Echocardiography
What is echocardiography?Echocardiography is a procedure used to assess the heart's
structures and function. Echocardiography is also called echo, cardiac
ultrasound or ultrasonography, cardiac Doppler, transthoracic
echocardiography, or TTE. A small probe called a transducer is placed on
your child's chest and sends out ultrasonic sound waves at a frequency too
high to be heard. When the transducer is placed on your child's chest in
certain locations and at certain angles, the ultrasonic sound waves move
through the skin and other body tissues to the heart tissues, where the
waves bounce (or "echo") off of the heart structures. The transducer picks
up the reflected waves and sends them to a computer. The computer
interprets the echoes into an image of the heart walls and valves.
What are the different types of echocardiography?An echocardiogram can utilize one, or more, of four special
types of echocardiography, as listed below:
- M-Mode echocardiography
This is the simplest type of echocardiography, and produces an image
that is similar to a tracing rather than an actual picture of heart
structures. M-mode echo is useful for measuring heart structures, such
as the heart's pumping chambers, the size of the heart itself, and the
thickness of the heart's walls.
- Doppler echocardiography
This Doppler technique is used to measure and assess the flow of blood
through the heart's chambers and valves. The amount of blood pumped out
with each beat is an indication of the heart's functioning. Also,
Doppler can detect abnormal blood flow within the heart, which can
indicate such problems as an opening between chambers of the heart, a
problem with one or more of the heart's four valves, or a problem with
the heart's walls.
- color Doppler
Color Doppler is an enhanced form of Doppler echocardiography. With
color Doppler, different colors are used to designate the direction of
blood flow. This simplifies the interpretation of the Doppler images.
- 2-D (2-dimensional) echocardiography
This technique is used to "see" the actual structures and motion of
the heart structures. A 2-D echo view appears cone-shaped on the
monitor, and the real-time motion of the heart's structures can be
observed. This enables the physician to see the various heart structures
at work and evaluate them.
What problems can echocardiography diagnose?Several diseases of the heart may be detected by
echocardiography, including the following:
- aneurysm - a dilation of a part of the coronary arteries or
the aorta (the large artery which carries oxygenated blood out of the
heart to the rest of the body) which may cause a weakness of the tissue
at the site of the aneurysm. In extreme cases, the aneurysm may rupture,
which is an emergency situation, causing rapid blood loss out of the
blood vessels.
- cardiomyopathy - an enlargement of the heart due to
thickening or weakening of the heart muscle.
- congenital (present at birth) defects - abnormalities or
deficiencies in one or more heart structures that occur during formation
of the fetus.
- congestive heart failure - a condition in which the heart
muscle has become weakened to an extent that blood cannot be pumped
efficiently; thus, causing a build up (congestion) in the blood vessels,
lungs, feet, ankles, and other parts of the body.
- pericarditis - an inflammation of the membrane (thin
covering) that surrounds the heart.
- valve disease - one or more of the heart's four valves
becomes defective, or may be congenitally (since birth) malformed.
How is an echocardiogram performed?The test may be done in a cardiologist's office, in a clinic,
at a hospital or medical center as an outpatient, or as an inpatient in a
medical facility. In most cases, you will be allowed to stay with your
child to provide reassurance during the procedure.
- The technician will need to see your child's chest from the waist
up. Privacy will be maintained by drapes across your child's chest and
by limiting access into the procedure area.
- EKG electrodes will be attached to your child's chest with adhesive
patches.
- Your child will lie on a table or bed during the procedure. A pillow
or wedge may be placed behind your child's back for support.
- The room will be darkened so that the images on the echo monitor can
be better viewed by the technician.
- The technician will place gel on your child's chest and then place
the transducer probe on the gel. Your child will feel a slight pressure
as the technician positions the transducer to get the desired image of
your child's heart.
- During the test, the technician will move the transducer probe
around and apply varying amounts of pressure to obtain images of
different locations and structures of your child's heart. The amount of
pressure behind the probe should not be uncomfortable, but if it makes
your child uncomfortable, he/she should let you or the technician know.
- After the procedure has been completed, the technician will wipe the
gel from your child's chest and remove the EKG electrodes.
In order to obtain clear pictures, it is important for children who are
old enough to cooperate to try to hold still during the echocardiogram.
Parents can usually be involved in reassuring and encouraging their child
during the procedure. However, an echocardiogram can be a lengthy
procedure. Younger children may become restless during the test,
preventing clear images from being achieved. For this reason, young
children may be given a medication (sedative) to help relax them during
the echocardiogram. A nurse will monitor the child during the procedure if
sedation is administered. For safety reasons, you will need to remain at
the echo clinic until your child has woken up fully and the medicine has
worn off.
Depending on the results of the echo, additional tests or procedures
may be scheduled to gather further diagnostic information.
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Online Resources page of this Web. |
Pediatric Cardiology
Cardiovascular Disorders (Pediatrics)
Diagnosing and Evaluating Heart Disease in Children