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Echocardiography

What is Echocardiography?

Also known as echo or an ultrasound of the heart, echocardiography is a test that utilizes sound waves in order to create moving pictures of a person’s heart. These pictures can tell the shape and size of your heart, as well as pinpoint how well your heart’s valves and chambers are doing.

An echo can show the structure, movement the size of different parts of your heart. They can include the septum (the wall which separates the left and right heart chambers), the walls of the heart chambers, and the heart valves.

An echo can also location areas in the heart that aren’t contracting well either because of an injury from a previous heart attack or poor blood flow. Doppler ultrasound, a type of echo, can show how well blood flows through the heart.

An echo can also pinpoint possible blood clots in your heart, problems with the aorta (the main artery), or any fluid buildup in the pericardium (a sac around the heart).

An echocardiograph can be also used to detect heart problems in children and infants.

What are the Different Types of Echocardiography?

There are a few types of echocardiography, but they all use sound waves to generate moving pictures of your heart. And yes, it is the same technology used to see a baby inside a pregnant woman.

Transthoracic Echocardiography

This is the most common type of test. It’s noninvasive, meaning that no surgery is performed on your body.

This type of echocardiography places a device in your chest called a transducer. This device sends ultrasounds from your chest wall to your heart. When the ultrasound waves bounce around your heart, the echo machine converts them into pictures on a screen.

Stress Echocardiography

This is done as part of a stress test. You basically exercise or take medicine to make your heart beat fast. A technician will utilize echo before and after exercise to create pictures of your heart.

Transesophageal Echocardiography

Also called a TEE, the test involves a transducer being attached to the end of a flexible tube. It is then guided down into your esophagus through your throat. Dr. Golshani can get a more detailed picture of your heart, particularly if they have a difficult time seeing the aorta or other parts of your heart using a transthoracic echo.

Fetal Echocardiography

This type of echo is used to see an unborn baby’s heart. Dr. Golshani might want this test done to determine if a baby has heart problems. If recommended, this is commonly done around 18 to 22 weeks of pregnancy.

Three-Dimensional Echocardiography

A 3D echo generates 3D pictures of your heart. A detailed image can show how your heart looks and works. Your doctor may recommend this test as part of your TEE. A 3D echo may be used to diagnose children heart problems or overseeing and planning heart valve surgery.

What Kind of People Need Echocardiography?

You might be asked to get an echo if you have any symptoms of signs of heart problems. Examples would include swelling in the legs or shortness of breath, as they may be signs of heart failure. Since heart failure means that your heart can’t pump enough oxygen-rich blood to help your body’s needs, an echo can determine how well your heart is pumping blood.

Dr. Golshani might also want to determine:
  • Any heart valve problems, since an echo can show if your heart valves open or close tightly.
  • Your heart’s size, as an enlarged heart might be from leaky heart valves, high blood pressure, or heart failure.
  • If your heart muscles are weak, particularly if you have had damage from a heart attack. A weak heart means that you might have coronary heart disease, which means you’re not getting enough blood supply.
  • Any blood clots or tumors, particularly if you’ve had a stroke.
  • How your heart responds to different heart treatments, and possibly guide next steps in treatment.
  • Any problems with the structure of your heart, such as congenital heart defects, which have been present since birth.


What Can I Expect Before My Echocardiograph?

An echo normally takes less than an hour to perform and is painless. Depending on what type of echo you do, Dr. Golshani might need to inject a special dye or saline into one of your veins. It will help to make your heart show up more clearly in the pictures.

You will need to take off your clothing from the waist up. Your privacy will be respected, as women will wear a gown during the test. You lie either on your left side or back on an exam table.

Electrodes will be attached to your chest so an electrocardiogram (a test that records the heart’s activity) can be performed. Dr. Golshani will then apply gel to your chest. A transducer will be moved on your chest. The transducer will transmit ultrasound waves into your chest, and a computer will convert the echoes into pictures. Dr. Golshani will record these pictures and put them on a file for a heart specialist to look over them.

During the test, you might need to hold your breath for a short while or change positions. The light might also be dimmed. They may also apply light pressure on your chest with the inducer. This is both to help the sonographer get a better picture of your heart. If you feel uncomfortable, let the doctor or sonographer know.

There are some variations to the procedure mentioned above. They are detailed below.

Transesophageal Echocardiography

The technology is a bit different as the transducer is attached to the end of a flexible tube. Dr. Golshani will guide the tube into your esophagus down from your throat so that can see the major blood vessels lead from and to the heart.

You will get medicine to help you relax for the duration of the test. Dr. Golshani will inject it in to one of your veins. You will need to remove dentures or partials if you wear them.

Before the tube is guided down, Dr. Golshani will numb the back of your mouth with gel or spray. She will then guide the tube down until it is right behind your heart. Throughout the procedure, your vital signs such as the oxygen content or your blood and blood pressured will be monitored. You will also be given oxygen via a tube in your nose.

Pictures will be recorded as Dr. Golshani positions the transducer around in your stomach and esophagus. As this happens, you shouldn’t feel any discomfort.

Even though the whole process takes less than an hour, you might be monitored for a few hours in the procedure center afterwards.

Stress Echocardiography

A stress echo is basically an exercise or pharmacological stress test combined a transthoracic echo. If you’re doing a pharmacological stress test, Dr. Golshani will give you medicine to speed up your heart rate. If you are doing an exercise stress test, you’ll either pedal a stationary bike or walk or run on a treadmill to force your heart to work hard and beat quickly. Pictures of your heart will be taken as soon as you finish exercising and before you do.

What Can I Expect After My Echocardiograph?

Usually, you can resume your normal activities after getting a echocardiograph. You might be monitored for a few hours afterwards, if you’ve had a transesophageal echo (TEE). Your throat might also be sore for several hours after the test. Dr. Golshani will also let you know if you might need to arrange a ride home because you might not be able to drive after having TEE.

Are There Any Risks?

Fetal and transthoracic echocardiography doesn’t have any risks. They are safe for everyone.

A stress echo might have some risks, but it’s more from the medicine used to raise your heart rate, or related to the exercise. It is very rare to have serious complications from a stress test.

There might be some risks with the medicine administered to help you relax, if you have a TEE. Some side risks include having trouble breathing, nausea, or having a bad reaction to the medicine. There is a rare chance that the tube used for TEE might cause a minor throat injury.

The Art of Healing

Dr. Roya Golshani, a board certified primary care physician, has been practicing general internal medicine since 2002. She is a passionate internist who not only practices internal medicine, but specializes in Women’s Health as well. With her additional training in medical, developmental, and psychological issues, she is fully capable of working with you to solve your problems. Talk with her today to learn more about an echocardiograph and how you can benefit from it.

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