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Echocardiogram: examination makes a diagnosis of heart disease

Echocardiogram: examination makes a diagnosis of heart disease

An echocardiogram is an ultrasound scan that looks at how your heart works. The results are more detailed than those obtained on an x-ray, in addition to not exposing the patient to radiation.

The device captures the sound waves that are emitted by all parts of the heart. These echoes are imaged and displayed on a monitor, allowing the physician to analyze all the characteristics of the patient's heart.

Synonyms

Echocardiography

Types

  • Transthoracic echocardiogram (TTE): is the most common type . Images of the heart are obtained as the doctor moves the device to different sites of the chest or abdominal wall.
  • Echocardiogram under stress: the examination is done before and after the heart is exposed to a stress, which can be obtained when the patient does activity physique or by the injection of a medicine that makes the heart beat stronger and faster. A stress echocardiogram is usually done to find out if the patient has coronary artery disease
  • Doppler echocardiogram: used to observe how blood flows through the chambers of the heart, heart valves, and blood vessels. The blood circulation reflects sound waves to the device. The computer then measures the direction and speed of blood flowing through the heart and blood vessels. Transesophageal echocardiogram (TEE): This method uses a probe, which is inserted orally and passes through the patient's esophagus to obtain the images. It is done with local anesthesia and used to complement the transthoracic echocardiogram. The scan shows sharper images of your heart since the probe is located closer to the heart and because the lungs and bones of the chest wall do not block sound waves.
  • The echocardiogram can also be used as part of a test of effort or in conjunction with the electrocardiogram.

When the examination is requested

The echocardiogram can be used to diagnose or monitor various diseases. Check the indications of the echocardiogram according to the type:

Transthoracic echocardiogram (TTE)

Monitor and diagnose congenital heart diseases, as well as observe the effects of a surgery done for the treatment of these diseases

  • Check the functioning of the heart after a heart attack
  • Identify the causes of heart failure
  • Diagnose pericardial diseases
  • For fetal monitoring during pregnancy
  • Stress echocardiography

Identify and monitor the reduction of blood flow to the heart (ischemia). This phenomenon is more apparent when the heart is under stress, that is, working more intensively.

Doppler echocardiogram

A Doppler echocardiogram can be used to complement the other types of examination in order to:

- Evaluate the speed at which blood travels through the heart Evaluate blood pressure and blood velocity within the heart valves

Transesophageal echocardiogram

Monitor heart function during surgery

  • Check the operation of artificial heart valves
  • Finding intracardiac masses and tumors
  • Diagnosing pulmonary thromboembolism
  • Diagnosing endocarditis
  • Diagnosing cardioembolic disease
  • Serving as a guide during cardiac catheterization
  • Diagnosing aortic dissection
  • Pregnant

There are no express contraindications to the examination in pregnant women, especially transthoracic echocardiography, which is used as part of prenatal testing.

Contraindications

Contraindications to echocardiography are rare, but transesophageal therapy may be contraindicated for those with severe esophageal diseases such as esophageal cancer or esophageal stricture. When in doubt, talk to your doctor.

No special preparation is required for transthoracic or Doppler echocardiograms.

However, for stress echocardiography, the patient may be instructed not to eat very heavy food hours before the examination, in order to prevent any type of nausea or motion sickness due to physical activity or medication injection. In addition, it is recommended to wear comfortable clothing and shoes.

For transesophageal echocardiography, fasting is required six hours prior to the test. In addition, it may be necessary to remove dentures before the exam. Because transesophageal echocardiography is done under the effect of anesthesia, you will not be allowed to drive or leave the hospital alone - so an accompanying person is required.

Talk to your doctor or doctor about any concerns about the examination and preparation. Also tell which medications you take regularly and if you need to stop any medications.

How it is done

An echocardiogram can be done in hospitals, clinics or doctors' offices. It is necessary to remove all jewelry and clothing above the waist. Patients may be offered surgical clothing.

Transthoracic Doppler echocardiography and stress echocardiography are performed by a trained ultrasound technician. Transesophageal echocardiography is performed by an endoscopist or cardiologist.

In all types of echocardiography, heart rate may be being monitored by electrodes. For more information, see electrocardiogram.

Intravenous access may be required if contrast is required on the examination. Contrast can be used in cases where it is difficult to obtain clear images of the heart due to conditions such as obesity or COPD. When this substance is injected into the patient's vein, it passes into the bloodstream and will manifest differently depending on the organ with which it is in contact, making it possible to detect some lesions or structures more easily.

Transthoracic echocardiogram

Transthoracic echocardiography is the most common type.

The patient is lying on his or her back or on the left side of a bed or table. A small amount of gel will be rubbed on the left side of the chest to help catch sound waves, and then the transducer is used to pick up sound waves and form the images.

This device captures high frequency sound waves and sends them to a monitor, which displays images of the heart, upper abdomen and area near the left nipple. The transducer captures the echoes of sound waves and transmits them in the form of electrical impulses. The echocardiogram machine converts these electrical impulses into animated images of the heart.

