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Frequently Asked
Questions
Support for your adult cardiac echo concerns
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What is
echocardiography?
Echocardiography utilizes
high frequency sound waves to image the human heart for diagnostic
medical purposes. Echocardiography is used to evaluate cardiac chamber
size, wall thickness, wall motion, valve configuration and motion, and
the proximal great vessels. Doppler ultrasound is also utilized to
evaluated blood flow characteristic with in the heart and great vessels.
Using ultrasound, anatomic relationships can be determined and
information regarding cardiac function can be derived.
Why is
echocardiography/cardiac sonography important?
It can be quite helpful in
establishing a specific diagnosis and estimating the severity of various
cardiac diseases. It is important to recognize, however, that the
ultrasound exam is only a part of the complete cardiac work-up. Findings
on the echocardiogram must be integrated with information obtained from
the history and physical exam, cardiac and pulmonary auscultation,
electrocardiogram, thoracic radiographs and other pertinent ancillary
tests in order to determine the complete diagnosis and optimal
therapeutic plan for each individual patient. Technical expertise in
performing and interpreting the echocardiographic examination are
prerequisites to the valid use of this clinical tool.
What is a
transthoracic echo or TTE?
A transthoracic echocardiogram or
TTE is ordered by a physician to obtain two dimensional ultrasound
real-time images of the heart and other information about heart
function. An ultrasound transducer is placed directly on the chest
wall. The hand held transducer can be manipulated “to look” between
the ribs space from different angles and record these images and
measurements on a videotape or other media. These images are
reviewed by a cardiologist who interprets the images for diagnostic
purposes and helps to determine treatment strategies.
What is a
transesophageal echo or TEE?
A transesophageal echocardiogram or
TEE is similar to a TTE except the transducer is located on the end
of a 100cm flexible scope, called a TEE probe. The TEE probe is
placed in the esophagus via the mouth. The heart lies directly over
the esophagus and the TEE examination allows for unobstructed images
of the heart. A TEE examination is used when ribs and air in the
lungs limit the information available from a TTE. Ultrasound
transmission is altered when the sound waves pass through air filled
tissue such as lung or bone tissue such as ribs.
What is a stress
echo?
A stress echo is a form of
echocardiography in which an echocardiographer obtains a set of
images of the heart in the resting conditions. Then the patient
exercises on a treadmill or other equipment to increase the heart
rate and the demand of the heart. When the patient reaches his or
her maximum exercise capacity a second set of images are obtain
within one minute. The cardiologist compares the two sets of images
and draws some conclusions about the condition of the heart and its
function under stress. The same results may be obtained by an
intravenous infusion of a drug, usually dobutamine. This type of
examination is known as a pharmacological stress echocardiogram and
is useful when patients are unable to exercise on a treadmill. If
abnormalities are noted between the two or more sets of images, then
these abnormalities may indicate obstruction in the coronary
arteries that supply blood to the heart muscle.
Who performs the
echocardiogram?
Cardiac sonographers, also known as
echocardiographers are skilled technologists who have obtained a highly
specialized education in the art and science of cardiac ultrasound
imaging.
How long does a
transthoracic echocardiogram take?
Depending of the condition of the
patient, the amount of cardiac pathology present, and the questions
poised by the referring physician the echocardiogram will require a
minimum of 20 minutes up to a maximum of 60 minutes. Occasionally,
an echocardiogram may require addition time, however this situation
is a rare occurrence.
How is a
transthoracic echocardiogram performed?
The patient is positioned on an
examination bed or table facing up and laying on the left side,
undress from the waist up and covered with a gown and towel (for
privacy). EKG electrodes are place on the arms and abdomen to
monitor the heart rhythm. The technologist acquires images on
videotape or other forms of electronic digital storage media
following a standard protocol. This protocol is a set of rules or
instructions the sonographers follows to collect not only the images
or views, but also a predetermined set of measurements and
calculations on a wide variety of intracardiac structures. The
images and measurements will be reviewed by a cardiologist, who will
dictate a report of the echocardiographic findings, along with
possible recommendations for treatment options. This report will be
sent to the appropriate primary care physician or specialist.
Are there any
special instructions prior to a transthoracic echocardiogram?
If you smoke, you should not smoke
four hours before your scheduled examination. You may eat and drink
fluids, but you should only do so in moderation, since one of the
standard imaging positions requires the sonographer to place the
transducer over the upper abdomen. Patients should refrain from
applying cologne or body lotions on the day of the examination.
