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Echocardiogram
Transthoracic echocardiogram (TTE); Echocardiogram – transthoracic; Doppler ultrasound of the heart; Surface echo
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a standard x-ray image. An echocardiogram does not expose you to radiation.
How the Test is Performed
TRANSTHORACIC ECHOCARDIOGRAM (TTE)
TTE is the type of echocardiogram that most people will have.
- A trained sonographer performs the test. A heart doctor (cardiologist) interprets the results.
- An instrument called a transducer is placed on various locations on your chest and upper abdomen and directed toward the heart. This device releases high-frequency sound waves.
- The transducer picks up the echoes of sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of the heart. Still pictures are also taken.
- Pictures can be two-dimensional or three-dimensional. The type of picture will depend on the part of the heart being evaluated and the type of machine.
- A Doppler echocardiogram records the motion of blood through the heart.
An echocardiogram shows the heart while it is beating. It also shows the heart valves and other structures.
In some cases, your lungs, ribs, or body tissue may prevent the sound waves and echoes from providing a clear picture of heart function. If this is a problem, the sonographer may inject a small amount of liquid (contrast) through an IV to better see the inside of the heart.
Rarely, more invasive testing using special echocardiography probes may be needed.
TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE)
The back of your throat is numbed and a scope is inserted down your throat.
On the end of the scope is a device that sends out sound waves. A heart doctor with special training will guide the scope down the esophagus. This method is used to get a clearer echocardiogram of your heart.
How to Prepare for the Test
No special steps are needed before a TTE test. If you are having a TEE, you will not be able to eat or drink for several hours before the test.
How the Test will Feel
During the test:
- You will need to take off your clothes from the waist up and lie on an exam table on your back.
- Electrodes will be placed on your chest to monitor your heartbeat.
- A gel is spread on your chest and the transducer will be moved over your skin. You will feel a slight pressure on your chest from the transducer.
- You may be asked to breathe in a certain way or to roll over onto your left side. Sometimes a special bed is used to help you stay in the proper position.
Why the Test is Performed
This test is done to evaluate the valves and chambers of the heart from the outside of your body. The echocardiogram can help detect:
- Abnormal heart valves
- Abnormal heart rhythms
- Congenital heart disease
- Damage to the heart muscle from a heart attack
- Heart murmurs
- infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">Inflammation ( pericarditis ) or fluid in the sac around the heart (pericardial effusion)
- Infection on or around the heart valves (infectious endocarditis)
- Pulmonary hypertension
- Ability of the heart to pump (for people with heart failure )
- Source of a blood clot after a stroke or TIA
Your health care provider may recommend a transesophageal echocardiogram (TEE) if:
- The regular or transthoracic echocardiogram is unclear. Unclear results may be due to the shape of your chest, lung disease, or excess body fat.
- An area of the heart needs to be looked at in more detail.
Normal Results
A normal echocardiogram reveals normal heart valves and chambers and normal heart wall movement.
What Abnormal Results Mean
An abnormal echocardiogram can mean many things. Some abnormalities are very minor and do not pose major risks. Other abnormalities are signs of serious heart disease. You will need more tests by a specialist in this case. It is very important to talk about the results of your echocardiogram with your provider.
Risks
There are no known risks from an external transthoracic echocardiogram (TTE) test.
There is some risk associated with the transesophageal echocardiogram (TEE) test. Transesophageal echocardiogram (TEE) is an invasive procedure. Talk with your health care provider about risks associated with this test.
Considerations
Abnormal results may indicate:
- Heart valve disease
- Cardiomyopathy
- Pericardial effusion
- Other heart abnormalities
ECO In Adults
This test is used to evaluate and monitor many different heart conditions.
ECG; EKG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart
How the Test is Performed
You will be asked to lie down. The health care provider will clean several areas on your arms, legs, and chest, and then will attach small patches called electrodes to those areas. It may be necessary to shave or clip some hair so the patches stick to the skin. The number of patches used may vary.
The patches are connected by wires to a machine that turns the heart’s electrical signals into wavy lines, which are often printed on paper. The doctor reviews the test results.
You will need to remain still during the procedure. The provider may also ask you to hold your breath for a few seconds as the test is being done.
It is important to be relaxed and warm during an ECG recording because any movement, including shivering, can alter the results.
Sometimes this test is done while you are exercising or under light stress to look for changes in the heart. This type of ECG is often called a stress test.
How to Prepare for the Test
Make sure your provider knows about all the medicines you are taking. Some drugs can interfere with test results.
DO NOT exercise or drink cold water immediately before an ECG because these actions may cause false results.
How the Test will Feel
An ECG is painless. No electricity is sent through the body. The electrodes may feel cold when first applied. In rare cases, some people may develop a rash or irritation where the patches were placed.
