what are the indications for echocardiography

Full Answer

What does an echocardiogram tell you?

The most common information found in an echocardiogram report includes:

• The reason (s) your provider ordered the test
• The size of the heart chambers and thickness of the heart muscle
• The function of the left and right ventricles (pumping chambers)
• A description of the shape, movement, and function of the heart valves

More items...

What to expect during an echocardiogram?

What to Expect During an Echocardiogram. Your test will be done in a doctor’s office or hospital by a specially trained technologist. No special preparations are necessary, and the test usually takes about 30 to 60 minutes. The test will take place in a darkened room so your technologist can see the test monitor better.

Why should I get an echocardiogram?

You may need an echocardiogram if you have:

• Signs and symptoms of a heart problem, like chest pain or pressure, shortness of breath, irregular heartbeats, or abnormal heart sounds
• Had a heart attack or heart surgery
• Been diagnosed with a heart condition like cardiomyopathy (heart muscle disease) or heart valve disease

How often should you have an echocardiogram?

There are a variety of opinions on how often echocardiograms should be ordered. In general, physicians tend to order more echocardiograms than are necessary. Recently, Dr. Catherine Otto [ 1] offered what appear to be acceptable guidelines for the use of echocardiography in patients with mitral regurgitation.

What is the indication of echocardiography?

Your doctor may suggest an echocardiogram to: Check for problems with the valves or chambers of your heart. Check if heart problems are the cause of symptoms such as shortness of breath or chest pain. Detect congenital heart defects before birth (fetal echocardiogram)

What is contraindication for echocardiography?

Some of the common contraindications to stress echocardiography include acute myocardial infarction within two days, severe symptomatic aortic stenosis, heart failure exacerbation, acute pericarditis, uncontrolled arrhythmias, hypertension (more than 200/110 mmHg), and unstable angina not stabilized medically.

What are the indications of 2D echo?

2D Echo is done to detect the following heart conditions: Any underlying heart diseases or abnormalities. Congenital heart diseases and blood clots or tumors. Malfunctioning of the heart valve.

Who needs echocardiography?

The echocardiogram is one of the most common cardiac tests. Your primary care physician or cardiologist will typically order an echocardiogram if they hear a murmur, if you are experiencing new symptoms suggestive of heart disease, or if you have a known history of heart disease.

Is hypertension an indication for echo?

Because echocardiography can detect cardiac morphologic and hemodynamic change caused by systemic arterial hypertension, echocardiography is a powerful tool for the evaluation of target organ damage, which is essential for the evaluation of cardiovascular risk.

What 5 abnormalities can be found on the echocardiogram?

The echocardiogram can help detect:Abnormal heart valves.Congenital heart disease (abnormalities present at birth)Damage to the heart muscle from a heart attack.Heart murmurs.Inflammation ( pericarditis ) or fluid in the sac around the heart (pericardial effusion)More items...•

What is difference between ECG and echo?

Thus, the precise difference between ECG and ECHO is that ECG showcases the heart's electrical system, whereas ECHO showcases the heart's mechanical system for further investigation and planning of the respective patient's treatment.

Which is better ECG or 2D echo?

An EKG is a good first test, and can show when there is an irregularity that would be associated with heart disease.” However, an EKG is not very accurate in evaluating the pumping ability of the heart. For that, an echocardiogram is recommended.

What is an echocardiogram and what can it detect?

An echocardiogram is a noninvasive (the skin is not pierced) procedure used to assess the heart's function and structures. During the procedure, a transducer (like a microphone) sends out sound waves at a frequency too high to be heard.

Does echo test show blockage?

This test checks your heart and valves when you can't exercise on a treadmill or stationary bike. It can tell your doctor how well your heart handles activity. It also helps them figure out your risk of coronary artery disease (blocked arteries) and how well any cardiac treatments are working.

Should everyone have an echocardiogram?

