Diagnosing Heart Disease: Echocardiogram

Heart Disease (Coronary Artery Disease) Slideshow

• Why do I need an echocardiogram?
• What are the types of echocardiograms?
• How should I prepare for the echocardiogram?
• What happens during the test?
• What should I do to prepare for a stress echo?
• What should I do if I have diabetes?
• What happens during the stress echo test?
• What should I do to prepare for the transesophageal echo?
• What happens during the transesophageal echo?

An echocardiogram (often called "echo") is a graphic outline of the heart's movement. During this test, high-frequency sound waves, called ultrasound, provide pictures of the heart's valves and chambers. This allows the technician, called a sonographer, to evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.

Why Do I Need an Echo?

Your doctor may perform an echocardiogram to:

• Assess the overall function of your heart.
   
• Determine the presence of many types of heart disease .
   
• Follow the progress of heart valve disease over time.
   
• Evaluate the effectiveness of medical or surgical treatments.

What Are the Types of Echocardiograms?

There are several types of echocardiograms and your doctor will help determine which is best for you.

• Transthoracic echocardiogram: This is the standard echocardiogram. It is a painless test similar to X-ray, but without the radiation. The procedure uses the same technology used to evaluate a baby's health before birth. A hand-held device called a transducer is placed on the chest and transmits high frequency sound waves (ultrasound). These sound waves bounce off the heart structures, producing images and sounds that can be used by the doctor to detect heart damage and disease.
  
  
• Transesophageal echocardiogram (TEE): This test requires that the transducer be inserted down the throat into the esophagus (the swallowing tube that connects the mouth to the stomach). Because the esophagus is located close to the heart, clear images of the heart structures can be obtained without the interference of the lungs and chest.
  
  
• Stress echocardiogram: This is an echocardiogram that is performed while the person exercises on a treadmill or stationary bicycle. This test can be used to visualize the motion of the heart's walls and pumping action when the heart is stressed. It may reveal a lack of blood flow that isn't always apparent on other heart tests. The echocardiogram is performed just prior and just after the exercise.
  
  
• Dobutamine or adenosine/sestamibi stress echocardiogram: This is another form of stress echocardiogram. However, instead of exercising to stress the heart, the stress is obtained by giving a drug that stimulates the heart and makes it "think" it is exercising. The test is used to evaluate your heart and valve function when you are unable to exercise on a treadmill or stationary bike. It is also used to determine how well your heart tolerates activity and your likelihood of having coronary artery disease (blocked arteries), as well as evaluating the effectiveness of your cardiac treatment plan.
  
  
• Intravascular ultrasound: This is a form of echocardiography performed during cardiac catheterization. During this procedure, the transducer is threaded into the heart blood vessels via a catheter in the groin. It is often used to provide detailed information about the atherosclerosis (blockage) inside the blood vessels.

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