Echocardiogram

Also known as a cardiac ultrasound or echo, an echocardiogram uses sound waves to create pictures of your heart. Your doctor may use an echocardiogram to check the condition of your heart valves and to evaluate symptoms such as shortness of breath.

We are a world leader in the development and application of the 2D echocardiogram, with utilization 3D technology if permits. 

There are three types of echocardiogram:

• Transthoracic echocardiogram, the most common type of echocardiogram
• Stress echocardiogram, which can help identify heart issues triggered by physical activity
• Transesophageal echocardiogram, which is used when more detailed images are needed

Transthoracic Echocardiogram

A transthoracic echocardiogram is a heart imaging test used to help physicians identify heart conditions, such as:

• Atherosclerosis – plaque buildup inside your arteries
• Cardiac tumors
• Cardiovascular disorders
• Congenital defects, including adult congenital heart disease
• Congestive heart failure – when your heart muscle doesn’t pump blood as well as it should
• Pulmonary hypertension
• Valve disease – damage to or a defect in one of the four heart valves

In addition to real-time images of the heart, echocardiography can incorporate Doppler techniques to show the movement of blood through the heart and blood vessels. It creates highly accurate images of the heart, its chambers and valves.

How a Transthoracic Echocardiogram Is Performed

The technician will instruct you to remove clothing from the waist up, and ask you to lie on your left side with your arm up by your head on an exam table or stretcher. The technician will then attach small pads (electrodes) to various places on your torso.

After applying gel to the chest, the technician will move around a transducer, which transmits ultrasound waves. The sound waves are converted into images of the heart on a computer screen.

During the test, the technician may ask you to hold your breath or change position to capture the best image. Depending on how well the technician can visualize your heart muscle, he or she may or may not use an image enhancer.

Most echocardiograms take less than an hour to complete. 

Stress Echocardiogram

Some heart issues are more likely to occur during physical activity. Also known as a stress echo, a stress echocardiogram is used to see how your heart works under stress — which is induced by either exercise or medicine. The test shows your heart structures and how well your heart muscle is pumping. It also shows how blood flows through your heart.

A stress echocardiogram is used to:

• Determine how much exercise is safe for your heart
• Find the cause of symptoms such as chest pain or shortness of breath
• Monitor or diagnose a heart condition, such as coronary artery disease or a heart valve problem
• Make sure your heart is strong enough for surgery

How a Stress Echocardiogram Is Performed

During a stress echocardiogram, images of your heart are taken before, after and sometimes during exercise or pharmacologic stress via injection with medicine. Please allow a minimum of one-and-a-half hours for a stress echocardiogram.

In preparation for a stress echocardiogram, your doctor may ask you to fast or temporarily stop certain medications. For the test to be as accurate as possible, it’s important to follow your doctor’s instructions. You should also inform you doctor if you’re unable to exercise.

Before the procedure, your nurse will bring you back to the procedure room and go over a checklist with you. He or she will ask you to undress from the waist up and give you a hospital gown to put on. The nurse will start an IV in your arm for medicine and the use of an image enhancer, depending on the type of stress.

An electrocardiogram (EKG) tech will attach small pads (electrodes) along your torso and a sonographer will obtain images of you heart via ultrasound. Then, you will either exercise on a treadmill or stationary bike or be exposed to pharmacologic stress.

For a pharmacologic stress echocardiogram, we will give you medicine that stimulates your heart in a way similar to exercise, called dobutamine. The nurse will start the medicine to flow every three minutes until you reach your target heart rate or maximum dose. The nurse will take your vitals and a sonographer will take pictures of your heart after each dose increase. Post procedure, when the medicine is turned off, we will repeat your vitals every three minutes until you heart rate has returned to normal, when another set of images will be obtained.

For an exercise stress echocardiogram, you will either walk on a treadmill or ride a stationary bike. The treadmill speed and incline or bike pedal resistance will increase every three minutes. We monitor your vitals until you can’t go any further or you’ve completed the protocol. After the exercise, the sonographer will take more images of your heart while it’s beating fast. Post exercise, we will repeat your vitals every three minutes until you heart rate returns to normal, when we will obtain another set of images.

If your EKG or echo shows any changes to your heart, your doctor will discuss the findings with you.

Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram is an imaging test that helps your doctor detect heart conditions, such as:

• Cardiac source of embolus
• Defects in the walls or valves of your heart
• Heart valve infection

Cardiologists also use this imaging test during left atrial appendage (LAA) exclusion for atrial fibrillation.

Transesophageal echocardiogram, also known as a TEE, is similar to a transthoracic echocardiogram — although it is far more detailed. In the case of the transesophageal echocardiogram, a probe made up of a thin tube with a camera is passed through your mouth, down your throat and into your esophagus.

How a Transesophageal Echocardiogram Is Performed

You should allow about two hours for the test and arrange someone to drive you home after the exam.

First, your nurse will ask you to change into a hospital gown and lie on the table. He or she will then attach an EKG and take your vitals, insert a peripheral IV line and give you oxygen and a mild sedative. Once you are mildly sedated, the doctor will gently insert the probe into your mouth. As you swallow, the doctor will slowly guide the tube into your esophagus. You may feel the doctor moving the probe, but it shouldn’t hurt or interfere with your breathing. It will take approximately 20 to 40 minutes to finish the test, and then the nurse will monitor you for 30 minutes afterwards to make sure you are fully awake before you go home.