Echocardiogram Facts - Questions & Answers

Q: What is an Echocardiogram?

A: An echocardiogram is a safe, non-invasive procedure used to diagnose cardiovascular disease. It uses high-frequency sound waves to literally see all four chambers of the heart, the heart valves, the great blood vessels entering and leaving the heart, as well as the sack around the heart. Echocardiography allows doctors to visualize the anatomy, structure, and function of the heart. It can quickly diagnose the presence and severity of heart valve problems, as well as determine abnormal flow within the heart which occurs with congenital heart disease that you may have been born with. This window to the heart enables the doctors to diagnose a number of cardiovascular diseases, so they can begin proper treatment.

Q: Why is an Echocardiogram Preformed?

A: Doctors use an echocardiogram to diagnose and evaluate conditions of the heart and surrounding veins and arteries. Echocardiography can be used to determine causes for chest pain, establish a baseline for reference in tracking chronic heart conditions, evaluate the effects of a heart attack, diagnose narrowed or leaking heart valves, as well as to determine the need for intervention or as a follow-up to evaluate the effectiveness of treatment. An echocardiogram also can determine if the heart or aorta has been damaged in an accident and can help evaluate a donor heart prior to a transplant. Young children or infants could have echocardiography performed if there is suspected congenital heart disease.

The Doppler Echocardiograms

Evaluate blood flow in the heart and blood vessels. This procedure measures the speed and direction of the blood flow within the heart. It screens the four valves for leaks or other abnormalities. With Doppler echocardiograms, as the transducer moves over your heart you will hear a "whooshing" sound much like that of a washing machine. This sound relates to the movement of blood within your heart chambers

The Stress Echocardiogram

combines the echo exam with a treadmill or bike exercise test, or medication that simulates the effect of exercise on the heart. Both forms of stress echocardiograms are used to diagnose the presence and severity of narrowing of the coronary arteries.

Q: What types of Echocardiograms are there?

A: The conventional echocardiogram usually performed is the transthoracic echo, which is performed by placing the probe on the outside of the chest wall with a gel-like substance to transmit sound waves into the body.

Pumping function of the heart can also be assessed by echocardiography. One can tell if the pumping power of the heart is normal or reduced to a mild or severe degree. This measure is known as an ejection fraction or Echocardiography can also identify if the entire heart is pumping poorly due to a condition known as cardiomyopathy, or if one or more areas of the heart muscle have sustained prior damage (from heart attacks).

Echocardiography identifies the structure, thickness and movement of each heart valve. It can help determine if the valve is normal, scarred from an infection or rheumatic fever, thickened, calcified (loaded with calcium), torn, etc. It can also assess the function of prosthetic or artificial heart valves.

Echocardiography is used to diagnose mitral valve prolapse. The presence of mitral regurgitation frequently prompts the use of antibiotics prior to any dental or non-sterile surgical procedure. Such action helps reduce the rare complication of valve infection.

Echocardiography is useful in the diagnosis of fluid in the pericardium (the sac that surrounds the heart). It also determines when the problem is severe and potentially life-threatening. Other diagnoses made by Doppler or echocardiography includes congenital heart diseases, blood clots or tumors within the heart, active infection of the heart valves, abnormal elevation of pressure within the lungs, etc

Q: What type of Information can Echocardiography Provide?

A: Echocardiography displays the size of the chambers of the heart, including the dimension or volume of the cavity and the thickness of the walls. The appearance of the walls may also help identify certain types of heart disease that predominantly involve the heart muscle.

Q: Do health plans cover Echocardiography?

A: Most health plans, HMO's, and Medicare cover echocardiography for established reasons.

SonoNet has compiled - a list of common question and their answers that most patient have about ultrasound examinations. We feel that education is the most important part of your examination. If you have further questions feel free to ask your ultrasound technician. Each technician is trained in every aspect of ultrasound and in each exam they perfrom and can answer all your questions.

Q. How does it Work?

A: It uses high-frequency sound waves to literally see all four chambers of the heart, the heart valves, blood vessels entering and leaving the heart and the sack around the heart.

Q: Who gets an Echocardiogram?

A: The procedure can be performed on all ages, from fetuses to senior citizens.

Q: How long does an Echocardiogram take?

A: An echo takes approximately 30 to 45 minutes.

Q: Will I be exposed to Radiation?

A: The sound waves are painless, and are not radioactive. This test is completely non-invasive in terms of needles and probes

Q: What happens if the Doctor finds a Problem?

A: The doctor will explain the findings of the echocardiogram to the referring physician. Then additional tests may be performed or treatment may be recommended. Treatment for heart problems includes medication, surgery and lifestyle modification.

The Contrast Echocardiogram

Combines an echocardiogram with an administration, through a vein, of a sterile contrast solution, which allows visualization of the inside of the heart. This is a harmless agent that has no known side effects. You will need to have an IV started to receive a contrast echocardiogram.

Transesophageal Echo

Is a form of echo where a miniature ultrasound camera is passed down the esophagus, or food pipe, behind the heart. This allows the physician to obtain very high quality images. Transesophageal echocardiograms are typically performed to evaluate strokes and transient ischemic attacks (TIA), previous valve replacements and bypass surgeries, and other serious heart conditions.

Q: How is each Procedure Performed?

A: The transthoracic echocardiogram is a painless procedure that involves the patient lying quietly while a small probe, called the transducer, is gently placed on various positions of the chest, from which to obtain the images or pictures of the heart in real-time. Because the sound waves do not readily pass through air, a clear jelly-like substance is applied between the chest and the transducer to improve the contact of the transducer with the skin. Transesophageal echo involves the passage of a very small tube down the food pipe, or esophagus. Because the esophagus lies in close proximity (behind) the heart, outstanding images of the heart can be obtained. To minimize the amount of discomfort that a patient might have from swallowing the probe, patients are often given oral sprays of novocaine-like medicine, as well as intravenous medicine to relax them and minimize any discomfort.

Q: Where does the Procedure take Place?

A: An echocardiogram can be performed in any setting, i.e., wherever the patient is. While it is usually performed in a hospital or doctor's office, it can be performed bedside in the emergency room, an intensive care unit, or in an operating room. A cardiac sonographer, a health care professional specially trained and certified in ultrasound imaging of the heart, usually performs the procedure, and the results are reviewed and interpreted by a cardiologist. In some cases, such as with transesophageal echocardiography or when the echo is performed in the operating room, the cardiologist both performs the exam and interprets the results.

Q: What is the difference between and Echocardiogram and an EKG?

A: An echocardiogram shows an image of a beating heart on a television-like screen as the sonographer performs the test. An EKG, or electrocardiogram, measures the electrical currents in the heart. These are different diagnostic techniques used to obtain different information. The EKG tells about the electrical health of the heart while the echocardiogram tells the structural health of the heart and its valves.

Q: How long has Echocardiography been around?

A: Echocardiography began to be used in a clinical setting in the late 1960s. Echocardiography is still going through improvements and development of new technologies that make the procedure

Q: How can I tell if my Echocardiogram is being performed by Qualified Personnel?

A: The professionals involved in your echocardiogram should follow specific guidelines to provide high quality service. Check with them to see if the sonographer has passed a nationally recognized certification exam such as the Registered Diagnostic Cardiac Sonographer (RDCS), the physician has passed the ASCeXAM for special competency in cardiac ultrasound, and the lab is accredited by the Intersocietal Commission of Accreditation of Echocardiographic Laboratories (ICAEL).