| Echocardiography |
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What is General Echocardiography? |
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An echocardiogram is a test that uses high-frequency sound waves (ultrasound) to create an image of the heart (Figure 1). A Doppler test uses sound waves to measure the speed and direction of blood flow. By combining these tests, a pediatric cardiologist gets useful information about the heart’s anatomy and function. Echocardiography is the most common test used in children to diagnose or rule out heart disease and also to follow children who have already been diagnosed with a heart problem. |
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How should I prepare for the procedure? |
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You should wear comfortable, loose-fitting clothing for your Echocardiography exam. There is no need for fasting. Other preparation depends on the type of examination you will have. For some scans your doctor may instruct you not to eat or drink for as many as 12 hours or overnight fasting before your appointment. For others you may be asked to drink few glasses of water one hour prior to your exam and avoid urinating so that your bladder is full when the scan begins. |
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What does the equipment look like? |
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Echocardiography scanners consist of a console containing a computer and electronics, a video display screen and a transducer that is used to scan the body. The transducer is a small hand-held device about the size of a bar of soap, attached to the scanner by a cord. The physician or technologist spreads a lubricating gel on the patient's abdomen in the area being examined and then presses the transducer firmly against the skin to obtain images. The ultrasound image is immediately visible on a nearby screen that looks much like a computer or television monitor. The physician or technologist watches this screen during an examination and captures representative images for storage. Often, the patient is able to see it as well.
An example of the Echocardiography equipment at Focus Imaging is shown at the of this page. |
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How does the procedure work? |
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This test can be performed on children of all ages and sizes including fetuses and newborns.
Blood can be seen to flow from the left ventricle (LV) into the left atrium (LA) in systole on this color flow Doppler image. The jet is large, extending into the distended pulmonary vein seen earlier. There is also a color jet emanating from the right ventricle (RV) into the right atrium.
This image shows blood flowing from the left atrium (LA) through the defect in the atrial septum into the right atrium (RA) during systole (cursor on the ECG is between the QRS complex and the end of the T wave). PV; pulmonary vein. AO; aorta. PA; pulmonary artery. |
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How is the procedure performed? |
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The Echocardiography test is done with your child lying down comfortably on a bed or examination table. Infants may be able to lie in their parents lap.
The test is done by a cardiac sonographer (a technologist with extensive training in ultrasound) and/or by your pediatric cardiologist. The examiner will put a few stick-on patches called electrodes on your child for an electrocardiographic (EKG) tracing during the exam. He or she will also put a small handheld device (called a transducer) on the chest and abdomen. It sends and receives the sound waves and is connected by a cable to the Echocardiography machine (Figure 2). The Echocardiography machine is a computer that converts sound waves to pictures. A small amount of clear gel is used between the transducer and chest to make sure there is proper contact. The gel doesn’t stain and is wiped off when the test is over.
The examiner may select and show a variety of pictures on a TV screen. You’ll be able to see a picture of the beating heart, and you may be able to see and hear the flow of blood. The picture normally changes when the transducer is moved. Expect to hear loud sounds from the Echocardiography instrument. Portions of the test may be recorded on videotape or stored as computer files for later measurement, interpretation and storage as part of the patient record.
Echocardiographic examinations take 20 to 30 minutes. Younger children may require sedation for the test. Many can be comforted by watching a videotape or DVD. If sedation is needed, your child may be asked not to eat or drink for several hours prior to testing. These children usually fall asleep within 30 minutes and sleep for about an hour. When they wake up, they may have poor balance for more than an hour. During this time they must not be allowed to sit, stand or walk alone, and should be watched closely. If sedation is required, your child will need careful observation until he or she is fully awake.
Older children and teenagers usually don’t need sedation and may enjoy watching the test. To avoid any anxiety, be sure your child knows that the test is fun, that it doesn’t hurt, and that you or whoever brings your child to the test may stay in the exam room and watch.
Except for allowing for the possibility of sedation, you don’t need to make any special preparations. Having your child wear a shirt or blouse that buttons down the front is helpful. Your child may eat normally before the test; bring a bottle if you have an infant or a video for your child to watch. |
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What will I experience during the procedure? |
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Most Echocardiography examinations are painless, fast and easy. You will lie on your back on an examining table. The technologist or doctor will spread some warm gel on your skin and then press the transducer firmly against your body, moving it until the desired images are captured. There may be varying degrees of discomfort from pressure as the technologist guides the transducer over your abdomen, especially if you are required to have a full bladder. The examination usually takes less than 30 minutes. Also, you may dislike the feeling of the water-soluble gel applied to your abdomen. With transvaginal scanning, there may be minimal discomfort as the transducer is moved in the vagina, especially when the bladder begins to refill. No feeling comes from the sound waves themselves; sometimes the skin feels mildly warm. |
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Who interprets the results and how do I get them? |
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Your Echocardiography examination is interpreted by a panel of highly qualified and experienced Cardiologists (see our doctors). If a doctor is present during the test or reviews it, you may be able to get the results within 30 minutes or one hour. Some physicians will discuss your case before the study is performed and will contact you if there are significant unexpected findings. For example, if you are expected to have a finding or known to have a given disease, your physician may indicate that he or she will call you only if there are significant unexpected findings. You may also be contacted if echocardiography reveals a finding that influences a change in treatment. For example, the presence of a distended inferior vena cava (discussed above) may result in increasing the dose of your diuretic or water pill, if it is indicated by other aspects of your condition. If you are anxious or confused about the results feel free to contact the physician's office staff. They can usually clarify a question for you. We retains exam films and reports electronically for a set length of time. Please contact our reception counter after your diagnostic imaging procedure if you have questions regarding the timings (Usually available within few hours unless emergency case) and procedure for collecting the reports or next steps or follow-up appointments. New technology also allows us for distribution of diagnostic reports and referral images over the Internet at many facilities. Our radiologists have established themselves as valued consultants and colleagues with our referring physicians. They pride themselves on being accessible and responsive. |
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What are the benefits vs risks? |
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Benefits
- Echocardiography scanning is noninvasive (no needles or injections in most cases) and is usually painless.
- Echocardiography is widely available and easy to use.
- Echocardiography uses no ionizing radiation and is the preferred image modality for diagnosis and monitoring of pregnant women and their unborn infants.
- Echocardiography provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as needle biopsies.
- Echocardiography images can visualize structure, movement and live function in the body's organs and blood vessels.
Risks
- For standard diagnostic Echocardiography there are no known harmful effects on humans.
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How long does it take? |
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A brief examination in an uncomplicated case may be done within 15 to 20 minutes. The additional use of Doppler may add an additional 10 to 20 minutes. However, it may take up to an hour when there are multiple problems or when there are technical problems (for example, patients with lung disease, obesity, restlessness, and significant shortness of breath may be more difficult to image). |
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Can Echocardiography be harmful to me? |
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Echocardiography is extremely safe. There are no known risks from the clinical use of Echocardiography during this type of testing. No. There are no known ill effects of the sound waves used during a standard echocardiogram. |