Do I need an echocardiogram? If you're healthy and don't have any heart disease symptoms or risk factors, then you probably don't need an echocardiogram. Echocardiograms also aren't usually done for certain heart diseases, like coronary artery disease or heart murmurs.

What are the side effects of an echocardiogram?

Risks of Echocardiogram Intracardiac testing carries the same low risk for bleeding, heart attack, and stroke as an angiogram performed during cardiac catheterization. A transesophageal echocardiogram can include a bad reaction to the sedative and cause a sore throat or (rarely) a minor throat injury.

What are common contraindications?

Some of the most commonly occurring contraindications for medications include:Sensitivity or allergy to the medication.Pregnancy.Lactation.Renal disease.Hepatic disease.

What are some examples of contraindications?

Anything (including a symptom or medical condition) that is a reason for a person to not receive a particular treatment or procedure because it may be harmful. For example, having a bleeding disorder is a contraindication for taking aspirin because treatment with aspirin may cause excess bleeding.

What are the types of contraindications?

There are two types of contraindications: Relative contraindication means that caution should be used when two drugs or procedures are used together. (It is acceptable to do so if the benefits outweigh the risk.) Absolute contraindication means that event or substance could cause a life-threatening situation.

What are contraindications for ECG monitoring?

There are no absolute contraindications for an electrocardiogram.

What is the name of the device that aims ultrasound through the heart?

In this standard type of echocardiogram: A technician (sonographer) spreads gel on a device (transducer). The sonographer presses the transducer firmly against your skin, aiming an ultrasound beam through your chest to your heart. The transducer records the sound wave echoes from your heart.

How long does it take to get an echocardiogram?

Most echocardiograms take less than an hour. If you have a transesophageal echocardiogram, you may be watched for a few hours at the doctor's office or hospital after the test.

How do sound waves change pitch?

Sound waves change pitch when they bounce off blood cells moving through your heart and blood vessels. These changes (Doppler signals) can help your doctor measure the speed and direction of the blood flow in your heart. Doppler techniques are generally used in transthoracic and transesophageal echocardiograms.

How to check heart rhythm?

Echocardiogram. Echocardiogram. An echocardiogram checks how your heart's chambers and valves are pumping blood through your heart. An echocardiogram uses electrodes to check your heart rhythm and ultrasound technology to see how blood moves through your heart. An echocardiogram can help your doctor diagnose heart ...

What can a doctor do with an echocardiogram?

Your doctor can use the images from an echocardiogram to identify heart disease. Depending on what information your doctor needs, you may have one of several types of echocardiograms. Each type of echocardiogram involves few, if any, risks.

Why is oxygen level monitored during an echocardiogram?

Your oxygen level will be monitored during the exam to check for any breathing problems caused by sedation medication. During a stress echocardiogram, exercise or medication — not the echocardiogram itself — may temporarily cause an irregular heartbeat. Serious complications, such as a heart attack, are rare.

What is a technician who spreads gel on a device?

A technician (sonographer) spreads gel on a device (transducer).

What is color flow velocity mapping?

Doppler color flow-velocity mapping is an appropriate addition to an ECHO when the examination is expected to contribute significant information relative to the patient’s condition or treatment plan. Typically, color flow-velocity mapping is indicated in the evaluation of the symptoms of syncope and dyspnea, some heart murmurs, valvular problems, suspected CHD, complications of myocardial infarction (MI), or cardiomyopathy. Medicare does not cover this service when performed routinely with all ECHO exams (i.e., without a clinical indication). This is true even when the results of the test reveal abnormalities. If an unsuspected finding on TTE indicates medical necessity for additional study with Doppler color flow velocity mapping, it can be covered.

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Does dobutamine stress echo reduce sensitivity?

In patients with known LV hypertrophy and reduced LV end-diastolic dimensions, there may be reduced sensitivity and Dobutamine stress echo may produce suboptimal diagnostic information.

How does stress echocardiography help with revascularization?

