Echocardiology, oftentimes referred to as Echocardiography, constitutes a vital constituent of the Cardiology domain, necessitating a proficient Cardiologist or cardiac sonographer to execute the technique. By harnessing the prowess of ultrasound machinery, this non-invasive diagnostic modality generates vivid representations of the cardiac anatomy, thereby furnishing pivotal insights into the heart's structural and functional attributes. (1) (2)
A scholarly investigation has indicated that stress Echocardiology is predominantly employed for individuals afflicted with stable angina, who exhibit an intermediate likelihood of coronary artery disease, with a pre-test probability ranging between 15% and 85%. The advent of Echocardiology has engendered a paradigm shift within the realm of Cardiology, as medical professionals can now discern cardiac complications in their nascent stages, thus facilitating prompt interventions and enhancing patient prognoses. (3) (4)
Definition and Overview
A test called echocardiography creates real-time images of the heart using sound waves. An echocardiogram is the name given to the resulting image. This test allows the doctor to monitor how the patient's heart and valves are working.
Images can help doctors learn about:
- the size of the heart if there is any change in chamber size, enlargement or thickening,
- blood clots in the heart chambers,
- fluid in the sac around the heart,
- problems with the aorta, the main artery connected to the heart,
- problems with the pumping or relaxing function of the heart,
- problems with the function of heart valves,
- pressure in the heart.
Echocardiography is a painless procedure. In order to evaluate the condition of the heart muscle, echocardiography is essential, especially after a heart attack. Additionally, it can identify heart defects or problems in unborn babies. (5)
Doctors may request an echocardiogram from a patient for a variety of reasons, for example, they may have discovered something unusual on other tests or while listening to the heartbeat with a stethoscope.
If the patient has an irregular heartbeat, the doctor may want to examine the heart valves or chambers or check the heart's ability to pump. If the patient has symptoms of heart disease such as chest pain or shortness of breath, or if an abnormal EKG (electrocardiogram) result is obtained, the doctor may subject the patient to an echocardiogram test. There are several different ways an echocardiogram can be performed. The most commonly used types of echocardiograms are as follows.
- Transthoracic echocardiography
This is the most used type of echocardiography. Over the heart, a device known as a transducer is placed into the chest. From the chest, the transducer directs ultrasound waves toward the heart. Sound waves are decoded by a computer as they reach the transducer. This results in real-time images that are shown on a monitor.
A healthcare professional will adhere to directions to collect various kinds of images and information. Transthoracic echocardiography is a non-invasive, painless procedure. There is no need for any special preparation before having this test.
- Transesophageal echocardiography
In cases where data are not sufficient, the doctor may recommend a transesophageal echocardiogram for more detailed images. In this procedure, the doctor directs a much smaller transducer from the mouth down the throat. The throat is anesthetized to facilitate this process and to eliminate the gag reflex.
The esophagus, the tube that connects the throat to the stomach, is the path taken by the transducer tube. With the transducer at the back of the heart, the doctor can better see any problems and visualize some chambers of the heart that are not visible on the transthoracic echocardiogram.
- Stress echocardiography
A stress echocardiogram uses transthoracic echocardiography, but the doctor takes images before and after exercising or taking medication to make the heart beat faster. This allows the doctor to test how the heart performs under stress. Additionally, it can reveal if the patient has symptoms of heart failure, excessive blood pressure, or any other issues.
- Three-dimensional echocardiography
A three-dimensional echocardiogram creates a three-dimensional image of the heart using transesophageal or transthoracic echocardiography. This covers a variety of perspectives from various angles. It is used to diagnose children's heart problems and prior to heart valve surgery.
- Fetal echocardiography
Fetal echocardiography is employed in expectant mothers between 18 and 22 weeks of pregnancy. To look for fetal heart problems, the transducer is positioned in the mother's abdomen. Since the test does not involve radiation, unlike X-rays, it is thought to be safe for unborn babies. (6)
Echocardiography procedures are administered to patients for whom the following needs to be learned.
- The heart's size and shape, as well as the heart's walls' dimensions, thickness, and movement,
- Movement of the heart during heartbeats,
- The heart's pumping power,
- How heart valves work,
- Whether blood is leaking backward through the heart valves (insufficiency) or the heart valves are too narrow (stenosis),
- Whether there is a tumor or infectious growth around the heart valves,
- Whether there are issues with the heart's pericardium or the large blood vessels that enter and leave the heart,
- Whether there are blood clots in the chambers of the heart or abnormal holes between the chambers of the heart. (7)
Risks and Side Effects
Standard echocardiography is an easy, safe procedure. The scan has no negative effects, however, when the electrodes are withdrawn from the skin at the end of the procedure, the lubricating gel may cool and there may be some discomfort. An echocardiogram uses no radiation, unlike some other exams and scans like X-rays and CT scans. (8)
Post-Procedure and Follow-up
In some circumstances, it can be possible for the screening healthcare professional to go over the results with the patient right away.
In general, there is little or almost no recovery time required for an echocardiogram. Following a transesophageal echocardiography, a sore throat is relatively common for a few hours. The following day, however, patients can simply resume their regular routines.
Making the measurements typically takes 20 to 30 minutes after the technician has taken the images. The doctor may examine the images and report the findings to the patient right away or within a few days. The results can show many conditions such as damage to the heart muscle, heart defects, abnormal heart chamber size, problems with pumping function, blood flow of the heart, and pressure in the heart. The doctor will strive to create the best treatment plan if the patient is found to have a heart problem. (9)
(1) - https://www.mayoclinic.org/tests-procedures/echocardiogram/about/pac-20393856
(2) - https://www.healthline.com/health/echocardiogram
(3) - https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/echocardiogram-echo
(4) - https://www.ncbi.nlm.nih.gov/books/NBK558940/
(5,6,7,8,9) - Healthline. Echocardiogram. (https://www.healthline.com/health/echocardiogram)