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#1 2025-08-20 23:38:26

Jai Ganesh
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Registered: 2005-06-28
Posts: 51,439

Echocardiogram / Echocardiography

Echocardiogram / Echocardiography

Gist

An echocardiogram is a noninvasive medical test that uses high-frequency sound waves (ultrasound) to create moving pictures of your heart and its structures. It is also known as an "echo" and provides detailed images of the heart's size, shape, and how well it's pumping blood. The test helps doctors diagnose heart conditions like valve problems, heart failure, and congenital heart disease, and can be performed in different ways, including a standard transthoracic echo, a more detailed transesophageal echo (using a probe in the esophagus), or during exercise for a stress echo.

Summary

Echocardiography, also known as cardiac ultrasound, is the use of ultrasound to examine the heart. It is a type of medical imaging, using standard ultrasound or Doppler ultrasound. The visual image formed using this technique is called an echocardiogram, a cardiac echo, or simply an echo.

Echocardiography is routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic imaging modalities in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart (internal chamber size quantification), pumping capacity, location and extent of any tissue damage, and assessment of valves. An echocardiogram can also give physicians other estimates of heart function, such as a calculation of the cardiac output, ejection fraction, and diastolic function (how well the heart relaxes).

Echocardiography is an important tool in assessing wall motion abnormality in patients with suspected cardiac disease. It is a tool which helps in reaching an early diagnosis of myocardial infarction, showing regional wall motion abnormality. Also, it is important in treatment and follow-up in patients with heart failure, by assessing ejection fraction.

Echocardiography can help detect cardiomyopathies, such as hypertrophic cardiomyopathy, and dilated cardiomyopathy. The use of stress echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease.

The most important advantages of echocardiography are that it is not invasive (does not involve breaking the skin or entering body cavities) and has no known risks or side effects.

Not only can an echocardiogram create ultrasound images of heart structures, but it can also produce accurate assessment of the blood flowing through the heart by Doppler echocardiography, using pulsed- or continuous-wave Doppler ultrasound. This allows assessment of both normal and abnormal blood flow through the heart. Color Doppler, as well as spectral Doppler, is used to visualize any abnormal communications between the left and right sides of the heart, as well as any leaking of blood through the valves (valvular regurgitation), and can also estimate how well the valves open (or do not open in the case of valvular stenosis). The Doppler technique can also be used for tissue motion and velocity measurement, by tissue Doppler echocardiography.

Echocardiography was also the first ultrasound subspecialty to use intravenous contrast. Echocardiography is performed by cardiac sonographers, cardiac physiologists (UK), or physicians trained in echocardiography.

The Swedish physician Inge Edler (1911–2001), a graduate of Lund University, is recognized as the "Father of Echocardiography". He was the first in his profession to apply ultrasonic pulse echo imaging, which the acoustical physicist Floyd Firestone had developed to detect defects in metal castings, in diagnosing cardiac disease. Edler in 1953 produced the first echocardiographs using an industrial Firestone-Sperry Ultrasonic Reflectoscope. In developing echocardiography, Edler worked with the physicist Carl Hellmuth Hertz, the son of the Nobel laureate Gustav Hertz and grandnephew of Heinrich Rudolph Hertz.

Details

An echocardiogram is an ultrasound test that checks the structure and function of your heart. An echo can diagnose a range of conditions including cardiomyopathy and valve disease. There are several types of echo tests, including transthoracic and transesophageal. Talk with your provider about the type that’s best for you.

Overview:

What is an echocardiogram?

An echocardiogram (echo) is a graphic outline of your heart’s movement. During an echo test, your healthcare provider uses ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest to take pictures of your heart’s valves and chambers. This helps the provider evaluate the pumping action of your heart.

Providers often combine echo with Doppler ultrasound and color Doppler techniques to evaluate blood flow across your heart’s valves.

Echocardiography uses no radiation. This makes an echo different from other tests like X-rays and CT scans that use small amounts of radiation.

Who performs an echo test?

A technician called a cardiac sonographer performs your echo. They’re trained in performing echo tests and using the most current technology. They’re prepared to work in a variety of settings including hospital rooms and catheterization labs.

What are the different types of echocardiogram?

There are several types of echocardiogram. Each one offers unique benefits in diagnosing and managing heart disease. They include:

* Transthoracic echocardiogram.
* Transesophageal echocardiogram.
* Exercise stress echocardiogram.

What techniques are used in echocardiography?

