Echocardiography:
In echocardiography, high-frequency sound waves (also called ultrasound) are used to create a moving image of the heart. The sound waves are sent into the body through a handheld device called a probe. These sound waves vibrate the structures and fluids within the heart, and the echoes are received back through the transducer (probe). The echoes are then converted into images on a monitor.
How Echocardiography is Performed:
Echocardiography can be performed both in a doctor's office and in a hospital. It does not require any special preparation. You will be asked to remove your upper clothing, and then the doctor will apply a special gel to your chest to aid in sound wave transmission. The doctor will place the echocardiography probe on your chest and heart, applying slight pressure, and may ask you to lie in different positions or hold your breath to obtain a clearer image of the heart on the monitor.
Echocardiography shows your doctor how the heart's chambers or walls have been altered by conditions such as heart attack, high blood pressure, previous heart disease, or heart failure. It also allows the doctor to analyze the heart's pumping ability, described as the ejection fraction (EF). A normal EF is approximately 55 to 65%, meaning more than half of the blood in the left ventricle (the heart's main pumping chamber) is ejected with each heartbeat. If this percentage (EF) is too low, echocardiography can identify where the pumping function is weak—for example, it can show the area of the heart weakened by a heart attack. Echocardiography may be particularly valuable in diagnosing certain genetic conditions associated with a risk of sudden death, such as hypertrophic cardiomyopathy, an abnormal thickening of the heart muscle often seen in young athletes who suffer sudden death.
Additionally, echocardiography reveals the condition of all four heart valves and how they function. Doppler echocardiography shows how blood flows through the valves, which may indicate the nature of a heart condition—for example, backward blood flow may suggest valve regurgitation. Echocardiography also provides information about blood volume, which may be affected by medications such as diuretics. It also answers the following questions: How do multiple factors in the heart interact? How do treatments address a specific condition? And what actions should be taken to maintain the heart's pumping function at its best?
Transesophageal Echocardiography (TEE):
Your doctor may request a transesophageal echocardiography (TEE), a type of echocardiography that overcomes some limitations of standard echocardiography. As the name suggests, TEE is performed using a very small probe (less than 1.5 cm in diameter) that is inserted into the esophagus (the tube connecting the mouth to the stomach). Instead of viewing the heart through the chest wall, TEE captures images of the heart from inside the esophagus, which is very close to the heart.
Stress Echocardiography:
Like other stress tests, a stress echocardiogram shows how your heart functions under intense physical activity. A stress echo is often performed to confirm or rule out coronary artery disease. The moving images produced during the test allow the doctor to identify blockages in the coronary arteries.
A stress echocardiogram may be performed in a doctor's office or a hospital. The test has two parts: First, the doctor performs a resting echocardiogram while you lie on an exam table. Then, you exercise on a stationary bike or treadmill until your heart rate reaches its peak. A second echocardiogram is performed while your heart rate is still elevated. If there are any exercise-induced changes in the heart, this test will reveal them. For example, areas of the heart with restricted blood flow due to blocked coronary arteries may not contract properly. Another example is reduced blood flow to the heart muscle during exercise that is not present at rest, indicating reversible blood flow abnormalities. This condition must be treated to prevent heart attacks.
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