M L HEALTH
WHAT IS AN ECHOCARDIOGRAM ?
by Dr Prathap Kanagala , Consultant Cardiologist at Spire Liverpool Hospital .
Dr Prathap Kanagala is a Consultant Cardiologist and Honorary Associate Professor at the University of Liverpool . He provides private consultations at the Spire Liverpool Hospital . His specialty interests are in Heart Failure and Cardiac Imaging for which he has received numerous International and National Awards . He has over a decade of experience serving on several National Committees , contributing to Education and Research . He has published several National guidelines related to Echocardiography and currently sits on the Editorial Board of the prestigious Ultrasound Journal , as well as the Research and Audit Committee of the British Society of Echocardiography . He was recently nominated for and made a Finalist for Employee of the Year Award at Liverpool University Hospital . In this issue , Dr Prathap Kanagala talks to us about Echocardiograms .
What is an Echocardiogram ? An echocardiogram or ‘ echo ’ or ‘ cardiac ultrasound ’ is a type of heart scan which uses ultrasound waves to create detailed images of the heart and nearby major blood vessels . It also provides useful information about the blood flow within the heart . The scan is very similar to an ultrasound scan which is often used during pregnancy . There are 4 different types of echocardiograms which use the same principles – a standard , transthoracic echocardiogram ( TTE ) which is the main type of scan we are discussing today , a transoesophageal echocardiogram ( TOE ), a stress echocardiogram and a contrast echocardiogram .
Is it a common test ? An echo is the most common imaging test used for diagnosis in Cardiology . I often refer to it as the workhorse of Cardiac imaging . The technology is mobile , easily transportable and a lot cheaper than other specialist tests such as CT scans or MRI scans .
What happens during the scan ? We recommend that patients are undressed from the waist up and lie down on an examination bed . During a standard scan , a sonographer or Cardiologist will apply some lubricating gel on a small probe . The probe is then gently pressed against the skin , aiming an ultrasound beam directed towards the heart . The probe then records the ultrasound waves echoing back from the heart and feeds back into a computer , creating moving images of the heart on a monitor . The scan typically takes between 15 minutes to one hour .
Can you hear the ultrasound waves during the scan ? No but you might hear a swishing or whooshing noise . This is perfectly normal and is just the sound of blood flowing through the heart and blood vessels .
Is it painful ? Is it safe ? A standard scan is painless and completely safe . Sometimes , the lubricating gel can feel a little cold on the skin . There might very occasionally be minor discomfort from having to press down more firmly on the probe but this would be done so that we can generate the best possible images of the heart . Unlike other tests such as X-rays or CT scans , no radiation is used during an echo .
Why would you routinely perform an echo ? What problems can it detect ? In simple terms , an echo provides detailed information about the structure and function of the four chambers of the heart and the heart valves . The scan may be used to check if there are any heart abnormalities which might explain patients ’ symptoms such as breathlessness , ankle swelling or chest pain . Most commonly , we perform an echocardiogram to help detect the extent of heart muscle damage following a heart attack and in the investigation of heart failure , valve disease , congenital heart disease , cardiomyopathies ( heart muscle or pump problems ) and endocarditis ( infection of the heart valves ).
Scans are routinely requested by doctors not just to investigate symptoms but also to provide a risk assessment . This can be carried out in those people who have risk factors for developing heart disease , who already have established heart problems or who are waiting for surgery to be performed for other non-heart related problems . We also perform scans to screen people who are at risk from genetic heart conditions and to assess response to treatments including medicines and following heart surgery .
If the scan detects a problem , what does it mean ? An abnormality detected during the scan does not necessarily mean that the patient ’ s symptoms are because of the abnormality . This might just be an incidental finding unrelated to the patient ’ s symptoms . The advances in imaging technology also means that we are detecting heart abnormalities more frequently during scans , often before symptoms or heart disease actually develops . The responsible Doctor should explain what the scan findings mean and provide a treatment plan tailored to patients . This might involve simple lifestyle recommendations , more detailed tests , medicines or further followup plans . We often repeat scans to monitor progress and to guide if and when interventions are required .
To contact Spire Liverpool Hospital , please call 0151 522 1881 .
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