Education

Echocardiogram with Color Flow and Doppler


What is an Echocardiogram?

      An echocardiogram is a test in which ultrasound is used to examine the heart. It has several components:

  • M-mode: provides a single dimension or an ice-pick view of the heart. It allows for accurate measurement of the heart chambers and valve openings.
  • 2-D:  or two- dimensional echo is capable of displaying a cross-sectional "slice" of the beating heart, including the chambers, valves and the major blood vessels that exit from the left and right ventricle.
  • Color Flow: shows the direction of blood flow through the heart. It can easily detect abnormal blood flows and valve leakages.
  • Doppler: measures the velocity of blood jets through the heart valves and used to calculate valve areas.


How is the test done?

An echocardiogram can be obtained in a Cardiologist’s office or in the hospital. For a resting echocardiogram no special preparation is necessary. The clothing from the upper body is removed and covered by a gown or sheet to keep you comfortable and maintain the privacy of females. The patient then lies on an examination table. Sticky patches or electrodes are attached to the chest and shoulders and connected to electrodes or wires. These help to record the electrocardiogram (EKG or ECG) during the echocardiography test. The EKG helps in the timing of various cardiac events (filling and emptying of chambers). A colorless gel is then applied to the chest and the echo transducer is placed on top of it. The echo technologist then makes recordings from different parts of the chest to obtain several views of the heart. You may be asked to move form your back and to the side. Instructions may also be given for you to breathe slowly or to hold your breath. This helps in obtaining higher quality pictures. The images are constantly viewed on the monitor. It is also recorded on photographic paper and on videotape. The tape offers a permanent record of the examination and is reviewed by the physician prior to completion of the final report.


How long does the test take?

The test usually takes about 20 to 30 minutes


Is this test harmful to me in any way?

No the test is completely safe. It does not use any x-rays or radiations of any kind. Nothing is injected in the body for a regular echo with color flow and Doppler. No intravenous line is needed. There are no needles involved.


What information does Echocardiography and Doppler provide?

Echocardiography is an invaluable tool for your Cardiologist to understand the functioning of your heart such as:

  • Heart chamber sizes and wall thicknesse
  • Pumping power of the heart. One can tell if the pumping power of the heart is normal or reduced to a mild or severe degree
  • Functioning of heart valves. If the valves or narrow or leaking
  • Checking for fluid around the heart called pericardial effusion
  • Congenital heart defect
  • Abnormal growths, masses, tumors or clots in the heart.


What are some of the situations when an echocardiogram is helpful?

Echocardiography is an invaluable tool for your cardiologist. Some of the clinical situations where it is particularly helpful are:

  • Evaluating heart murmurs
  • Evaluating shortness of breath
  • Evaluating palpitations
  • Evaluating the causes of swelling or edema
  • Evaluating the heart as a source of clots in patients with or stroke or suspected to have mini-strokes called TIA.
  • Monitor the pumping power of the heart especially in patients who have a weak heart or congestive heart failure, who have suffered a heart attack or undergoing some forms of chemotherapy which can affect the heart muscle.


Why do I need an echo when I already have a stress test?

Echocardiogram and stress tests are two entirely different tests. They both provide entirely different information about the heart. The stress test is a way to evaluate the adequacy of the blood flow to the heart muscle itself. It is an indirect way to assess if blockages might be building up in the coronary arteries (or the plumbing system of the heart) which feed the heart muscle. The echocardiogram would not give any clue about coronary blockages until they have progressed to a point that they start to weaken the heart muscle and you clearly do not want to wait for that to happen. On the other hand, stress test does not tell anything about heart valve functioning, muscle thickening etc just to name a few.


Why was my echo called inadequate or a poor study?

The quality of an echo is dependant on multiple factors. The resolution or quality of the images depends on the ability of ultrasound waves to penetrate the chest wall to reach the heart. Patients who might be overweight or obese or have bad lungs or COPD or emphysema produce poor resolution images. The test is also very dependent on the training and experience of the echo technician and the equipment used.


I already had an echo done, why do I need another one?

Echo is frequently needed to follow progression of disease processes or to monitor progress with therapy. For ex. If you have valve problems or weak heart or fluid around your heart it needs to be periodically monitored to make sure things are stable. You might also need it to be repeated if you have developed any new symptom or any new finding related to your heart since your last study. Also, If you start to see a Cardiologist or go to a new one, he or she is at a considerable disadvantage to efficiently diagnose and treat you without being able to obtain and review images himself. He might need to do a study himself and review the images rather than treating you based on somebody else's interpretation.


When can I expect to receive the results?

Your cardiologist is not required to be present for the test. The Echo technician would gather and record all images on video tape or digitally. The cardiologist then reviews these images and provides an interpretation. Sometimes it could take a few days for the results to be ready. If your test was ordered by another physician, your results would be sent to him. If you are a patient of our practice we would discuss your results at the time of next office visit. If the test reveals any unexpected results requiring change in treatment plan we would call you
 

Would my insurance cover it?

This depends on your particular insurance or plan. Most insurance do however cover it if done for appropriate reasons and done by trained professionals