Echocardiographic studies may help in planning revascularization procedures by demonstrating the functional significance of a given coronary stenosis. This may be of particular value in determining the need for percutaneous transluminal coronary angioplasty, particularly when the degree of angiographic stenosis is of uncertain physiological significance or when multiple lesions are present. Moreover, because restenosis is a common complication, stress echocardiography is useful in evaluating patients after coronary angioplasty. 151 Reassessment roughly 1 month after angioplasty is a reasonable time frame within which to assess the functional results of angioplasty. However, in an asymptomatic stable patient, routine stress testing (with or without an imaging modality) does not appear to be cost-effective. In a symptomatic patient or when there are other clinical indications, an evaluation can be performed using either treadmill, bicycle, or pharmacological methods to induce stress, depending on the patient’s physical capabilities. Compared with the preangioplasty evaluation, improvement in wall motion on stress echocardiography evaluation after angioplasty confirms a successful result; persistent evidence of inducible ischemia after angioplasty indicates an inadequate result or restenosis. More extensive studies are needed to document the value of stress echocardiography in assessing the results of percutaneous revascularization.

What is the most common indication for TTE?

In the recent prospective study by Krumholz et al, 203 evaluation of LV systolic function was the primary indication for TTE in 26% of inpatients studied, a frequency at least twice that of the next most common indication. Current echocardiographic techniques permit a comprehensive assessment of LV size and function. LV cavity measurements and wall thickness at end diastole and end systole and shortening fraction may be obtained with precision by M-mode echocardiography; conventions for obtaining these measurements 204205 and reference normal values have been published. Two-dimensional echocardiography, because of its superior spatial resolution, is used to guide appropriate positioning of the M-mode beam and is used for direct measurements of ventricular size 204 as well as LV volumes and ejection fraction. An advantage of two-dimensional (compared with M-mode) echocardiography is that the myocardial mass, chamber volumes, and ejection fraction of an abnormally shaped ventricle can be measured. Therefore, in most laboratories two-dimensional echocardiography is the principal noninvasive method used for quantitating LV volumes and assessing global and regional systolic function. LV mass and volume quantitation by echocardiography requires high-quality images, meticulous attention to proper beam orientation, and the use of geometric models to approximate LV shape. 206

Why is echocardiography important?

Echocardiographic techniques, at rest and particularly coupled with stress, can be helpful in clinical decision making regarding medical therapies and clinical interventional therapies, in evaluating the results of therapy, in prognostication, and clinical follow-up of patients with known coronary artery disease and new or changing symptoms.

Why does my chest hurt?

Chest pain can result from many cardiac and noncardiac causes. In mature adults the most common clinical cardiac disorder presenting as chest pain is coronary artery disease (see section IV, “Ischemic Heart Disease”). Other cardiovascular abnormalities that frequently cause chest pain, including hypertrophic cardiomyopathy, valvular aortic stenosis, aortic dissection, pericarditis, MVP, and acute pulmonary embolism, produce distinctive and diagnostic echocardiographic findings (see sections II, IV through VI, VIII, and IX).

What causes peripheral edema?

The causes of peripheral edema, both cardiac and noncardiac, are numerous. Cardiac causes include any abnormality that results in elevated central venous pressure and thus encompasses the full spectrum of myocardial, valvular, and pericardial disease. Echocardiography provides the diagnosis in most instances.

What is the purpose of echocardiography?

Echocardiography can be used to rapidly diagnose the presence of regional contraction abnormality resulting from acute myocardial infarction, evaluate the extent of associated regional dysfunction, stratify patients into high- or low-risk categories, document serial changes in ventricular function, and diagnose important complications. Some patients with acute chest pain have unstable angina; in these individuals, echocardiography can also be helpful in diagnosis and risk assessment.

What is the most commonly used method of screening for heart disease?

Cardiac auscultation remains the most widely used method of screening for heart disease. Heart murmurs are produced by turbulent blood flow and are often signs of stenotic or regurgitant valve disease or acquired or congenital cardiovascular defects.

What does the color doppler scale on the left of the mitral valve mean?

