An echocardiogram. Image shows that the human heart has four chambers. Apical view - left side of the heart to the right. Anatomically correct image - heart's apex at bottom. The trace in the lower left shows the cardiac cycle and the red mark the time in the cardiac cycle that the image was captured.

An abnormal echocardiogram. Image shows a mid-muscular ventricular septal defect. The trace in the lower left shows the cardiac cycle and the red mark the time in the cardiac cycle that the image was captured. Colors are used to represent the velocity and direction of blood flow.

An echocardiogram is an ultrasound of the heart. Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. The latest ultrasound systems now employ 3D real-time imaging. Image File history File links Echocardiogram_4chambers. ... Image File history File links Echocardiogram_4chambers. ... The heart and lungs, from an older edition of Grays Anatomy. ... Cardiac cycle is the term used to describe the sequence of events that occur as a heart works to pump blood through the body. ... Image File history File links This is an ultrasound picture of the heart, an echocardiogram. ... Image File history File links This is an ultrasound picture of the heart, an echocardiogram. ... A ventricular septal defect (or VSD) is a defect in the ventricular septum (the wall dividing the left and right ventricles of the heart). ... Cardiac cycle is the term used to describe the sequence of events that occur as a heart works to pump blood through the body. ... Medical ultrasonography (sonography) is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structures and possible pathologies or lesions. ... The heart and lungs, from an older edition of Grays Anatomy. ...

In addition to creating two-dimensional pictures of the cardiovascular system, an echocardiogram can also produce accurate assessment of the velocity of blood and cardiac tissue at any arbitrary point using pulsed or continuous wave doppler ultrasound. This allows assessment of cardiac valve areas and function, any abnormal communications between the left and right side of the heart, any leaking of blood through the valves (valvular regurgitation), and calculation of the cardiac output as well as the Ejection fraction. Medical ultrasonography is an ultrasound-based imaging diagnostic technique used to visualize internal organs, their size, structure and their pathological lesions. ... Cardiac output is the volume of blood being pumped by the heart, in particular a ventricle in a minute. ... In cardiovascular physiology, ejection fraction (Ef) is the fraction of blood pumped out of a ventricle with each heart beat. ...

Echocardiography was an early medical application of ultrasound. Echocardiography was also the first application of intravenous contrast-enhanced ultrasound. This technique injects gas-filled microbubbles into the venous system to improve tissue and blood delineation. Contrast is also currently being evaluated for its effectiveness in evaluating myocardial perfusion. It can also be used with Doppler ultrasound to improve flow-related measurements (see Doppler echocardiography). Contrast-enhanced ultrasound (CEU) is the application of ultrasound contrast agents to traditional medical sonography. ... Doppler echocardiography is a procedure which uses ultrasound technology to examine the heart by creating an image of it and measuring the speed and direction of blood flow. ...

Echocardiography is usually performed by cardiologists or cardiac sonographers. It has been suggested that this article or section be merged into Echocardiography. ...

Purpose

Echocardiography is used to diagnose certain cardiovascular diseases. In fact, it is one of the most widely used diagnostic tests for heart disease. It can provide a wealth of helpful information, including the size and shape of the heart, its pumping strength, and the location and extent of any damage to its tissues. It is especially useful for assessing diseases of the heart valves. It not only allows doctors to evaluate the heart valves, but it can detect abnormalities in the pattern of blood flow, such as the backward flow of blood through partly closed heart valves, known as regurgitation. By assessing the motion of the heart wall, echocardiography can help detect the presence and assess the severity of coronary artery disease, as well as help determine whether any chest pain is related to heart disease. Echocardiography can also help detect hypertrophic cardiomyopathy, in which the walls of the heart thicken in an attempt to compensate for heart muscle weakness. The biggest advantage to echocardiography is that it is noninvasive (doesn't involve breaking the skin or entering body cavities) and has no known risks or side effects.

Transthoracic echocardiogram

A standard echocardiogram is also known as a transthoracic echocardiogram (TTE), or cardiac ultrasound. In this case, the echocardiography transducer (or probe) is placed on the chest wall (or thorax) of the subject, and images are taken through the chest wall. This is a non-invasive, highly accurate and quick assessment of the overall health of the heart. A cardiologist can quickly assess a patient's heart valves and degree of heart muscle contraction (an indicator of the ejection fraction). The images are displayed on a monitor, and are recorded either by videotape (analog) or by digital techniques. The thoracic cavity is the chamber of the human body (and other animal bodies) that is enclosed by the ribcage and the diaphragm. ... ... In cardiovascular physiology, ejection fraction (Ef) is the fraction of blood pumped out of a ventricle with each heart beat. ...

