Heart echo – indications, preparation, interpretation of results. What does the examination look like?

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The heart echo is a non-invasive and painless test that allows you to evaluate the work of the heart, especially in people with heart problems. It is performed using a specialized device emitting ultrasonic waves. What are the indications for a heart echo? What should I know about the course of the study and how to interpret the results?

Echo of the heart is a colloquial name heart echocardiography. The test is also called an ultrasound of the heart or an ultrasound (ultrasound cardiogram). The echo of the heart is classified as a diagnostic imaging test. The test uses ultrasonic waves that reflect from the examined structures, which allows the finished image to be read on the monitor. Ultrasounds with a frequency of 1 to 10 MHz are used to make the echo of the heart. The examination image can be printed or saved as a video.

Echocardiogram – basic assessed parameters

Based on the echo of the heart, the following is assessed:

  1. location of the heart, thickness of the heart, dimensions and proportions of the heart cavities,
  2. assessment of the systolic function of the left ventricle,
  3. construction of valves and flows,
  4. abnormal connections and flows between the heart chambers,
  5. heart tumors
  6. pericardium.

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As part of the prevention of cardiovascular diseases, perform a heart fitness test at least once a year. You can do this by performing blood tests available in the Heart control package – blood tests offered by the uPatient’s medical company, which has facilities all over Poland.

Heart echo – the main indications for examination

The echo of the heart is indicated for people with disturbances in the functioning of this organ: including murmurs, rhythm problems and difficult to explain pain. In addition, echocardiography should be performed on people suffering from serious heart conditions, such as:

  1. ischemic disease,
  2. myocarditis,
  3. endocarditis,
  4. thrombotic disease,
  5. past heart attacks.

An indication to go for echocardiography is also diagnosed with arterial hypertension. Complications of this disease may affect the heart muscle and lead to left ventricular hypertrophy. Chronic heart disease or valve disease should also be monitored, and your doctor may order an ultrasound scan for this purpose.

During the examination, you can detect:

  1. damage caused by a heart attack – in which the blood supply to the heart is suddenly blocked
  2. heart failure – when your heart does not pump enough blood to the right pressure
  3. congenital heart disease – birth defects that affect the normal functioning of the heart,
  1. problems with heart valves – problems with the valves that control blood flow in the heart
  2. cardiomyopathies – in which the walls of the heart thicken or enlarge
  3. endocarditis – an infection of the heart valves.

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Heart echo – types of examination

Echocardiography is performed in several ways, and also with the use of additional techniques. The basic methods of making the UKG are:

1.The echo of the thoracic heart – examination performed through the chest wall, it is the basic diagnostic method chosen both to diagnose the causes of syncope, heart murmurs or chest pain, as well as in the diagnosis of heart attacks, ischemic disease, arterial and pulmonary hypertension, pericardial and aortic diseases.

2.Transesophageal echo of heart (TEE) – wherein the echocardiogram probe is introduced through throatso that it adheres directly to your heart (your throat will be numbed with a local anesthetic spray, or you may be given a sedative to help you relax). You may need to avoid eating for several hours prior to this test. The image obtained in the TEE study is very clear and undisturbed by specific anatomical conditions (e.g., obesity, chest deformity) due to the close proximity of the esophagus to the left side of the heart, which minimizes the distance between the probe and the heart structures. The test is performed if the usual transthoracic examination cannot provide us with the exact information we need to treat the patient.

Transesophageal examination is performed when there is a suspicion of:

  1. aortic dissection,
  2. blood clots in the heart cavities,
  3. endocarditis on artificial valves,
  4. functional disorders of such prostheses.

However, there are contraindications for the above examination, including:

  1. narrowing of the esophagus
  2. esophageal tumors
  3. oesophageal ulceration and perforation
  4. esophageal diverticulosis,
  5. active bleeding from the upper gastrointestinal tract,
  6. visceral perforation,
  7. hemorrhagic diathesis.

3. Stress echocardiogram (exercise, pharmacological, Stress echo) – it is an echocardiographic examination using two diagnostic methods: exercise electrocardiography (ECG stress test) and echocardiography (heart echo). ECHO stress consists in the use of various types of tests stimulating contractility and / or causing controlled hypoxia of the heart muscle with simultaneous echocardiographic assessment of cardiac contractility. This test is done during or just after exercising on a treadmill or exercise bike, or after injection of a drug (dobutamine, vasodilators) that makes the heart work harder. This test is used in the diagnosis of the disease coronary heart, valvular heart disease and hypertrophic cardiopathy.

