Heart problem? Let's learn everything about the Echocardiogram!

Have you ever wondered what goes on inside your heart and how it works? Sometimes a doctor might tell you to 'do an echo'. So, today we will talk briefly about what an echocardiogram is and what it can detect. Simply put, an echocardiogram is a test that shows a picture of your heart's movements. In this test, a doctor or a trained technician places a small handheld device on your chest and uses high-frequency sound waves called ultrasound to take pictures of the valves and chambers of your heart. This can help you see exactly how your heart is pumping blood .

Doctors often use this test in conjunction with Doppler ultrasound and color Doppler to look at how blood flows through the heart valves. The best part is that this test does not use any radiation. This is different from other tests that use radiation , such as X-rays or CT scans .

Who performs this echocardiogram?

Do you know who does this echocardiogram? There is a person who has received special training for it, we call him a cardiac sonographer . They are the ones who use this latest technology and perform this test in a hospital room, or sometimes in a special cardiac treatment facility ( catheterization lab ).

Are there different types of echocardiograms?

Yes, there are actually several types of echo tests. Each type has its own specific benefits in diagnosing and treating your heart disease. The main types are:

• Transthoracic echocardiogram: This is the most commonly performed type and the one most people are familiar with.
• Transesophageal echocardiogram: This is a slightly special method that allows a closer look at the heart.
• Exercise stress echocardiogram: This tests your heart while you exercise.

What are the techniques used in echo testing?

Different techniques are used to take pictures of your heart. The best method will depend on your condition and what the doctor wants to see.

• Two-dimensional (2D) ultrasound: This is the most commonly used type. The heart is seen on the computer screen as "slices".
• Three-dimensional (3D) ultrasound: This 3D method has become much more advanced with new technology. It can take a complete three-dimensional image of the heart. It shows the way the blood is pumped very clearly, and you can also see the heart from different angles.
• Doppler ultrasound: This checks how fast and in which direction your blood is flowing.
• Color Doppler ultrasound: This also shows the flow of blood, but in color. It is easier to understand because the blood flows in different directions, showing different colors.
• Strain imaging: This shows subtle changes in the way the heart muscle moves. This can be very helpful in identifying early signs of some heart diseases.
• Contrast imaging: In this, a special liquid ( contrast agent ) is injected into your vein. This liquid shows up clearly on the images, so details of the heart can be seen better. Some people may have a slight allergic reaction to this, but it is usually not a big deal and will go away quickly.

How long does an echo test take?

An echocardiogram usually takes about 40 to 60 minutes. However, a transesophageal echo, which is done with a tube inserted down the throat, can take about 90 minutes.

Are Echo and EKG the same thing? Or are they two?

One thing that confuses many people is whether an Echo and an ECG (EKG or ECG) are the same thing or not. Both look at your heart, but the things they look at and the way they look are different.

An echo looks at the overall shape, structure, and function of the heart. It produces moving images of the heart.

An ECG (EKG) measures the electrical activity of the heart. It does not produce pictures of the heart, but a graph. The lines on this graph show the heart rate and rhythm.

When do I need an echocardiogram?

Now let's see when a doctor would tell you to have an echocardiogram.

• If you have any symptoms (e.g. chest pain, difficulty breathing), find the cause (either diagnose an illness or confirm that there is no such illness).
• If the doctor thinks you have some kind of heart disease,That there is. Then we do something to find out exactly what it is and find out more about it.
• If you already have a diagnosed heart condition, check its status. For example, some people with heart valve disease need to have regular echocardiograms.
• If you are preparing for surgery or another medical procedure.
• See what the results are like after a surgery or medical procedure.

What does an echocardiogram show?

An echocardiogram can diagnose many different types of heart disease. Here are a few examples:

• Congenital heart disease: This means heart disease that is present at birth.
• Cardiomyopathy: This is a disease that affects the heart muscle.
• Infective endocarditis: This is an infection of the heart chambers or valves.
• Pericardial disease: This is a disease that affects the thin sac ( pericardium ) that surrounds the heart.
• Valve disease: This is a disease that affects the valves, which are like "doors" between the chambers of the heart.

Also, an echo can show the following changes in the heart:

• Aortic aneurysm
• Blood clots
• Cardiac tumor

How is a Transthoracic Echo performed?

