One of the most important methods of functional diagnostics in cardiology is echocardiography, which allows a non-invasive assessment of myocardial function and the geometry of the heart chambers, valves and aorta.
Echocardiography provides a picture of global and local myocardial contractility, ventricular function and the size of the heart chambers and connections. In addition, this study is considered the "gold standard" for diagnosing heart diseases, identifying pathological blood flow through the valves and septum and for assessing the ascending aorta.
ADVANTAGES OF ECHOCARDIOGRAPHY
- The study is highly sensitive and specific with regard to providing precise anatomic and hemodynamic information about the patient
- It is a safe procedure for the patient and the doctor
- It is noninvasive
- It provides an opportunity to observe the heart working in real time.
One feature of echocardiography is that its quality is highly dependent on the skill of the person performing the study. At the European Medical Center, a great deal of attention is paid to following the algorithms for performing echocardiography and their compliance with current guidelines. In addition, the expert class equipment (GE Vivid E9) allows the use of the most modern modes of study (tissue Doppler, the assessment of myocardial deformation and transesophageal echocardiography).
INDICATIONS FOR ECHOCARDIOGRAPHY
Echocardiography is indicated primarily for patients suffering from any cardiologic problem. For many people, the echocardiography results become the basis for choosing the extent and type of therapy. Many cardiac diseases are dangerous because in their initial stages of development they are asymptomatic, so screening echocardiography is also important. Very often, pathology in other organs leads to cardiac complications. With this in mind, there are a number of diseases (chronic pulmonary diseases, thyroid diseases, diabetes, blood diseases, systemic connective tissue diseases, diseases of the joints, etc.) where regular echocardiography is recommended. Often, chronic infections lead to the development of valvular heart disease or the development of infective endocarditis, which make this method of diagnosis very useful. Recent clinical guidelines suggest that echocardiography be performed before elective surgery and in people who are professionally engaged in sports.
In general, echocardiography is appropriate in the following situations:
- Cardiac arrhythmias, palpitations/infrequent palpitations
- Fainting, dizziness
- Changes noted on ECG
- Prolonged febrile conditions
- Chest pain
- Shortness of breath
- Edema of the lower extremities
- Visible changes of the cardiac silhouette on chest x-ray
- When a doctor hears a heart murmur
- Unintentional increase or decrease in blood pressure
- A family history of cardiovascular disease
There are no absolute contraindications to the study, but performing echocardiography may be difficult in certain cases: excessive patient weight, inflammatory diseases of the skin of the breast, as well as severe chest deformities. In these cases, transesophageal echocardiography should be considered, which is a type of ultrasound examination of the heart using an endoscopic probe.
Our clinic widely uses transesophageal echocardiography. The close proximity of the ultrasonic sensor to the heart allows us to obtain high quality images of the cardiac chambers and structures, which significantly increases this method's diagnostic accuracy.
The doctor may recommend transesophageal echocardiography in the following situations:
- If the heart is poorly visualized during standard transthoracic echocardiography
- Prolonged fever of unknown origin, suspected infective endocarditis
- In order to study the structure and function of heart valve prostheses
- In the case of atrial fibrillation (in search of an intracavitary thrombosis), especially if there are plans to restore sinus rhythm
- To reveal the source of emboli in stroke or transient ischemic attacks
- Before planned cardiac surgery
- In order to diagnose the state of the thoracic aorta, to exclude aortic dissection
- For a suspected cardiac septum defect, as well as to select the type of surgery to close it.
The study is performed either under local or general anesthesia. If general anesthesia is chosen, the patient is hospitalized at the clinic for 2-3 hours. Sedation during transesophageal echocardiography is often preferred because it makes the study more comfortable and informative.
The patient is placed on the left side for the study. The pharyngeal cavity is irrigated with a solution of a local anesthetic (10% lidocaine spray), after which a flexible endoscope is introduced into the oral cavity. Next, the patient is asked to swallow and the endoscope is advanced into the esophagus. The end of the endoscope contains an ultrasonic sensor that scans the heart and transmits the image to the monitor. These images are stored in the memory of the ultrasonic device and can be recorded on electronic media, along with the study interpretation.
PREPARATIONS FOR TRANSESOPHAGEAL ECHOCARDIOGRAPHY
- Refrain from eating for 6 hours before and 2 hours after the study. For 2 hours after treatment avoid drinking water.
- If you have dental prostheses, remove them beforehand.
- Take all necessary medicines at least 2 hours before the procedure, washing them down with a little bit of water.
- In the case of general anesthesia consider arranging transportation back home as you will not be able to drive a vehicle for at least 12 hours. The use of public transport is not contraindicated.
- In the presence of chronic diseases of the esophagus, pharynx, allergic reaction to lidocaine, or problems swallowing solid food, inform the doctor prior to the study.
Modern echocardiography is a central study in many clinical situations, providing accurate and timely information about the state of the cardiovascular system. The opportunities available to the European Medical Center allow for highly technical echocardiography to be performed.
Cardiologist, Doctor of the higher category. M.D., Specialist in echocardiography and functional diagnostics, Specialist in pediatrician echocardiography
Cardiologist, specialist in echocardiography and functional diagnostic. M.D., Doctor of the higher category
Cardiologist, specialist in ultrasound diagnostics