4. Contrast echocardiogram – in this test, it is used when a contrast agent is injected into the bloodstream before an echocardiogram is performed. This substance clearly shows up on the echocardiogram monitor and can help create a better picture of the heart.

5. Intracardiac echocardiogram (ICE) – this type of echocardiography is performed with probes as part of cardiac catheterization, and does not require general anesthesia.

The type of echocardiogram depends on the assessed heart condition and the degree of detail of the images. For example, an exercise echocardiogram may be recommended if exercise-induced heart problems.

There are four special types of echocardiography:

  1. Echocardiography in the M mode – this is the simplest type of echocardiography. It allows you to obtain a dynamic cross-section of the heart in one selected plane. It is used in the diagnosis of rapidly moving structures (e.g. valves, thrombus, tumors, vegetation), which also allows you to measure the thickness of individual walls of the heart, dimensions of cavities, large vessels (aorta, pulmonary artery, upper and lower vena cava) and other space. It also enables the assessment of contractility and asynchrony of contraction of the heart ventricles.
  2. Doppler echocardiography – the Doppler technique measures and assesses blood flow through the heart chambers and valves. The amount of blood pumped out with each beat indicates how the heart is functioning. In addition, the Doppler can detect abnormal blood flow in the heart, which may indicate problems such as a loss between the heart chambers, a problem with one or more of the heart valves, or a problem with the walls of the heart.
  3. Color Doppler — it is an improved form of Doppler echocardiography. Color Doppler uses different colors to determine the direction of blood flow. This simplifies the interpretation of the Doppler technique.
  4. 2-D (2-dimensional) echocardiography – this technique is used to view the actual structures and movement of the heart structures. The 2D echo view displayed on the monitor is cone-shaped and you can observe the movement of heart structures in real time. This allows the doctor to see and evaluate the different structures of the heart at work.

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The method of preparing for a heart echo depends on the type of examination. In the case where the transthoracic echo is performed, it is necessary to undress from the waist up and lie on the back. Transesophageal echocardiography requires an empty stomach or at least four hours after the last meal. Besides, no other preparation for the standard UKG is required.

It is also recommended to forgo a meal shortly before the examination in the case of a load ultrasound. When the procedure requires the patient to perform specific physical exercises, it is also advisable to choose a comfortable outfit and shoes.

Before your heart echoes, tell your doctor if you’ve ever had one heart problems. Such information is very important for the interpretation of the test results. It is also important to know what medications you are taking, e.g. insulin. Ask your doctor if you can take all pharmaceuticals for chronic diseases as normal before the examination.

The classic transthoracic echo takes place in a quiet room. To the patient lying on his back, the doctor applies a gel to the skin to facilitate the propagation of ultrasound waves. Usually, the ultrasound examination itself is performed while lying on the left side.

When the patient is in this position, the doctor places the head of the device against the body. The test equipment receives an echo by the transmitted sound waves. The monitor shows an image of the heart, which allows any abnormalities to be detected. The examination lasts from a few to several minutes and you must not move during it.

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In the case of a transesophageal heart echo, local anesthesia of the back of the pharynx is performed with an aerosol. If the patient is stressed and does not take the test well, sedatives are also given. Then a special probe is inserted into the mouth, which reaches a depth of 32 to 38 cm below the teeth (i.e. around the heart muscle). This allows you to present an accurate picture to the doctor performing the examination.

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The duration of the cardiac echo is approximately 15–30 minutes for transthoracic and Doppler examinations. A transesophageal echo takes an average of 10-15 minutes.

The traditional echo of the heart through a thoracic shearing is not associated with any postoperative recommendations. You have to remember, however, that after echo of the heart by the transesophageal method alcohol consumption is forbidden for 24 hours. You can also expect discomfort such as dry throat, slight tickling, sore throat and hoarseness. These symptoms are not disturbing, but if you develop speech difficulties or shortness of breath, there are complications that should be consulted with your doctor.

important

Another point concerns disease. Tell your doctor about infections with viruses such as HIV and hepatitis, as well as any chronic conditions, especially those related to the cardiovascular and respiratory systems.

