Makindo Medical Notes

Cardiac echocardiography, often referred to as an "echo," is a non-invasive imaging technique that uses ultrasound to visualize the heart. It provides detailed images of heart structures, including the chambers, valves, and blood vessels.

Introduction

• Ultrasound technology: High-frequency sound waves are used to produce real-time images of the heart.
• Non-invasive: Typically performed on the chest surface (transthoracic), making it painless and risk-free.
• Real-time imaging: Offers dynamic, moving images of the heart, allowing the observation of its function and blood flow.

Different Views

Types of Cardiac Echocardiography

• Transthoracic Echocardiography (TTE): The most common type, where the ultrasound probe is placed on the chest to visualize the heart.
• Transesophageal Echocardiography (TEE): A more invasive method where the ultrasound probe is passed down the oesophagus to get a clearer image of the heart, especially in patients with obesity or poor-quality TTE images.
• Stress Echocardiography: Combines echocardiography with physical or pharmacological stress to assess the heart's function under stress conditions.
• Doppler Echocardiography: A technique used to measure blood flow through the heart's chambers and valves, detecting abnormal flow patterns or pressure gradients.
• 3D Echocardiography: Advanced imaging technique that provides three-dimensional views of heart structures for detailed anatomical assessment.

Key Uses of Cardiac Echocardiography

Echocardiography is a versatile tool used to assess various aspects of heart function and diagnose a wide range of cardiac conditions.

• Evaluation of heart function: Determines ejection fraction (EF) and assesses the pumping efficiency of the heart.
• Assessment of heart valves: Detects valvular abnormalities like stenosis, regurgitation, or prolapse.
• Diagnosis of heart diseases: Helps identify conditions like heart failure, cardiomyopathy, and congenital heart disease.
• Detection of fluid around the heart: Identifies pericardial effusion (fluid accumulation in the pericardium).
• Assessment of blood flow: Doppler echocardiography helps analyze blood flow patterns, detect turbulence, and assess pressures across valves and chambers.
• Monitoring after cardiac surgery: Useful for evaluating surgical outcomes, such as valve repair or replacement.
• Stroke risk assessment: Helps detect potential sources of emboli in the heart, such as left atrial thrombus or patent foramen ovale (PFO).

Advantages of Cardiac Echocardiography

• Non-invasive: Minimal to no risks associated with routine transthoracic echocardiography.
• Real-time dynamic imaging: Provides live views of heart function, aiding in the rapid diagnosis of cardiac conditions.
• Widely available and cost-effective: Echocardiography is accessible in most healthcare settings and is generally less expensive than other imaging techniques like CT or MRI.
• No radiation exposure: Unlike X-rays or CT scans, echocardiography does not involve ionizing radiation.

Limitations of Cardiac Echocardiography

• Image quality variability: Factors such as obesity, chest wall deformities, or lung disease can reduce image clarity.
• Limited by acoustic windows: Obtaining high-quality images can be challenging depending on patient anatomy.
• TEE is invasive: Though rare, transesophageal echocardiography may have complications such as oesophageal injury or discomfort.

Indications for Echocardiogram

• Diagnosis of Cardiac Conditions:
  • Heart valve diseases (e.g., stenosis, regurgitation).
  • Cardiomyopathies (e.g., hypertrophic, dilated).
  • Congenital heart defects.
  • Pericardial diseases (e.g., pericarditis, effusion).
  • Cardiac tumours.
• Assessment of Cardiac Function:
  • Left and right ventricular function (e.g., ejection fraction, wall motion).
  • Chamber size and volume.
  • Stroke volume and cardiac output.
• Evaluation of Symptoms:
  • Shortness of breath, chest pain, palpitations, syncope.
  • Heart murmurs and abnormal heart sounds.
• Monitoring of Treatment:
  • Response to medical therapy for heart failure or valvular disease.
  • Post-surgical evaluation (e.g., valve replacement, repair).
• Screening and Preventive Care