This color Doppler image across the mitral valve shows evidence of mitral regurgitation; the color Doppler scale shown on the left indicates the Nyquist limit.

What is duty factor?

Duty factor - The fraction of time during which a transducer is sending an ultrasound impulse

What is tissue doppler imaging?

Tissue Doppler imaging (TDI) provides information about movement of cardiac structures. The relation between the dynamics of cardiac structures and the hemodynamics of the blood inside these structures provides information about cardiac diastolic and systolic function. Echocardiography is continuously evolving and constantly being augmented by newer modalities, such as tissue harmonics, speckle tracking, tissue Doppler strain, and tissue characterization.

What is MCE in cardiology?

The advent of myocardial perfusion echocardiography (MCE) has allowed​ functional evaluation of the coronary microcirculation, including quantitative coronary blood flow and fractional flow reserve. [ 2] This has helped to improve "the definition of ischemic burden and the relative contribution of collaterals in noncritical coronary stenosis." Moreover, MCE identifies no-reflow within myocardial infarctions (MIs) and low-flow around MIs, predicts potential functional recovery of stunned myocardium with appropriate interventions, and appears to have a diagnostic performance comparable to positron emission tomography (PET) scanning in microvascular reserve/dysfunction in angina patients. [ 2]

How many interpreted echocardiography examinations are required?

The American College of Cardiology (ACC) and the American Heart Association (AHA) have recommended a set of minimum knowledge and training requirements for the performance and interpretation of echocardiography, including a minimum number of 150 performed and 300 interpreted examinations for basic level II (for level III: 300 performed/750 interpreted) in interpreting echocardiography. [ 3, 4, 5] Similar guidelines have been developed in Canada. [ 6, 7]

What is the image of mitral valve inflow?

Echocardiography. This is a spectral Doppler image of mitral valve inflow.

How deep does an ultrasound penetrate?

[ 8] The depth of penetration for adequate imaging tends to be limited to about 200 wavelengths. Thus, an obvious tradeoff exists between image resolution and depth of penetration. Thus, a 1-MHz transducer has a penetration depth of 30 cm and resolution of 1.5 mm, whereas a 5-MHz transducer has a lesser penetration depth, only 6 cm, but a higher resolution, approximately 0.3 mm.

CARDIO-ONCOLOGY

Expert Consensus for Multi-Modality Imaging Evaluation of Cardiovascular Complications of Radiotherapy in Adults: A Report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography, JASE, September 2013

VALVES

Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE, September 2009 ♦ A Chinese translation of this document is available.

MULTIMODALITY DOCUMENTS

Expert Consensus for Multi-Modality Imaging Evaluation of Cardiovascular Complications of Radiotherapy in Adults: A Report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography, JASE, September 2013

VASCULAR

Use of Carotid Ultrasound to Identify Subclinical Vascular Disease and Evaluate Cardiovascular Disease Risk: A Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force Endorsed by the Society for Vascular Medicine, JASE, February 2008

CHAMBER QUANTIFICATION

Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography, JASE, July 2010 Document Errata: 1. Page 686, last line should read “mm indicate at end-systole RA enlargement.” 2.

STRESS ECHOCARDIOGRAPHY

American Society of Echocardiography Recommendations for Performance, Interpretation, and Application of Stress Echocardiography, JASE, September 2007 .

DOPPLER

Permission to reuse portions of ASE guideline documents may be obtained from RIGHTSLINK. Reprints may be obtained from Elsevier: less than 250 copies; for more than 250 copies, please contact [email protected]. NOTICE AND DISCLAIMER: These reports are made available by ASE as a courtesy reference source for its members.

Overview

Why It's Done

Risks

How You Prepare

What You Can Expect

Results

• Information from the echocardiogram may show: 1. Changes in your heart size.Weakened or damaged heart valves, high blood pressure or other diseases can cause the chambers of your heart to enlarge or the walls of your heart to be abnormally thickened. 2. Pumping strength.The measurements obtained from an echocardiogram include the percentage of bloo...

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