This is the type that most people think of when they hear the word 'heart echo'. This is the most common and common method. It is done outside your body. A trained sonographer places a small, handheld device (called a transducer ) on your chest and sends sound waves into your heart. These sound waves bounce off parts of your heart and 'echo', or reflect, back. These 'echoes' are what appear as images on the sonographer's computer screen. These images can then be viewed by your cardiologist and other doctors.

How do I prepare for this transthoracic echo?

• There's no need to prepare much for this. Generally, you don't need to control your eating and drinking.
• If you have any medications, take them as usual.
• You can come wearing any clothes. You will have to change before the test.
• It's better to leave valuables at home. They provide a locker to store your belongings.

What happens during a Transthoracic Echo?

• First, you will be told to remove your clothes from the waist up and put on a hospital gown.
• The technician will then place small, flat, adhesive pads ( electrodes ) on your chest. These are connected to an EKG monitor.It is connected. This records the electrical activity of your heart throughout the test.
• You will have to lie down on an examination table. You will be asked to lie on your left side if possible.
• The technician places a device called a transducer (we'll call it a 'wand') on your chest at different points. The tip has a small amount of gel applied to it, which doesn't hurt the skin. This gel helps to take clear pictures.
• You may hear a 'swish swish' sound during the test. This is normal, don't worry. This is because the wand is capturing the sound of blood flowing through the heart.
• During the test, the technician will ask you to hold your breath for a few seconds and may also ask you to move into a different position.

You won't feel any discomfort during this test. The gel on the wand will make your skin feel a little cold. You may also feel a slight pressure when the wand is pressed against your chest.

How is a Transesophageal Echo (TEE) performed?

This takes pictures from inside the chest, not outside. It can see the heart and valves in much more detail than a transthoracic echo . This is because your bones and tissues don't come between the transducer and your heart. For this test, the technician inserts a small transducer through a long, flexible tube ( endoscope ) down your throat and into your esophagus . This is a minimally invasive procedure, so you may feel some temporary discomfort. But there are no major risks.

This type of echo can be used in the following situations:

• The doctor may want to take a closer look at your aorta or the back of your heart (especially the left atrium or left ventricle ).
• Check for blood clots .
• Check your mitral valve or aortic valve .
• If you have obesity or lung disorders .
• If a transthoracic echo cannot be performed for various other reasons.

How do I prepare for a transesophageal echo (TEE)?

When preparing for this, you should tell your doctor if you have any of the following:

• Esophagus problems, such as a hiatal hernia .
• Difficulty swallowing.
• Sleep apnea .
• If drugs are injected into the veins ( IV drug use ).

Also, it's important to mention if you are taking medication for any of the following:

• Insomnia problems.
• Anxiety .
• Pain .

Things to prepare on the day of the test:

• Be sure to bring someone to take you home. You will be sedated for this test, so you will not be able to drive for 24 hours.
• Do not eat or drink anything for at least six hours before the test. Your doctor will give you specific instructions about what to eat and drink. It is important to follow them exactly.
• Ask your doctor about the time you should take your regular medication. You may be able to take it at that time with a sip of water.
• If you are taking medication for diabetes , ask your doctor about when and how to take that medication.
• Please leave your valuable personal belongings at home. A locker will be provided to store your belongings.
• Please wear the most comfortable clothes you can. You will need to change into a hospital gown before the procedure begins.

What happens during a transesophageal echo (TEE)?

• You have to take off your clothes above the waist and put on a hospital gown.
• The doctor will place electrodes (small stickers) on your chest. These can monitor the electrical activity of your heart during the test.
• The doctor will attach a blood pressure cuff to your arm and a pulse oximeter to your finger.
• You will be given a throat rinse with a numbing liquid. The doctor will also spray a painkiller into your throat.
• To make you more comfortable, you will be given an IV and sedated. After a while, you will start to feel sleepy.
• You may have a small tube placed in your nose to give you oxygen.
• You need to turn left and lie down on the examination table.
• The doctor will insert an endoscope ( a long, thin, flexible tube with a transducer on the end) through your mouth. This tube will go down your throat and into your esophagus . It will be lubricated to help it go down more easily. Although this may feel a little uncomfortable, it will not hurt you.
• You may be asked to swallow to get the transducer exactly in the right place behind your heart.
• Then the doctor takes pictures. You won't feel anything at this time.
• After the doctor takes the pictures he needs, he will remove the tube from your throat. In a moment, you will be ready to change clothes and go.

