Echocardiography

Echocardiography is a very popular cardiac diagnostic tool which today is the second most commonly ordered test in cardiology. 

Echocardiography uses sound waves to evaluate heart anatomy. These sound waves are very high frequency and are not audible to the human ear. The use of these ultrasonic waves originally dates back to the military in WWII,  where sonar was used to detect underwater objects. In its 50 years of development echocardiography[ echo ] has proved itself again and again why it is so valuable. Here are the reasons why.

 Echo is a completely safe diagnostic tool in that the sound waves are basically harmless to cardiac structure. Not is echo only safe, it is a painless and non-invasive procedure. For the routine echo procedure there is no IV needed, and all the patient has to do is remove their shirt and/or put on a dressing gown, lie down upon an examining table and roll over onto their left side. The safety and ease of the procedure allow for repeated tests if necessary.

 All echo machines are portable and can be moved to various locations. Echoes can be performed in many locations including doctors’ offices, the emergency department, intensive care area, or the regular floors of a hospital. Over the years echo machines have been made smaller, and some are now hand held and weigh less than 10 pounds. In the military they are being used on the battlefield even with radio transmission of digital images to a central station.

 The echo technician will first apply some EKG leads to the chest so that the heart rate and rhythm can be monitored on the screen of the echo machine. The technician will then apply some ultrasound jell to the chest wall which allows for better penetration of sound waves. Following this the technician will hold the echo transducer onto the chest wall in various positions and may ask the patient to breath in or out on request. The procedure requires about 15 minutes or less to perform.

 All information is recorded onto videotape or CD for eventual review by a cardiologist. The information about cardiac structure and function which can be found is truly amazing. In contrast to other methods such as EKG or chest x-ray echo provides precise anatomic visualization as the sound waves bounce off of cardiac structures and return to the echo machine.

 The information learned includes the location and size of all cardiac chambers and valves including congenitally abnormal hearts. It can determine whether chamber size, wall thickness and valve shape are normal. Since echo is realtime the movement of all cardiac structures throughout the cardiac cycle can be evaluated. The use of simultaneous color Doppler with the basic images of the heart provides information on blood flow direction and velocity throughout the chambers and across the valves.

 It requires a trained cardiologist to interpret the images but valuable information is obtained for all types of heart disease including coronary where areas of previous or impending heart attack can be identified. Such information determines prognosis and treatment. Valvular disease which may be rheumatic or otherwise acquired is identified, and its severity is measured. This also determines prognosis and treatment. Evaluation of the effects of hypertension and chronic lung disease upon the heart makes echo a perfect diagnostic tool. After artificial valve replacement echo is used routinely and pediatricians diagnose and determine how to treat their congenital