Echocardiography

Echocardiography is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than x-ray image and involves no radiation exposure.

How the test is performed

A trained sonographer performs the test, then your physician interprets the results. An instrument that transmits high-frequency sound waves called a transducer is placed on your ribs near the breast bone and directed toward the heart. The transducer picks up the echoes of the sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of the heart.

Echocardiogram works well for most patients and allows doctors to see the heart beating and to visualize many of the structures of the heart. Occasionally, because your lungs, ribs, or body tissue may prevent the sound waves and echoes from providing a clear picture of heart function, the sonographer may administer a small amount of a dye through an IV to better see the inside of the heart.

Very rarely, more invasive testing using special echocardiography probes may be necessary.

If the echocardiogram is unclear due to a barrel chest, congestive obstructive pulmonary disease, or obesity, your health care provider may choose to perform a transesophageal echocardiogram, or TEE. With TEE, the back of your throat is anesthetized and a scope is inserted down your throat. On the end of the scope is an ultrasonic device that an experienced technician will guide down to the lower part of the esophagus, where it is used to obtain a more clear two-dimensional echocardiogram of your heart.

How to prepare for the test

There is no special preparation for the test.

How the test will feel

You will be asked to disrobe from the waist up and will lie on an examination table on your back. Electrodes will be placed onto your chest to allow for an ECG to be done. A gel will be spread on your chest and then the transducer will be applied. You will feel a slight pressure on your chest from the transducer. You may be asked to breathe in a certain way or to roll over onto your left side.

Why the test is performed

This test is performed to evaluate the valves and chambers of the heart in a noninvasive manner. The echocardiogram allows doctors to evaluate heart murmurs, check the pumping function of the heart, and evaluate patients who have had heart attacks. It is a very good screening test for heart disease in certain groups of patients.

Normal Values

A normal echocardiogram reveals normal heart valves and chambers and normal heart wall movement.

What abnormal results mean

An abnormal echocardiogram can mean many things. Some abnormalities are very minor and do not pose significant risks. Other abnormalities are signs of very serious heart disease that will require further evaluation by a specialist. Therefore, it is very important to discuss the results of your echocardiogram in depth with your health care provider.

Special considerations

Abnormal results may indicate heart valve disease, cardiomyopathy, pericardial effusion, or other cardiac abnormalities.

Stress Echocardiography

Stress echocardiography is a test that helps diagnose heart disease with the help of ultrasound images. (A more routine exercise stress test does not use imaging.) Following exercise or other stress to the heart, the images reveal parts of the heart that may not be receiving enough blood or oxygen because of blocked arteries.

This test may be used to monitor your progress if you already have a known heart condition.

How the test is performed

The ultrasound portion of this test is performed in the same way as an echocardiogram. Exercise (treadmill/bicycle) or medication is used to increase your heart rate and show how your heart works under exertion.

How to prepare for the test

  • Do not eat or drink for at least 3 hours before the test.
  • Ask your health care provider if you should take any of your routine medicines on the day of the test (especially if you are taking heart medication).
  • Wear loose, comfortable clothing.
  • You will be asked to sign a consent form before the test.

A stress echocardiogram includes the following steps:

  • A resting echocardiogram will be performed.¬†You will exercise or be given medicine until you reach the target heart rate.
  • Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.
  • A videotape of the ultrasound images will be taken during the procedure.
  • Another echocardiogram will be taken immediately after your target heart rate has been achieved.

Why the test is performed

The test is performed to see whether your heart is getting enough blood flow and, therefore, enough oxygen when it is put under stress. The intent is to discover and treat any blockage or disease before serious or life-threatening problems develop.

What the risks are

The risks are very low, and health care professionals will monitor you during the entire procedure. Rare complications include abnormal heart rhythm, heart attack, and collapse.

Special considerations

The main benefit is that a stress echocardiogram is a very effective, noninvasive test that can help determine whether you have blockages in your coronary arteries and if so, how serious the problem is. Early diagnosis and monitoring of heart disease allows treatment to begin early.

For patients who have already been diagnosed with coronary artery disease, this test can show whether your heart's function and blood flow are stable, or if blood flow to additional areas of your heart has become blocked.

If you have any questions about Echocardiography, please contact our Cardiopulmonary Department at (270) 251-4120.