ECHOCARDIOGRAPHY

ECHOCARDIOGRAPHY

An echocardiogram, often referred to as a cardiac echo or simply an echo, is a sonogram of the heart. (It is not abbreviated as ECG, because that is an abbreviation for an electrocardiogram.) Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart.

Echocardiography has become 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 tests in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart (internal chamber size quantification), pumping capacity, and the location and extent of any tissue damage. 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 suspected patients of cardiac disease. It is an early tool which helps in reaching a diagnosis of Myocardial infarction showing regional wall motion abnormality of the heart. Also, its important in treatment and followup in patients of Heart failure by assessing Ejection fraction.

Echocardiography can help detect cardiomyopathies, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and many others. The use of stress echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease. The biggest advantage to echocardiography is 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, any leaking of blood through the valves (valvular regurgitation), and 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.

USES

Health societies recommend the use of echocardiography for initial diagnosis when a change in the patient’s clinical status occurs and when new data from an echocardiogram would result in the physician changing the patient’s care.Health societies do not recommend routine testing when the patient has no change in clinical status or when a physician is unlikely to change care for the patient based on the results of testing.

A common example of overuse of echocardiography when not indicated is the use of routine testing in response to a patient diagnosis of mild valvular heart disease.[6] In this case, patients are often asymptomatic for years before the onset of deterioration and the results of the echocardiogram would not result in a change in care without other change in clinical status.

Echocardiography now has vast role in Pediatrics diagnosing patient of Valvular heart disease and other congenital abnormalities. Now an emerging branch of Echo is also seen as Fetal echocardiography which involves Echocardiography of unborn fetus by the use of Ultrasonic Waves with no known side effects to mother and fetus.

Three-dimensional echocardiography

Three-dimensional echocardiography (also known as four-dimensional echocardiography when the picture is moving) is now possible, using a matrix array ultrasound probe and an appropriate processing system. This enables detailed anatomical assessment of cardiac pathology, particularly valvular defects and cardiomyopathies. The ability to slice the virtual heart in infinite planes in an anatomically appropriate manner and to reconstruct three-dimensional images of anatomic structures make it unique for the understanding of the congenitally malformed heart. Real-time three-dimensional echocardiography can be used to guide the location of bioptomes during right ventricular endomyocardial biopsies, placement of catheter-delivered valvular devices, and in many other intraoperative assessments.

Three-dimensional echocardiography technology may feature anatomical intelligence, or the use of organ-modeling technology, to automatically identify anatomy based on generic models. All generic models refer to a dataset of anatomical information that uniquely adapts to variability in patient anatomy to perform specific tasks. Built on feature recognition and segmentation algorithms, this technology can provide patient-specific three-dimensional modeling of the heart and other aspects of the anatomy, including the brain, lungs, liver, kidneys, rib cage, and vertebral column.

What is an echocardiogram?

Echocardiography is a test that uses sound waves to produce live images of your heart. The image is called an echocardiogram. This test allows your doctor to monitor how your heart and its valves are functioning.

The images can help them get information about:

  • blood clots in the heart chambers
  • fluid in the sac around the heart
  • problems with the aorta, which is the main artery connected to the heart
  • problems with the pumping function or relaxing function of the heart
  • problems with the function of your heart valves
  • pressures in the heart.

An echocardiogram is key in determining the health of the heart muscle, especially after a heart attack. It can also reveal heart defects in unborn babies. Getting an echocardiogram is painless. There are only risks in very rare cases with certain types of echocardiograms or if contrast is used for the echocardiogram.

Uses

Doctors may order an echocardiogram for several reasons. For example, they may have discovered an abnormality from other testing or while listening to your heartbeat through a stethoscope.

If you have an irregular heartbeat, your doctor may want to inspect the heart valves or chambers or check your heart’s ability to pump. They may also order one if they see signs of heart problems, such as chest pain or shortness of breath.

Types

There are several different types of echocardiograms.

This is the most common type of echocardiography. It’s painless and noninvasive.

A device called a transducer will be placed on your chest over your heart. The transducer sends ultrasound waves through your chest toward your heart. A computer interprets the sound waves as they bounce back to the transducer. This produces the live images that are shown on a monitor.

Transesophageal echocardiography

If a transthoracic echocardiogram doesn’t produce definitive images or you need to visualize the back of the heart better, your doctor may recommend a transesophageal echocardiogram.

In this procedure, the doctor guides a much smaller transducer down your throat through your mouth. The doctor will numb your throat to make this procedure easier and eliminate the gag reflex.

The transducer tube is guided through your esophagus, the tube that connects your throat to your stomach. With the transducer behind your heart, your doctor can get a better view of any problems and visualize some chambers of the heart that are not seen on the transthoracic echocardiogram.

Stress echocardiography

A stress echocardiogram uses traditional transthoracic echocardiography. However, the procedure is done before and after you’ve exercised or taken medication to make your heart beat faster. This allows your doctor to test how your heart performs under stress.

Three-dimensional echocardiography

A three-dimensional (3-D) echocardiogram uses either transesophageal or transthoracic echocardiography to create a 3-D image of your heart. This involves multiple images from different angles. It’s used prior to heart valve surgery. It’s also used to diagnose heart problems in children.

Fetal echocardiography

Fetal echocardiography is used on expectant mothers sometime during weeks 18 to 22 of pregnancy. The transducer is placed over the woman’s abdomen to check for heart problems in the fetus. The test is considered safe for an unborn child because it doesn’t use radiation, unlike an X-ray.

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