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Echocardiography

Echocardiography is a test that uses sound waves for producing live images of the heart. The image produced is known as an echocardiogram. This test allows the doctor to see how the heart is beating and pumping blood. It monitors how the heart and heart valves are functioning.

Types: The different types of echocardiography procedures include:
1. Transthoracic echocardiogram:

  • It is the most common type of echocardiography.
  • A transducer, which is an ultrasound wand, is placed on the outside of the chest, near the heart region.
  • The transducer sends sound waves through the chest into the heart.
  • A gel is applied to the chest region to help the sound waves travel better.
  • The sound waves bounce off the heart to create pictures of the heart on the screen.

2. Transesophageal echocardiogram:

  • A thin transducer is attached to the end of a long tube.
  • The tube is inserted into the mouth to the esophagus (food pipe).
  • It helps in providing detailed images of the heart.

3. Three dimensional or 3D echocardiogram:
It helps in obtaining detailed images of the heart.

4. Doppler ultrasound:

  • Sound waves are generated at specific frequencies to determine how the sound waves bounce off and later return to the transducer.
  • Colored Doppler ultrasounds can be used to check the direction band velocity of the blood flowing in the heart.
  • Blood that flows toward the transducer will appear red, and the blood flowing away will appear blue.

5. Fetal echocardiogram:

  • An unborn baby’s heart can be viewed by a fetal echocardiogram.
  • This test usually takes place at 18 to 22 weeks of pregnancy.

6. Stress echocardiogram:

  • A physical activity, such as walking on a treadmill is performed to monitor the patient’s heart rate, the electrical activity of the heart, and blood pressure. This is known as a stress test.
  • A transthoracic echocardiogram is taken before and after the exercise.
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Symptoms

Purpose: An echocardiogram is performed for the following reasons:

  • Assessment of the overall function of the heart
  • Check the progress of valve diseases over time
  • Check the reasons for an abnormal electrocardiogram or ECG (electrical activity of the heart)
  • Check the effectiveness of medical or surgical treatments
  • Diagnose the presence of heart diseases, like blocked or leaky heart valves, enlargement of the heart chambers, stiffening or weak pumping of the heart muscle
  • Locating tumors or blood clots
  • Identification of congenital (present at birth) abnormalities of the heart

Symptoms: The symptoms that indicate the need for an echocardiogram are:

  • Shortness of breath
  • Irregular heartbeat (Arrhythmia)
  • Swelling of legs
  • High blood pressure or low blood pressure
  • Abnormal electrocardiogram (ECG) results
  • Heart murmurs (unusual sounds between heartbeats)

Echocardiography is required in the following conditions:

  • Heart attack
  • Heart failure
  • Enlarged heart (cardiomegaly)
  • Endocarditis
  • Cardiomyopathy

 

 

Treatment

  • You will be asked to remove your clothes from the waist up.
  • You will then be instructed to lie on a table on your back, or on your left side.
  • A dye or saline solution may be injected into your veins, to make the heart more defined on an echocardiogram.

In case of a transthoracic echocardiogram, the procedure is performed as follows:

  • A gel is applied to the chest region.
  • A transducer is moved around the chest to obtain the different images of the heart.
  • During the procedure, you may be asked to change positions, or hold a deep breath, or take a deep breath.
  • The transducer may be pressed into the chest to obtain a better image of the heart.

In case of a transesophageal echocardiogram, the procedure is performed as follows:

  • It helps in obtaining a more detailed image of the heart than a transthoracic echocardiogram.
  • You may receive a mild sedative to help you in relaxing the muscles in the throat region, and local anesthesia to numb the gag reflex.
  • The images of the heart are recorded as the transducer is moved around the esophagus.
  • You will not feel the transducer or the tube in the food pipe after the initial swallowing of the probe.

 

Risks

An echocardiogram is generally a safe procedure. A few complications that could be associated with echocardiography include:

  • Discomfort during electrode removal
  • Allergic reaction to the contrast
  • Esophageal irritation
  • Perforation of the esophagus 
  • Soreness in the throat
  • Drowsiness, in using a sedative
  • Irregular heartbeat causing a heart attack (stress echocardiogram)

After Procedure

  • You can resume your daily activities immediately after a transthoracic echocardiogram.
  • If you have a transesophageal echocardiogram, you will need to stay in the hospital for a couple of hours after the test.
  • You may have a sore throat for a couple of hours after a transesophageal echocardiogram.
  • If you receive a sedative before the test, you should not drive for a couple of hours after the echocardiogram.
  • You will most probably be able to resume your normal exercise and diet regime immediately after the procedure.

 

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