Diagnostic examination of the size, shape, and motion of the heart using high-frequency sound waves (ultrasound).
In addition to the standard test, there are specialized echocardiograms:
Contrast echocardiogram—a solution is injected into a vein that allows the doctor to see images from inside the heart
Stress echocardiogram—performed during a cardiac stress (exercise) test to assess cardiac motion when increased demands are placed on the heart
Transesophageal echocardiogram (TEE)—combines the ultrasound test with an endoscopy. A thin tube with a transducer on the end is inserted through the mouth, past the throat, and into the esophagus. The closer proximity to the heart produces clearer images and enables better visualization of heart valves
.
Echocardiograms also may be combined with a Doppler study to assess blood flow.
Echocardiography is used to diagnose conditions involving the structure or function of the heart. The test enables visualization of the four chambers of the heart, the valves, the blood vessels entering and leaving the heart, and the sac that surrounds the heart. The procedure is most often performed for the following reasons:
Evaluate a heart murmur
Diagnose and determine the extent of valve conditions
Determine the presence of abnormalities in the structure of the heart
Measure the size and thickness of the heart and its chambers
Assess motion of the chamber walls and the extent of damage to the heart muscle after a heart attack
Assess how different parts of the heart are functioning in patients with chronic heart disease
Determine if fluid is collecting around the heart
Identify the presence of tumors in the heart
Assess for and monitor congenital defects
Evaluate a patient's response to treatment or a corrective procedure
Evaluate blood flow through the heart
Assess if the heart or major blood vessels coming and going from the heart have been damaged by a traumatic injury, often done to determine a heart's condition before it is donated for transplant
Evaluate heart function and diagnose heart and lungs abnormalities in critically ill patients in an intensive care unit
Evaluate chest pain
Evaluate for presence of blood clots within heart chambers
Risk Factors for Complications During the Procedure
Certain disorders may interfere with clear imaging in a standard echocardiogram and may require transesophageal echocardiography. These include:
Evidence to date shows no risk from standard echocardiograms.
What to Expect
Prior to Procedure
Physical exam
Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
Diet—You may eat normally before the procedure.
During Procedure
You'll lie on a flat table in a darkened room and gel will be applied to your chest. The darkness helps the technician see images on the screen.
Anesthesia
None. With the endoscopic procedure, you may be given a mild sedative.
Description of the Standard Procedure
A conductive gel that helps with the transmission of sound waves is applied to your chest. The technician then presses a small, hand-held device called a transducer (a tool that converts energy from one form to another) against your skin where the gel has been applied. The transducer sends high-frequency sound waves toward your heart, which reflects the sound waves back to the transducer. The waves are received by the transducer and converted into electrical impulses that become a visible image on the echocardiography machine.
The images appear on the machine's screen. The technician can capture a still image or videotape moving images for review at a later time. To obtain clearer and more complete images, the technician may move the transducer to different areas of your chest. You may also be asked to change positions and slowly inhale, exhale, or not breathe for a short period of time during the exam.
After Procedure
Remove gel from the chest
How Long Will It Take?
30-60 minutes
Will It Hurt?
No. The gel may feel cold when it is first applied, and holding the transducer tightly against the skin produces a slight sensation of pressure.
Possible Complications
None
Average Hospital Stay
None
Postoperative Care
Remove gel from the chest.
Resume normal activities.
Outcome
The images made during the echocardiogram are analyzed and interpreted by a specialist, who will send a report to your doctor. Based on these findings, your doctor will make recommendations for treatment during a follow-up appointment.
Call Your Doctor If Any of the Following Occurs
Worsening of your heart-related symptoms
RESOURCES:
American Heart Association http://www.americanheart.org
American Society of Echocardiography http://asecho.org
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/Page.asp?PageID=24
University of Ottawa Heart Institute http://www.ottawaheart.ca/UOHI/Welcome.do
References:
American Heart Association website. Available at: http://www.americanheart.org. Accessed October 14, 2005.
American Society of Echocardiography website. Available at: http://asecho.org. Accessed October 14, 2005.
Huttemann E. Transoesophageal echocardiography in critical care.
Minerva Anestesiol. 2006;72:891-913.
Medical encyclopedia: echocardiogram. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003869.htm. Accessed October 14, 2005.
Radiological Society of North America website. Available at: http://www.rsna.org/. Accessed October 14, 2005.
Sanderson JE, Chan WW. Transoesophageal echocardiography.
Postgrad Med J. 1997;73:137-140.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
