Echocardiogram

An
echocardiogram (echo or ECG) 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 of the heart structures. These sound waves are sent to a computer
that can create moving images 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 technique is used to measure and assess the flow of blood
    through the heart’s chambers and valves. The amount of blood pumped out with each
    beat is an indication of the heart’s functioning. It can also detect abnormal
    blood flow within the heart, which can mean there is a problem with one 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 of blood flow. This
    simplifies the interpretation of the Doppler technique.

  • 2-D
    (2-dimensional) echo.
    This technique 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 seem. This lets the doctor see
    the various heart structures at work.

  • 3-D
    (3-dimensional) echo.
    3-D echo technique 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 assessment 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.

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 one 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 one 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 one 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
    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 but also when irregular blood flow is pushed through the circulation from the lungs and liver.

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

Your
doctor may have other reasons to recommend 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 doctor before the procedure.

  • Your doctor 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 doctor of all prescription and
    over-the-counter medicines and herbal supplements that you are taking.

  • Tell your doctor if you have a pacemaker.

  • Based on your medical condition, your doctor may request other specific preparation.

An
echocardiogram (ECG) may be done on an outpatient basis or as part of your stay in a
hospital. Procedures may vary depending on your condition and your doctor’s
practices.

Generally, an echocardiogram follows this process:

  1. 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.

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

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

  4. You will be connected to an ECG monitor that
    records the electrical activity of the heart and monitors 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.

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

  6. 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.

  7. 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.

  8. If the
    structures of your heart are hard to see, the technologist may use an 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.
  9. 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.

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

Generally, there is no special type of care after an echo. Y Your doctor may give you
other instructions after the procedure, depending on your situation.

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would  happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure