection of the heart valves, abnormal elevation of pressure within the lungs and the identification of pericardial fluid.

How does it work?

Ultrasound imaging is based on the same principles involved in the sonar used by ships at sea. Controlled sound waves bounce against objects and the echo pattern is used to identify how far away the object is, how large it is, its shape and its internal consistency (fluid, solid or mixed).

As the sound waves echo from the body's fluids and tissues, the sensitive “transducer” detects tiny changes in the sound's pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. The live images of the examination can be recorded for the radiologist to view in natural motion. In addition, still frame pictures may also be captured. Blood flow changes the pitch of the sound beam; this “Doppler” effect can be heard and recorded on the image as color and displayed graphically.

Patient Comfort

Most ultrasound studies are fast and easy. You will be asked to lie down on a padded table and a warm liquid gel will be spread on your skin above the area which is to be examined. The technologist will move a device called a "transducer" slowly over your skin and an image will appear on the monitor. The gel helps the transducer make a secure contact and eliminates air pockets between the transducer and the skin, since the sound waves cannot penetrate air. The vascular technologist or radiologist presses the transducer against the skin and sweeps along the area of interest, reviewing the images on the monitor.

In a standard echocardiogram, the transducer is applied to the front of the chest. The ultrasound beam travels through the chest wall (skin, muscle, bone, tissue) and lungs to reach the heart. Because it travels through the front of the chest a standard echocardiogram is also known as a “transthoracic echo”.

Sticky pads are attached to the chest and connected to electrodes wires. These help to record the electrocardiogram (EKG or ECG) during the echocardiography test. The EKG helps in the timing of various cardiac events (filling and emptying of chambers).

The exam is completely painless. It is important that you remain as still as possible to ensure clear images. When the examination is complete, you may be asked to dress and wait while the ultrasound images are reviewed. Most exams take between 30 - 40 minutes; however, more complicated examinations may take somewhat longer.

Preparation

You should wear comfortable, loose-fitting clothing for your ultrasound exam, otherwise you may be asked to change into a comfortable robe. No other special preparation is required.

After the test

Patients are able to return to normal activities immediately following the exam.

Results

At Lifescape Imaging - Cypress, we have a radiologist / cardiologist on site for your exam to be interpreted promptly. All of our radiologists are Board Certified by the American College of Radiology. The results will be phoned, faxed, mailed, or delivered electronically to your referring physician. Your referring physician will share the results with you.