Is there any
discomfort with a transthoracic echocardiogram?
There should be no discomfort to the
patient when an experienced sonographer performs the examination.
Occasionally, patients may have some discomfort due to condrocostal
arthritis (pain associated with the ribs) or fibromyalgia. However,
these conditions should not prevent the patient from undergoing the
procedure.
What is the
difference between adult and pediatric cardiac sonography?
Basically, the echocardiogram in
adults and children is the same procedure. Echocardiography in
adults will encompass a wide variety of cardiac pathology including
acquired heart valve disease, disease of the heart muscle, coronary
artery disease, intracardiac tumors, follow up on surgical
procedures to name a few.
Echocardiography in children, newborns and the unborn is primarily
focused on congenital abnormalities that arise during pregnancy.
What is the
difference between cardiac sonography, vascular sonography, and
regular ultrasound?
The difference is the targeted
organs. In cardiac ultrasound the focus is on the heart and the
great vessels in the chest cavity. In vascular ultrasound the focus
is on the rest of the arteries and veins that make up the
circulatory system in the human body. This includes arteries and
veins in the head, neck, arms, abdomen, pelvis and legs. In general
ultrasound the focus is on organs such as the liver, gall bladder,
kidneys, joints etc. The equipment used in all forms of ultrasound
are the same, however different transducers or probes are
specifically designed for each type of sonographic procedure.
How do I get the
test results after a thransthoracic echocardiogram?
Your physician or a heart
specialist will inform you to the echocardiographic finding.
What type of
education is required to become an echocardiographer?
There are numerous
educational training programs available to would cardiac sonographers.
There are Bachelors Degrees from university base four-year programs,
Associate Degrees from two-year community college base programs, and
some one to two year training certificate programs.
What is an
ultrasound?
An ultrasound test is a
radiology technique, which uses high- frequency sound waves to produce
images of the organs and structures of the body. The sound waves are
sent through body tissues with a device called a transducer. The
transducer is placed directly on top of the skin, which has a gel
applied to the surface. The sound waves that are sent by the transducer
through the body are then reflected by internal structures as "echoes."
These echoes return to the transducer and are transmitted electrically
onto a viewing monitor. The echo images are then recorded on a plane
film and can also be recorded on videotape. After the ultrasound, the
gel is easily wiped off.
The technical term for ultrasound testing and recording is "sonography."
Ultrasound testing is painless and harmless. Ultrasound tests involve no
radiation and studies have not revealed any adverse effects.
http://www.medicinenet.com/ultrasound/article.htm
For what purposes
are ultrasounds performed?
Ultrasound examinations can
be used in various areas of the body for a variety of purposes. These
purposes include examination of the chest, abdomen, blood vessels (such
as to detect blood clots in leg veins) and the evaluation of pregnancy.
In the chest, ultrasound can be used to obtain detailed images of the
size and function of the heart. Ultrasound can detect abnormalities of
the heart valves, such as mitral valve prolapse, aortic stenosis, and
infection (endocarditis). Ultrasound is commonly used to guide fluid
withdrawal (aspiration) from the chest, lungs, or around the heart.
Ultrasound is also commonly used to examine internal structures of the
abdomen. Gallstones in the gallbladder are easily detected, as are
kidney stones. The size and structure of the kidneys, the ureters,
liver, spleen, pancreas, and aorta within the abdomen can be examined.
Ultrasound can detect fluid, cysts, tumors or abscess in the abdomen or
liver. Impaired blood flow from clots or arteriosclerosis in the legs
can be detected by ultrasound. Aneurysms of the aorta can also be seen.
Ultrasound is also commonly used to evaluate the structure of the
thyroid gland in the neck.
During pregnancy, an ultrasound can be used to evaluate the size,
gender, movement, and position of the growing baby. The baby's heart is
usually visible early, and as the baby ages, body motion becomes more
apparent. The baby can often be visualized by the mother during the
ultrasound, and the gender of the baby is sometimes detectable. http://www.medicinenet.com/ultrasound/page2.htm
What is an ECG?
The electrocardiogram (ECG
or EKG) is a noninvasive test that is used to reflect underlying heart
conditions by measuring the electrical activity of the heart. By
positioning leads (electrical sensing devices) on the body in
standardized locations, information about many heart conditions can be
learned by looking for characteristic patterns on the ECG.
http://www.medicinenet.com/electrocardiogram_ecg_or_ekg/article.htm
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