Echo close – norm

The echo of the heart is an examination by which it is measured the so-called ejection fractionwhich determines the risk of cardiovascular diseases. It is the percentage of the volume of blood pumped from the heart during one contraction. The left ventricular ejection fraction is the most frequently assessed. As far as the norm is concerned, it amounts to a minimum of 60–65% in the heart echo. It should be emphasized here that the norms depend on gender, age and general body structure (height and weight).

The ejection fraction above normal means that there is no threat to life due to disease states. Its low values ​​mean, however, that the heart muscle is weak or inefficient.

The heart echo results can help you determine if you have a specific medical condition or disorder (for example, if you have had a heart attack). Low ejection fraction may be the result of untreated diseases of this organ or prolonged hypertension.

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The echo of the heart – procedure after the examination

A standard echocardiogram is a simple, painless, and safe procedure. It has no side effects, only the ultrasound gel that is used during the examination may be cold and may cause an allergic reaction in some people. Unlike other tests, such as X-rays and CT scans, no radiation is used during an echocardiogram.

Worth knowing

However, there are some dangers associated with less common types of echocardiogram. The esophageal test can be unpleasant, and your throat may feel sore for several hours after the test. You should not drive a car after taking sedatives.

You may experience nausea, dizziness, and chest pain during an exercise echocardiogram. There is also a small chance that the procedure will trigger a trigger irregular heartbeat or heart attackbut you will be closely monitored during the test and will be stopped if there are signs of any problems.

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Some people respond to the contrast agent used during a contrast echocardiogram. This often only causes mild symptoms such as itching, but in rare cases a serious allergic reaction can occur.

Fetal heart echo – examination during pregnancy

Pregnant women can make an echo of the fetal heart. It is not obligatory, but in some cases it may be ordered by the gynecologist, e.g. when there is a suspicion of a heart defect or arrhythmia in the fetus. Other indications for a fetal echo include:

  1. maternal autoimmune disease;
  2. gestational diabetes;
  3. taking certain medications by a pregnant woman;
  4. consumption of alcohol during pregnancy;
  5. the occurrence of heart defects in family members.

A fetal echo is performed like a normal examination. Thanks to the high frequency of ultrasound, it is possible to obtain accurate data on the structure of the fetal chest and heart, as well as on blood flow and heart rate.

The echo of the heart in a child

Echocardiography is an important test for imaging heart problems in infants and children. It can help diagnose any problems your child is experiencing gave birth (congenital), or those that appeared during the child’s growth. Indications for making a heart echo to a child:

  1. heart murmurs heard by the doctor over the child’s heart (differentiating between an innocent murmur and a congenital heart defect),
  2. identifying the causes of heart rhythm disturbances, including irregular heartbeat,
  3. diagnosing symptoms that indicate heart disease (e.g. chest pain, bruising of the body integuments),
  4. part of the diagnosis of some infectious diseases,
  5. an important element in the diagnosis of arterial hypertension,
  6. an important element of periodic diagnostics cardiovascular system in young people practicing sports,
  7. determining the indications for a possible cardiac surgery and monitoring its effects,
  8. prevention cardiovascular diseases (especially in patients with family history of cardiovascular disease).

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A child’s heart echo test it does not involve any risk, the child may only feel the cold from the ultrasound gel used. For smaller children, of course, it can be a kind of stress, but the parent is present throughout the study.

Your baby won’t need to do anything special before having an echocardiogram. It is important to explain to a small child especially that they will have such a test and what it is about. If transesophageal echo is required, make your child aware that he can get one throat painkillers and even sleeping pills.

Keep telling him that you will be with him all the time during the examination. In some offices, children are allowed to watch fairy tales during the study to ensure better comfort.

Echo of the heart – price

The echo of the heart is available free of charge under the contract with the National Health Fund. However, the use of such a service requires a referral from a cardiologist. You have to pay from 120 to 220 PLN for a private examination.

The echo of the heart is an examination that has many significant advantages. First of all, it is a non-invasive test (in the case of transesophageal echocardiography – semi-invasive), harmless and without side effects.

In addition, this examination is widely available, but in order to perform it, you need to get a referral from your family doctor to a cardiologist, then he will either carry out the examination himself or refer you to an echocardiogram.

Importantly, it is a repeatable (comparable) and developing examination (tissue techniques, 3D and 4D imaging, intravascular and intracardiac ultrasound).

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