Several techniques can be used to create pictures of your heart. The best technique depends on your specific condition and what your provider needs to see. These techniques include:

* Two-dimensional (2D) ultrasound. This approach is used most often. It produces 2D images that appear as “slices” on the computer screen. Traditionally, these slices could be “stacked” to build a 3D structure.
* Three-dimensional (3D) ultrasound. Advances in technology have made 3D imaging more efficient and useful. New 3D techniques show different aspects of your heart, including how well it pumps blood, with greater accuracy. Using 3D also allows your sonographer to see parts of your heart from different angles.
* Doppler ultrasound. This technique shows how fast your blood flows, and also in what direction.
* Color Doppler ultrasound. This technique also shows your blood flow, but it uses different colors to highlight the different directions of flow.
* Strain imaging. This approach shows changes in how your heart muscle moves. It can catch early signs of some heart disease.
* Contrast imaging. Your provider injects a substance called a contrast agent into one of your veins. The substance is visible in the images and can help show details of your heart. Some people experience an allergic reaction to the contrast agent, but reactions are usually mild.

How long does an echocardiogram take?

An echocardiogram usually takes 40 to 60 minutes. A transesophageal echo may take up to 90 minutes.

What is an echocardiogram vs. an EKG?

An echocardiogram and an electrocardiogram (called an EKG or ECG) both check your heart. But they check for different things and produce different types of visuals.

An echo checks the overall structure and function of your heart. It produces moving pictures of your heart.

An EKG checks your heart’s electrical activity. It produces a graph, rather than pictures of your heart. The lines on this graph show your heart rate and rhythm.

When would I need an echocardiogram?

Your provider will order an echo for many reasons. You may need an echocardiogram if:

* You have symptoms, and your healthcare provider wants to learn more (either by diagnosing a problem or ruling out possible causes).
* Your provider thinks you have some form of heart disease. The echo is used to diagnose the specific problem and learn more about it.
* Your provider wants to check on a condition you’ve already been diagnosed with. For example, some people with valve disease need echo tests on a regular basis.
* You’re preparing for a surgery or procedure.
* Your provider wants to check the outcome of a surgery or procedure.

What does an echocardiogram show?

An echocardiogram can detect many different types of heart disease. These include:

* Congenital heart disease, which you’re born with.
* Cardiomyopathy, which affects your heart muscle.
* Infective endocarditis, which is an infection in your heart’s chambers or valves.
* Pericardial disease, which affects the two-layered sac that covers the outer surface of your heart.
* Valve disease, which affects the “doors” that connect the chambers of your heart.

An echo can also show changes in your heart that could indicate:

* Aortic aneurysm.
* Blood clots.
* A cardiac tumor.

Additional Information:

What is an echocardiogram?

An echocardiogram (echo) is a noninvasive procedure. This means it does not pierce the skin. It's used to check the heart's function and structures. During the procedure, a transducer (like a microphone) sends out sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the sound waves move through the skin and other body tissues to the heart tissues. The waves bounce or "echo" off the heart structures. These sound waves are sent to a computer that can create moving images on the screen of the heart walls and valves.

There are several special types of echocardiography:

* M-mode echo. This is the simplest type of echo. It makes an image similar to a tracing rather than an actual picture of heart structures. M-mode echo is useful for measuring or viewing heart structures, such as the heart's pumping chambers, the size of the heart itself, and the thickness of the heart walls.

* Doppler echo. This method is used to measure and evaluate the flow of blood through the heart's chambers and valves. The amount of blood pumped out with each beat shows how well the heart is functioning. It can also find abnormal blood flow within the heart, which can mean there is a problem with 1 or more of the heart's valves, or with the heart's walls.

* Color Doppler. Color Doppler is an enhanced form of Doppler. With color Doppler, different colors are used to designate the direction and quantity of blood flow. This simplifies the interpretation of the Doppler method.

* 2-D (2-dimensional) echo. This method is used to "see" the actual motion of the heart structures. A 2-D echo view appears cone-shaped on the monitor, and the real-time motion of the heart's structures can be seen. This lets the provider see the various heart structures at work.

* 3-D (3-dimensional) echo. 3-D echo method captures 3-dimensional views of the heart structures with greater detail than 2-D echo. The live or "real time" images allow for a more accurate evaluation of heart function by using measurements taken while the heart is beating. 3-D echo shows enhanced views of the heart's anatomy and can be used to plan treatment for a person with heart disease.

Why might I need an echocardiogram?

An echocardiogram may be done for further evaluation of signs or symptoms that may suggest:

* Atherosclerosis. A gradual clogging of the arteries by fatty materials and other substances in the blood stream. It can lead to problems in the wall motion or pumping function of your heart.

* Cardiomyopathy. An enlargement of the heart due to thick or weak heart muscle.

