Everything You Need To Know About Echocardiograms
February 10, 2022
Echocardiograms are used in clinical settings to assess heart function and detect disease. In this article, we present the essential information on echocardiograms, including their definition, what they are used for, what they show, the various types, and their accuracy.
What is an echocardiogram?
An echocardiogram is an imaging test. It uses sound waves to produce images of the heart and surrounding vessels.
There are several types of echocardiogram, including:
- Transesophageal echocardiogram
- Transthoracic echocardiogram
- Intracardiac echocardiogram
We will go into more detail on the different echocardiograms later in this article. The echocardiogram that is most suitable will depend on which information the doctor requires.
What is an echocardiogram used to diagnose?
An echocardiogram is used to check for heart problems, like defects and abnormalities with the valves and chambers of the heart. By using the scan, the doctors can determine if heart problems are the cause of symptoms like breathing difficulty or chest pain. An echocardiogram is also used for the detection of congenital heart defects in babies during pregnancy (a fetal echocardiogram).
What does an echocardiogram show?
An echocardiogram can be used to accurately detect conditions and diseases including:
- Congenital heart disease
- Heart valve disease
- Atrial wall defects
- Septal wall defects
- Heart failure
- Cardiac tumor
- Pericardial effusion
Echocardiograms work with a small ultrasound transducer that sends out high-frequency sound waves which create echoes that bounce off the body. The echoes are picked back up by the small probe and then turned into moving images that are viewed during the procedure on a monitor. These images allow the heart rhythm and blood flow to be seen.
Types of echocardiogram
The different types of echocardiograms are a transesophageal echocardiogram, transthoracic echocardiogram, and stress echocardiogram.
The most common type of echocardiogram is a transthoracic echocardiogram, also known as a 2D echo. This simple procedure involves the spreading of gel on the probe, which is then placed against the skin firmly. The probe aims high frequency sound waves at the heart via the chest and picks up the echoes which bounce back. These echoes are then converted into moving images in real time.
Transesophageal echocardiograms provide more detailed moving imagery of the heart. After anesthetic is administered, a probe is guided into the esophagus. The probe then aims sound waves at the heart, and records the sound waves which bounce back.
Stress echocardiograms are ordered when chest pain may indicate a heart attack or coronary heart disease. The patient will run on a treadmill or cycle stationary bike during the procedure, continuing to exercise until the heart reaches its peak levels. Meanwhile, the doctor monitors heart rhythm and blood pressure, and images of the heart are taken. A stress echocardiogram can show if the heart’s muscles are getting enough blood and oxygen during exercise.
On rare occasions, an intracardiac echocardiogram will be used. This involves a catheter with a small probe at its tip. The catheter is threaded through a blood vessel to the heart and offers the advantage of producing more detailed moving images that can be required for the visualization of some structures.
Echocardiogram vs EKG
An echocardiogram and an electrocardiogram (EKG or ECG) are both tests that monitor the heart. The two procedures are also both relatively swift and painless - but they are not the same.
Rather than being based on ultrasound like an echocardiogram, EKG uses electrodes that record the electrical signals from the heartbeat – this allows it to look for abnormalities.
In some cases, a patient may need to have both an echocardiogram and an EKG, in order to provide a fuller picture of heart health. Echocardiograms are typically ordered following an EKG. While EKGs are used to reveal arrhythmias, heart palpitations, narrowing arteries, blocked arteries, and other heart problems, an echocardiogram can provide a more detailed picture of heart health, being used to diagnose or exclude heart disease and heart conditions.
Accuracy of echocardiogram imaging
The accuracy of echocardiogram imaging is relied upon for information related to the pumping function of the heart. A study concluded that “cardiac imaging is indispensable in the management of HF” and that “echocardiography is the most widely used test for this purpose and the most versatile in terms of providing clinically relevant information”.
Another study conducted into the accuracy of transthoracic echocardiogram for diagnosing bicuspid aortic valve determined that the procedure “yields almost ideal diagnostic accuracy when ideal investigators examine ideal patient” but that “transthoracic echocardiogram (TTE) yields suboptimal diagnostic accuracy under routine conditions”.
A meta-analysis of prospective studies into the accuracy of conventional transthoracic echocardiography for the diagnosis of intracardiac right-to-left shunt (RLS), found that the procedure “has a low sensitivity and extremely high specificity” which makes it “an excellent rule in test for the detection of intracardiac RLS”.
LVivo Solution for echocardiograms
Imaging software is crucial to efficiency when it comes to measuring clinical indications. Circle CVI’s LVivo is an AI based cardiac ultrasound workflow solution for transthoracic echocardiograms.
LVivo provides AI-based automation that can pre-select optimal views and significantly reduce generation time for Left Ventricle (LV) EF and Strain reports. Right Ventricle (RV) TAPSE, FAC, and FWS measurements, and reporting can be done in one click, with complete user control of adjustments.
Advanced imaging software such as Circle CVI’s LVivo Solution is hugely important to echocardiograms because it provides a seamless AI-based workflow. The most time-consuming processes attached to echocardiograms that are undertaken by clinicians – namely, finding the right views and generating reports – are fully automated without any user interaction necessary.