How to do an Exercise Stress Echo?

An exercise stress echo , sometimes called just a stress echo , shows how your heart works when it is working hard, that is, under 'stress'. This test is a traditionalIt's similar to an exercise stress test. A technician will monitor your heart rate, rhythm, and blood pressure (the same thing you would do during a regular stress test). However, this test also includes echo imaging (which isn't done during a regular stress test). This test shows how well your heart can withstand the activity. The technician will take pictures of you before you start exercising and after you finish.

In some cases, you won't have to exercise. Instead, your doctor will give you medicine to make your heart work harder, as if you were exercising. The goal is to make your heart need more oxygen. When your heart is stressed, the technician can see details that you can't see when you're just lying on the exam table. For example, problems with your coronary arteries or the lining of your heart.

How to prepare for an Exercise Stress Echo?

Your doctor will give you detailed instructions on how to prepare for this test. You will need to prepare a little more for this than for the other types.

• Do not eat or drink anything other than water for at least four hours before the test.
• Do not smoke on the day of the test.
• Do not consume anything containing caffeine for 24 hours before the test. This includes coffee, tea, decaf drinks (which also contain small amounts of caffeine), and some over-the-counter pain medications.

Ask your doctor about when and how to take your regular medications. You may need to stop taking some heart medications on the day of the test. Your diabetes medication dosage may also need to be adjusted. Follow your doctor's instructions exactly.

Although you will not be anesthetized for this, it is a good idea to have someone accompany you to and from the procedure, as you may feel tired after the procedure.

Wear comfortable clothes and shoes. You will be walking on a treadmill or riding a stationary bike during the test, so wear what you are most comfortable with.

What happens when you do an Exercise Stress Echo?

• The technician will place electrodes (small stickers) on your chest. These are connected to an EKG monitor to monitor your heart rate and rhythm throughout the test.
• Before you start moving, the doctor will measure your heart rate, heart rhythm, and blood pressure.
• While you lie on the examination table, the technician takes pictures of your heart. He or she places the hand-held wand used for regular echo tests on your chest at various points.
• Then you start moving. You can walk on a treadmill or ride a stationary bike . Gradually increase the speed/intensity.
• You have to keep doing it until you are exhausted. This usually takes about seven to twelve minutes.
• While you exercise, a technician will ask you how you feel. Tell them any symptoms you're experiencing. They'll also watch your heart on an EKG monitor .
• After you stop moving, the echo test will be performed again.
• Then you will cool down by walking or cycling for a while. The doctor will monitor your vital signs until they return to normal.

If you've been given medication to 'stress' your heart, the process will be a little different. You won't be on a treadmill or a bike. Talk to your doctor about what to expect and how you might feel during such a test.

How do I get my test results?

After your cardiologist reviews the test, he or she will enter the results into your electronic medical record. Your primary care provider can also see these results. You will discuss these results with one or both of these doctors.

Ask any questions you have about the images and what they mean. The doctor will explain to you what the images show and whether you need further tests or treatment.

What should you not do before an echocardiogram?

It really depends on the type of ultrasound you're having. Ask your doctor what exactly you should and shouldn't do. Here are some things you may not want to do before your ultrasound:

• Eating and drinking (especially for transesophageal and stress echoes ).
• Smoking or using other nicotine products.
• Coffee or anything that contains caffeine . This includes decaf drinks, which also contain a small amount of caffeine. This also includes some over-the- counter medications that contain caffeine.

You may also need to change your medication schedule before the exam. Do not stop or change any medications without talking to your doctor.

The take-home message from this article

An echocardiogram is an important test that can reveal a lot about the structure and function of your heart. If your doctor tells you to have an echo, ask about the type of test you're going to have and what to expect. You may need to have more than one echo, or several tests using different methods, to get all the details your doctor needs about your heart.

Ask your doctor to explain the pictures and help you understand what they mean. Taking an active role in your diagnosis and treatment can help you feel more comfortable with every step of the process.

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