* Congenital heart disease. Defects in 1 or more heart structures that occur during formation of the fetus, such as a ventricular septal defect (hole in the wall between the 2 lower chambers of the heart).

* Heart failure. A condition in which the heart muscle has become weakened or stiff during heart relaxation and blood can't be pumped efficiently. This can cause fluid buildup (congestion) in the blood vessels and lungs, and edema (swelling) in the feet, ankles, and other parts of the body.

* Aneurysm. A widening and weakening of a part of the heart muscle or the aorta (the large artery that carries oxygenated blood out of the heart to the rest of the body). The aneurysm may be at risk for rupture.

* Heart valve disease. Malfunction of 1 or more of the heart valves that may cause an abnormality of the blood flow within the heart. The valves can become narrowed and prevent blood from flowing through the heart or out to the lungs and body. The valves can also become leaky with blood flow leaking backwards. An echocardiogram can also check for infection of the heart valve tissue.

* Cardiac tumor. A tumor of the heart that may occur on the outside surface of the heart, within 1 or more chambers of the heart, or within the muscle tissue (myocardium) of the heart.

* Pericarditis. An inflammation or infection of the sac that surrounds the heart.

* Pericardial effusion or tamponade. The sac around the heart can become filled with fluid, blood, or infection. This can compress the heart muscle and prevent it from beating and pumping blood normally. This can cause symptoms of feeling dizzy, lightheaded, or a dangerous drop in blood pressure.

* Atrial or ventricular septal wall defects. Irregular channels between the right and left sides of the heart may be present at birth, or may occur form trauma, or after a heart attack. These defects occur in the upper filling chambers (atria) or the lower pumping chambers (ventricles). This may cause heart failure or poor blood flow. Or increase your risk for stroke.

* Shunts. Shunts can be seen in atrial and ventricular septal defects. And when irregular blood flow is pushed through the circulation from the lungs and liver.

An echocardiogram may also be done to evaluate the heart’s overall function and general structure.

Your healthcare provider may have other reasons to recommend an echocardiogram.

What are the risks of an echocardiogram?

This imaging procedure is not invasive and carries little to no risks. You may have discomfort from the positioning of the transducer because it can put pressure on the surface of the body. For some people, having to lie still on the exam table for the length of the procedure may cause some discomfort or pain.

You may have other risks depending on your specific health condition. Discuss any concerns with your healthcare provider before the procedure.

How do I get ready for an echocardiogram?

Your healthcare provider will explain the procedure to you and ask if you have any questions.

Generally, you don't need to do any preparation, such as fasting or having sedation.

Tell your healthcare provider of all prescription and over-the-counter medicines and herbal supplements that you are taking.

Tell your healthcare provider if you have a pacemaker.

Based on your medical condition, your healthcare provider may request other specific preparation.

Wear a loose-fitting top that is easy to remove or able to be unbuttoned.

What happens during the procedure?

An echocardiogram (Echo) may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition, type of echo, and your healthcare provider’s practices.

Generally, an echocardiogram follows this process:

* You will remove any jewelry or other objects that may interfere with the procedure. You may wear your glasses, dentures, or hearing aids if you use any of these.

* You will remove clothing from the waist up and will be given a gown to wear.

* You will lie on a table or bed, on your left side. A pillow or wedge may be placed behind your back for support.

* You will be connected to an ECG monitor that records the electrical activity of the heart and keeps track of the heart during the procedure using small, adhesive electrodes. The ECG tracings that record the electrical activity of the heart will be compared with the images displayed on the echocardiogram monitor.

* The room will be darkened so that the images on the echo monitor can be seen by the technologist.

* The technologist will place warmed gel on your chest and then place the transducer probe on the gel. You will feel a slight pressure as the technologist positions the transducer to get the desired images of your heart.

* During the test, the technologist will move the transducer probe around and apply varying amounts of pressure to get images of different locations and structures of your heart. The amount of pressure behind the probe should not be uncomfortable. If it does make you uncomfortable, let the technologist know. You may be asked to hold your breath, take deep breaths, or even sniff through your nose during the procedure.

* If the structures of your heart are hard to see, the technologist may use an intravenous (IV) contrast that helps the heart chambers show up better. This is not an iodine-based contrast, so you don't have to worry if you have an allergy to shrimp or shellfish with this type of contrast.

* After the procedure, the technologist will wipe the gel from your chest and remove the ECG electrode pads. You may then put on your clothes.

What happens after an echocardiogram?

You may resume your usual diet and activities unless your healthcare provider tells you differently.

Generally, there is no special type of care after an echo. Your healthcare provider may give you other directions after the procedure, depending on your situation. A cardiologist will interpret the images and send their final impression to your healthcare provider.

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