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Echocardiography (Echo, Cardiac Ultrasound, Doppler Echo, Trans-Esophageal Echo-TEE)
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Definition
An echocardiogram (Echo) uses sound waves to produce a moving picture of the heart as it beats. An Echo is an ultrasound procedure that uses a small transducer (a type of hand-held microphone) placed on the chest to send sound waves into the body. A recording of these sounds is then converted into moving pictures on a monitor.
Description
In an echocardiogram, sound waves, like sonar, are beamed through heart to diagnose valve disease and to determine quality of heart muscle contractions, heart chamber size, and presence of fluid around the heart. This procedure is also called M-mode echocardiography, two-dimension echocardiography, and real-time echocardiography. The Echo is combined with Doppler ultrasound and color. Doppler is used to evaluate blood as it flows through the cardiac valves. The Doppler part of the echocardiogram measures changes in the sound waves as the blood moves through the heart. This determines blood-flow speed and identifies turbulence. Measuring the "doppler effect" (or echo changes), can pinpoint the extent of valve leakage, valve stenosis (stiffness) and shunts (holes in the heart), as well as any abnormal connection between blood vessels.
Often the doctor orders a Stress Echo to evaluate how the heart muscle and the valves work with activity. This Echo test uses physical activity such as running on a treadmill to increase the heart rate. For individuals who are unable to run on a treadmill, special medications may be used to increase the heart rate. The medication makes the heart "think" that it is exercising and thereby the echo sonogapher (specially trained technician) records the heart in the resting state and then again when a target heart rate is achieved.
An additional and very specialized Echo is called a Trans-Esophageal Echo (TEE). A special transducer (microphone) is attached to a long, thin, flexible tube called an endoscope. After a light sedation is administered, the doctor gently slides the tube through the mouth and into the esophagus (the food tube leading to the stomach). Once in position, the TEE provides a close look at the heart without interference of the ribs or lungs. The TEE may be used during cardiac surgery to monitor how the heart is working. The TEE provides the doctor with a clear picture of all the heart valves. Although the TEE produces a clearer evaluation of the heart valves and the muscle function, it is not used as a screening procedure. The TEE requires special sedation and close monitoring for a hour or more after the procedure. The standard Echo provides comprehensive information for more than 80 percent of individuals. The TEE is used to evaluate more complicated individuals or during surgery.
John Muir Health Capabilities
John Muir Health offers full service cardiac care. Both John Muir Medical Center, Walnut Creek Campus and John Muir Medical Center, Concord Campus provide comprehensive diagnostic procedures. A variety of echocardiography procedures as well as stress procedures are available.
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