Why the Test is Performed
An ECG is used to measure:
- Any damage to the heart
- How fast your heart is beating and whether it is beating normally
- The effects of drugs or devices used to control the heart (such as a pacemaker)
- The size and position of your heart chambers
An ECG is often the first test done to determine whether a person has heart disease. Your provider may order this test if:
- You have chest pain or palpitations
- You are scheduled for surgery
- You have had heart problems in the past
- You have a strong history of heart disease in the family
Normal Results
Normal test results include:
- Heart rate: 60 to 100 beats per minute
- Heart rhythm: Consistent and even
What Abnormal Results Mean
Abnormal ECG results may be a sign of:
- Damage or changes to the heart muscle
- Changes in the amount of electrolytes (such as potassium and calcium) in the blood
- Congenital heart defect
- Enlargement of the heart
- Fluid or swelling in the sac around the heart
- infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">Inflammation of the heart (myocarditis)
- Past or current heart attack
- Poor blood supply to the heart arteries
- Abnormal heart rhythms ( arrhythmias )
Some heart problems that can lead to changes on an ECG test include:
- Atrial fibrillation/flutter
- Heart failure
- Multifocal atrial tachycardia
- Paroxysmal supraventricular tachycardia
- Sick sinus syndrome
- Wolff-Parkinson-White syndrome
Risks
There are no risks.
Considerations
The accuracy of the ECG depends on the condition being tested. A heart problem may not always show up on the ECG. Some heart conditions never produce any specific ECG changes.
Echocardiogram – children
Transthoracic echocardiogram (TTE) – children; Echocardiogram – transthoracic – children; Doppler ultrasound of the heart – children; Surface echo – children
An echocardiogram is a test that uses sound waves to create pictures of the heart. It is used with children to help diagnose defects of the heart that are present at birth (congenital). The picture is more detailed than a regular x-ray image. An echocardiogram also does not expose children to radiation.
How the Test is Performed
Your child’s health care provider may do the test in a clinic, in a hospital, or at an outpatient center. Echocardiography in children is done either with the child lying down or lying in their parent’s lap. This approach can help comfort them and keep them still.
For each of these tests, a trained sonographer performs the test. A cardiologist interprets the results.
TRANSTHORACIC ECHOCARDIOGRAM (TTE)
TTE is the type of echocardiogram that most children will have.
- The sonographer puts gel on the child’s ribs near the breastbone in the area around the heart. A hand-held instrument, called a transducer, is pressed on the gel on the child’s chest and directed toward the heart. This device releases high-frequency sound waves.
- The transducer picks up the echo of sound waves coming back from the heart and blood vessels.
- The echocardiography machine converts these impulses into moving pictures of the heart. Still pictures are also taken.
- Pictures can be two-dimensional or three-dimensional.
- The entire procedure lasts for about 20 to 40 minutes.
The test allows the provider to see the heart beating. It also shows the heart valves and other structures.
Sometimes, the lungs, ribs, or body tissues may prevent the sound waves from producing a clear picture of the heart. In this case, the sonographer may inject a small amount of liquid (contrast dye) through an IV to better see the inside of the heart.
TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE)
TEE is another type of echocardiogram children can have. The test is done with the child lying under sedation .
- The sonographer will numb the back of your child’s throat and insert a small tube into the child’s food pipe (esophagus). The end of the tube contains a device to send out sound waves.
- The sound waves reflect off the structures in the heart and are displayed on a screen as images of the heart and blood vessels.
- Because the esophagus is right behind the heart, this method is used to get clearer pictures of the heart.
How to Prepare for the Test
You can take these steps to prepare your child before the procedure:
- Do not allow your child to eat or drink anything prior to having a TEE.
- Do not use any cream or oil on your child before the exam.
- Explain the test in detail to older children so they understand that they should remain still during the test.
- Younger children less than 4 years of age may need medicine (sedation) to help them stay still for clearer pictures.
- Give children older than 4 a toy to hold, or have them watch videos to help them stay calm and still during the test.
How the Test will Feel
- Your child will need to remove any clothes from the waist up and lie flat on the exam table.
- Electrodes will be placed on your child’s chest to monitor the heart beat.
- A gel is applied on the child’s chest. It may be cold. A transducer head will be pressed over the gel. The child might feel pressure due to the transducer.
- Younger children may feel restless during the test. Parents should try to keep the child calm during the test.
Why the Test is Performed
This test is done to examine the function, heart valves, major blood vesssls, and chambers of a child’s heart from outside of the body.
- Your child may have signs or symptoms of heart problems.
- These may include shortness of breath, poor growth, leg swelling, heart murmur, bluish color around the lips when crying, chest pains, unexplained fever, or germs growing in a blood culture test.
Your child may have an increased risk for heart problems due to an abnormal genetic test or other birth defects that are present.