The physician or physician may request that the patient inhale and exhale slowly or hold their breath. The transducer is usually moved to different areas of your chest that offer specific views of your heart. Two-dimensional or three-dimensional photographs may also be taken, depending on which part of the heart needs to be examined.

Doppler Echocardiogram

The patient is lying on his or her back or on the left side of a bed or table. A small amount of gel will be rubbed on the left side of the chest to help pick up sound waves, and then the transducer is used to pick up sound waves and form the images.

Doppler echocardiogram difference for transthoracic echocardiography is that it records the movement of blood through the heart.

The doctor may request that the patient inhale and exhale slowly or hold their breath. The transducer is usually moved to different areas of your chest that offer specific views of your heart. You can also take two-dimensional or three-dimensional photographs, depending on which part of your heart needs to be examined.Stress echocardiogram

A transthoracic or Doppler echocardiogram will be done first. This is called the baseline, so the doctor knows how your heart works normally.

The patient will then be instructed to walk on the treadmill or to pedal on an exercise bike while being monitored by an electrocardiogram. Then you will lie on a bed or table and another echocardiogram will be done.

In some cases dobutamine is used instead of exercise to stress the heart. This medicine raises your heart rate, working similar to physical activity. After the baseline echocardiogram, the technician cleans the area of ​​the arm where the drug will be injected, and an intravenous access is done in a vein, where dobutamine will be given.

Peak heart rate is reached in about 15 minutes. After the maximum heart rate has been reached, the medicine will stop and the heart rate will return to normal. Then you will lie on a bed or table and another echocardiogram will be done.

The doctor may ask the patient to inhale and exhale slowly or hold their breath. The transducer is usually moved to different areas of your chest that offer specific views of your heart. Two-dimensional or three-dimensional photographs may also be taken, depending on which part of the heart needs to be examined.

Transesophageal Echocardiography

Before the test, an anesthetic will be applied to your throat. Medications to decrease salivation and production of stomach secretions may be given intravenously as well as sedatives. The patient should feel relaxed and sleepy but still alert enough to cooperate.

Heart rate, breathing rate, and blood pressure will be monitored throughout the procedure. In addition, a small device used to measure the amount of oxygen in the blood (pulse oximeter) can be attached to the finger or ear. You will be asked to lie on your left side with your head slightly tilted forward. A mouth guard can be inserted to protect the probe teeth. Then the lubricated tip of the probe will be guided, while the doctor gently presses the patient's tongue out of the way. The patient may be asked to swallow to help move the tube along the esophagus. When the probe is in the esophagus, it will be moved down gently to the heart level (upper right atrium), and ultrasound imaging will be done.

Examination duration

The test usually takes 30 to 60 minutes to be done

Caring after echocardiography

Most people do not feel any adverse effects after an echocardiogram.

On a stress echocardiogram, the patient may experience headache, nausea, dizziness, and pain in the chest due to increased heart rate. Symptoms, however, last for a few minutes.

The transesophageal examination can make the throat dry and causes symptoms such as coughing and irritation. The patient will be instructed not to drink alcohol for the next 24 hours after the test. Contact your health care provider if there is:

Difficulty swallowing or speaking

Short, rapid breathing

Chest pain.

Frequency of examination

  • There is no consensus on the periodicity of
  • Risks
  • There are few risks involved in a standard transthoracic echocardiogram.

If a transesophageal echocardiogram is done, the tube may scratch the inside of your throat, causing discomfort.

If a transesophageal echocardiogram is done, the tube may scratch the inside of your throat, causing discomfort. During a stress echocardiogram, exercise or medication may temporarily cause an irregular heartbeat. Severe complications, such as a heart attack, are rare.

Results

Results are usually available within a day. If the examination is performed by a cardiologist, the results may be available immediately after the test.

Normal results

Heart walls and chambers are of normal size and thickness, and move normally

Heart valves are running smoothly, without leaks or nips. There is no sign of infection

Amount of blood pumped from the left ventricle with each normal heartbeat.There is no excess fluid in the sac that surrounds the heart, and the tissue around the heart is not thickened.There are no tumors and clots of blood in the cardiac chambers

Abnormal results

  • Very large cardiac chambers
  • Thicker or thinner heart walls
  • One or more cardiac valves do not open / close adequately or appear to be normal

Signs of infection are present

  • Amount of blood pumped from the left ventricle with each heartbeat (ejection fraction)
  • There is fluid around the heart (pericardial effusion). The lining around the heart is very thick
  • A tumor or blood clot can be found in the heart.
  • What might affect the test result?
  • You may not be able to take the test or the results may not be helpful if the patient:
  • Is overweight or obese
  • Has large breasts

Has COPD

Is unable to lie during the test

  • Is not able to have a probe in your throat during a transesophageal echo.

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