An echocardiogram can be used to evaluate all four chambers of the heart. It can determine strength of the heart, the condition of the heart valves, the lining of the heart (the pericardium), and the aorta. It can be used to detect a heart attack, enlargement or hypertrophy of the heart, infiltration of the heart with an abnormal substance. Weakness of the heart, cardiac tumors, and a variety of other findings can be diagnosed with an echocardiogram.

The TTE is highly accurate for identifying vegetations, but the accuracy can be reduced in up to 20% of adults because of obesity, chronic obstructive pulmonary disease, chest-wall deformities, or otherwise technically difficult patients. TTE in adults is also of limited use for the structures at the back of the heart, such as the left atrial appendage. Transesophageal echocardiography, if available, may be more accurate than TTE because it excludes the variables previously mentioned and allows closer visualization of common sites for vegetations and other abnormalities. Transesophageal echocardiography also affords better visualization of prosthetic heart valves. Chronic obstructive pulmonary disease (COPD) is an umbrella term for a group of respiratory tract diseases that are characterized by airflow obstruction or limitation. ... An echocardiogram. ...

Transesophageal echocardiogram

This is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus. This allows image and Doppler evaluation which can be recorded. This is known as a transesophageal echocardiogram, or TEE (TOE in the United Kingdom). The advantage of TEE over TTE is usually clearer images, especially of structures that are difficult to view transthoracicly (through the chest wall). The explanation for this is the heart rests directly upon the esophagus leaving only millimeters in distance that the ultrasound beam has to travel. This reduces the attenuation (weakening) of the ultrasound signal, generating a stronger return signal, ultimately enhancing image and Doppler quality. Comparatively, transthoracic ultrasound must first traverse skin, fat, ribs and lungs before reflecting off the heart and back to the probe before an image can be created. All these structures, and the distance the beam must travel, attenuate the ultrasound signal, degrading image and Doppler quality. The esophagus (also spelled oesophagus/Å“sophagus, Greek ), or gullet is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ...

In adults, several structures can be evaluated and imaged better with the TEE, including the aorta, pulmonary artery, valves of the heart, both atria, atrial septum, left atrial appendage, and coronary arteries. While TTE can be performed quickly, easily and without pain to the patient, TEE requires a fasting patient, a team of medical personel, takes longer to perform, is uncomfortable for the patient and has some risks associated with the procedure (esophageal perforation--1 in 10,000, and adverse reactions to the medication). The aorta (generally pronounced or ay-orta) is the largest artery in the human body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation. ...

Before inserting the probe, conscious sedation is induced with the patient to ease the discomfort of the individual and to decrease the gag reflex, thus making the ultrasound probe easier to pass into the esophagus. Conscious sedation is a light sedation usually using the medications midazolam (a benzodiazepine with sedating, amnesiac qualities) and fentanyl (an opioid 100 times stronger than morphine). Sometimes a local anesthetic spray is used for the back of the throat, such a xylocaine and/or a jelly/lubricant anesthetic for the esophagus. Children are anesthetized. Unlike the TTE, the TEE is considered an invasive procedure and is thus performed by physicians in the U.S., not sonographers. Sedation is a medical procedure involving administration of sedative drugs, generally to facilitate a medical procedure, such as endoscopy, vasectomy, or minor surgery with local anaesthesia. ... This article does not cite any references or sources. ... Sedation is a medical procedure involving administration of sedative drugs, generally to facilitate a medical procedure, such as endoscopy, vasectomy, or minor surgery with local anaesthesia. ... Anesthesia or anaesthesia (see spelling differences) has traditionally meant the condition of having the perception of pain and other sensations blocked. ...

To insert the TEE probe, the probe is placed in the patient’s mouth through a bite block (to protect the $30,000 TEE probe), and then passed down the patient's throat when they swallow, preventing inadvertent placement into the trachea. Although the placement of the pinky-wide transducer is uncomfortable, there are very few complications with gagging from the patient once the transducer is in the correct location.

See also

• Aortic valve area calculation

Aortic valve area calculation is an indirect method of determining the area of the aortic valve. ...

References

External links

• SeeMyHeart - Patient Information on Echocardiograms (Heart Ultrasounds)
• American Society of Echocardiography
• Stress Test with Echocardiography from Angioplasty.Org
• Echocardiography information from Children's Hospital Heart Center, Seattle.
• Coronary heart disease And echocardiography
• Echocardiography Resources Simple echocardiography tutorials
• Atlas of Echocardiography Echocardiography Database
• E-chocardiography Internet Journal of Cardiac Ultrasound
• Echobasics Basic introduction to echocardiography - German/Spanish English planned for 2007

International Society of Cardiovascular Ultrasound