The provider may recommend a TEE if:
- The TTE is unclear. Unclear results may be due to the shape of the child’s chest, lung disease, or excess body fat.
- An area of the heart needs to be looked at in more detail.
Normal Results
A normal result means that there are no defects in the heart valves or chambers and there is normal heart wall movement.
What Abnormal Results Mean
An abnormal echocardiogram in a child can mean many things. Some abnormal findings are very minor and do not pose major risks. Others are signs of serious heart disease. In this case, the child will need more tests by a specialist. It is very important to talk about the results of the echocardiogram with your child’s provider.
The echocardiogram can help detect:
- Abnormal heart valves
- Abnormal heart rhythms
- Birth defects of the heart
- infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">Inflammation ( pericarditis ) or fluid in the sac around the heart (pericardial effusion)
- Infection on or around the heart valves
- High blood pressure in the blood vessels to the lungs
- How well the heart can pump
- Source of a blood clot after a stroke or TIA
Risks
TTE in children does not have any known risk.
TEE is an invasive procedure. There may be some risks with this test. Talk with your provider about risks associated with this test.
Stress echocardiography
Echocardiography stress test; Stress test – echocardiography; CAD – stress echocardiography; Coronary artery disease – stress echocardiography; Chest pain – stress echocardiography; Angina – stress echocardiography; Heart disease – stress echocardiography
Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body. It is most often used to detect a decrease in blood flow to the heart from narrowing in the coronary arteries .
How the Test is Performed
This test is done at a medical center or health care provider’s office.
A resting echocardiogram will be done first. While you lie on your left side with your left arm out, a small device called a transducer is held against your chest. A special gel is used to help the ultrasound waves get to your heart.
Most people will walk on a treadmill (or pedal on an exercise bicycle). Slowly (about every 3 minutes), you will be asked to walk (or pedal) faster and on an incline. It is like being asked to walk fast or jog up a hill.
In most cases, you will need to walk or pedal for around 5 to 15 minutes, depending on your level of fitness and your age. Your doctor will ask you to stop:
- When your heart is beating at the target rate
- When you are too tired to continue
- If you are having chest pain or a change in your blood pressure that worries the provider administering the test
If you are not able to exercise, you will get a drug such as dobutamine through a vein (intravenous line). This medicine will make your heart beat faster and harder, similar to when you exercise.
Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.
More echocardiogram images will be taken while your heart rate is increasing, or when it reaches its peak. The images will show whether any parts of the heart muscle do not work as well when your heart rate increases. This is a sign that part of the heart may not be getting enough blood or oxygen because of narrowed or blocked arteries.
How to Prepare for the Test
Ask your provider if you should take any of your routine medicines on the day of the test. Some medicines may interfere with test results. Never stop taking any medicine without first talking to your doctor.
It is important to tell your doctor if you have taken any of the following medicines within the past 24 hours (1 day):
- Sildenafil citrate (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
DO NOT eat or drink for at least 3 hours before the test.
Wear loose, comfortable clothing. You will be asked to sign a consent form before the test.
How the Test will Feel
Electrodes (conductive patches) will be placed on your chest, arms, and legs to record the heart’s activity.
The blood pressure cuff on your arm will be inflated every few minutes, producing a squeezing sensation that may feel tight.
Rarely, people feel chest discomfort, extra or skipped heartbeats, dizziness, headache, nausea or shortness of breath during the test.
Why the Test is Performed
The test is performed to see whether your heart muscle is getting enough blood flow and oxygen when it is working hard (under stress).
Your doctor may order this test if you:
- Have new symptoms of angina or chest pain
- Have angina that is getting worse
- Have recently had a heart attack
- Are going to have surgery or begin an exercise program, if you are at high risk for heart disease
- Have heart valve problems
The results of this stress test can help your provider:
- Determine how well a heart treatment is working and change your treatment if needed
- Determine how well your heart is pumping
- Diagnose coronary artery disease
- See whether your heart is too large
Normal Results
A normal test will most often mean that you were able to exercise as long as or longer than most people of your age and gender. You also did not have symptoms or concerning changes in blood pressure and your ECG. Your heart pictures show that all parts of your heart respond to increased stress by pumping harder.
A normal result means that blood flow through the coronary arteries is probably normal.
The meaning of your test results depends on the reason for the test, your age, and your history of heart and other medical problems.
What Abnormal Results Mean
Abnormal results may be due to:
- Reduced blood flow to a part of the heart. The most likely cause is a narrowing or blockage of the arteries that supply your heart muscle.
- Scarring of the heart muscle due to a past heart attack.
After the test you may need:
- Angioplasty and stent placement
- Changes in your heart medicines
- Coronary angiography
- Heart bypass surgery
Risks
The risks are very low. Health care professionals will monitor you during the entire procedure.
Rare complications include:
- Abnormal heart rhythm
- Fainting (syncope)
- Heart attack
