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Echocardiography

Introduction

Echocardiography is a painless test that uses sound waves to create pictures of the heart.

Echocardiography can detect many different types of heart problems. Some of these can be minor and pose no risk to you. Others can be signs of serious heart disease or other heart problems.

Problem

Doctors need a noninvasive test that will give them insight into how a patient’s heart is built (size and shape) and how well the heart’s chambers and valves are working.  Doctors also may be looking for confirmation based on a previous diagnosis to determine the status of an existing problem, or help guide ongoing treatment.  Additionally, the diagnostic tool needs to work on infants and children.

 

Previous Options

There are a number of alternatives to having an echocardiogram. Some of these are listed below.

  • Electrocardiogram (ECG). This test measures the electrical activity of the heart to see how well it’s working, but doesn’t give any information about how the heart valves are working.
  • Transoesophageal echocardiogram (TOE). This is another type of echocardiogram used to get clear pictures of the heart valves. Images are taken from a probe placed inside the oesophagus (the pipe that goes from the mouth to the stomach). This is good if you have artificial heart valves (because they shown up less well with a conventional echocardiogram) and for detecting any blood clot (thrombus) in the heart.
  • Radionuclide test. During this test you’re injected with a harmless, radioactive substance when you’re resting and when the heart is under stress. The radioactive substance is seen with a special camera as it travels through the heart.
  • Cardiac MRI (magnetic resonance imaging) test. An MRI scan uses magnets and radiowaves to produce images of the inside of the body.

 

Radionuclide tests and MRI scans aren’t often used and are only available at a few specialist hospitals.

Solution

Echocardiography is the most noninvasive yet comprehensive test available for determining overall heart health.  The test can identify areas of heart muscle that aren’t contracting normally due to poor blood flow or injury from a previous heart attack. In addition, a type of echo called Doppler ultrasound shows how well blood flows through the chambers and valves of the heart.

 

Echo can detect possible blood clots inside the heart, fluid buildup in the pericardium, and problems with the aorta.  Specifically, routine Echocardiography can be rationalized in patients with hypertension, atrial fibrillation, stroke and endocarditis.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1303430/pdf/westjmed00354-0077.pdf

 

Implementation

Echocardiograms are done at the doctor’s office and require less than an hour.  Patients can typically go back to their normal activities right after having an echo.  Doctors should order an Echocardiogram to help diagnose any of the following:

  • 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 the 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 (Congestive Heart Problems)
    • Identify presence of tumors in the heart
    • Assess for and monitor congenital defects
    • Evaluate a patient’s response to a treatment or a corrective procedure
    • Evaluate blood flow through the heart
    • Assess the heart condition prior to transplant; see if major blood vessels have been damaged by traumatic injury
    •  Assess problems with the heart muscle (known as cardiomyopathy)
    • Assess abnormal heart rhythms (arrhythmias)
    • Assess Bacterial Endocarditis (BE—an infection of the valves and inner lining of   the heart. This happens when bacteria from the skin, mouth or intestines enter the bloodstream and infect the heart.
    • Assess EF –ejection fraction levels (heart flow)
    • Rule out any of the above mentioned abnormalities

Summary

Heart Ultrasounds are not for everyone, but patients with a family history of heart disease, are in a high-risk group, or are experiencing any symptoms (shortness of breath, pain in your arm, etc.—see AHA guidelines), are candidates for Echo Screening.  

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