A closer look at heart health: Echocardiogram with Strain

You've probably heard a doctor say, "Let's do an echo test" when you have the slightest suspicion of a heart condition. Today we're going to talk about a similar test, but a little more specialized, that can look at the functioning of the heart in more depth. This is called an Echocardiogram with Strain . Maybe this name is a little new to you. But don't worry, today we'll talk about what it is, when it's done, and how it's done.

What is this so-called echocardiogram with strain?

Simply put, this is a type of ultrasound test. That is, it uses sound waves to take pictures of your heart. However, it is different from a regular echo test. As the word "strain" suggests, this test measures the length of your heart muscle, the myocardium . That is, it can very precisely measure the changes in the heart muscle as it contracts and relaxes .

Think of it like a pump. Its muscles need to contract and relax properly to pump blood throughout the body. Sometimes, very small, subtle changes in the heart's function, called mechanical abnormalities, can occur. Just like that, even small changes that are difficult to detect with a regular echo can be detected with this strain echo test.

The biggest advantage of this is that if there is a heart disease, it can be identified early (early diagnosis) . It also helps in predicting the future of the disease, that is, making a prognosis .

This test is also called echocardiographic deformation imaging .

In what cases is this test performed?

Not everyone needs to have this test. However, doctors recommend it in some special cases. Let's see what it is:

• For people taking cancer treatment: There are some anti-cancer drugs that can be harmful to the heart. They are called cardio-toxic drugs . So, this test is done to monitor someone taking such drugs and see if the drugs have affected the heart.
• For those who have had radiation treatment to the chest: If you have had radiation treatment to the chest area, it may have some effect on the heart. This test is also useful to find out about that.
• For those with specific heart conditions:
• To evaluate and monitor people with cardiomyopathy (a disease that weakens the heart muscle).
• People with heart failure , especially before and after the implantation of a biventricular pacemaker .
• To evaluate people with pericardial disease ( disease of the lining around the heart).

How does this strain echo test work? Is it very simple?

The procedure for this test is very simple. You won't feel any discomfort.

This test is usually performed by a cardiac sonographer . That is, a technician trained to perform these tests. He or she will place a small device called a transducer over your chest. The transducer sends high-frequency sound waves (called ultrasound) into your heart. When the waves bounce back, they create a live, moving image of your heart on the ultrasound machine’s screen.

This technology allows the doctor to gain a better understanding of the function and structure of your heart, including the heart chambers and valves.

How should we prepare before this test?

There's no need for much preparation. But, keep these things in mind:

• Food and Drink: You can eat and drink normally on the day of the test. There are no special dietary restrictions.
• Medication: If you have daily medications, take them on time.
• Clothing: You can wear whatever you like, but you will need to wear a hospital gown from the waist up before the test.
• Valuables: Do not bring valuable jewelry or money. If you do, they will provide a locker to store them.
• Be informed: A doctor or technician will explain to you how the test is performed, the possible (very rare) complications, and side effects. Listen carefully, and be sure to ask any questions you have.

What happens during the test? Is there anything to be afraid of?

This test usually takes about an hour . It is often done in an echocardiogram lab at a hospital or clinic. During the test, the following things will happen:

• First, three small, flat, sticky stickers (electrodes) are placed on your chest in three places. These are connected to an EKG (Electrocardiograph) monitor that records your heart's electrical activity throughout the test.
• Then, you will be asked to lie on the left side of the examination table. Sometimes you will be asked to place your left arm above your head.
• The transducer, which I mentioned earlier, is a device that uses a gel to attach to the tip of the device, which is placed on your chest in several places to take pictures of your heart. This gel won't hurt your skin. It helps to take clear pictures.
• During the test, you will be asked to change positions several times because images need to be taken from different sides of the heart.
• Sometimes, they tell you to hold your breath for a while.

How will it feel during the test? Will it hurt?

This is a non-invasive test. Therefore, you should not feel any discomfort or pain. However, you may feel the following:

• The skin may feel a little cold due to the gel on the transducer.
• You may feel a slight pressure on your chest from the transducer.
• You may hear noises coming from the machine during the test.

These are normal things, nothing to be afraid of.

What happens after the test?

When the test is over, you can go home and get back into your normal clothes or go about your normal activities. There are usually no side effects after this test, unless you are given medication to make you sleep during the test (which is very rare).

What are the results like? What do they tell us?

The images and data from your test will be carefully reviewed by a cardiologist . The results will then be entered into your electronic medical record. Your treating doctor will be able to see the results and discuss them with you.

"It's normal to feel a little nervous when you're told you need to have your heart tested. But remember, this strain echo test is a safe, painless test. The biggest discomfort you'll feel is the transducer pressing against your skin."

The doctor will tell you what the images show, whether there is a problem with the heart, and whether treatment is needed.

Finally, things to remember (Take-Home Message)

Okay, so let's summarize some of the important points you'll find important from what we've talked about:

• An echocardiogram with strain is an advanced ultrasound test that can detect even subtle changes in the function of the heart, especially the heart muscle.
• This helps to detect heart disease early and gain insight into the future course of the disease.
• This test may be recommended for people undergoing cancer treatment, those who have had radiation therapy to the chest, and those with certain heart conditions.
• The test doesn't require much preparation, and it's not painful.
• There are usually no side effects after the test.
• Your doctor will explain the results to you clearly.

So, if a doctor recommends this test for you or someone you know, don't be unnecessarily afraid of it. It's a safe procedure that can provide valuable information about your heart health. Always follow your doctor's instructions and ask if there are any concerns.

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