Two main types of echocardiography exist.
During a transthoracic echocardiography, or TTE, a small probe called a transducer is placed on your chest. This transducer sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on your 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 displays the echoes as images of the heart walls and valves.
A transesophageal echocardiography, or TEE, is more invasive than a transthoracic echo. Patients are sedated so that a probe can be placed into the esophagus, the swallowing pipe between the mouth and the stomach. The esophagus lies directly behind the heart, so TEE images provide higher-resolution images of certain parts of the heart.
An echocardiogram can utilize one or more of several special types of echocardiography, as listed below:
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.
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 problems. These include an abnormal opening between the chambers of the heart, a problem with one or more of the heart’s four valves or a problem with the heart’s walls.
With color Doppler, different colors are used to designate the direction of blood flow. This simplifies the interpretation of the Doppler images.
2-D (Two-Dimensional) Echocardiography
This technique is used to “see” the 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 doctor to see the various heart structures at work and evaluate them.
3-D (Three-Dimensional) Echocardiography
This test represents generates 3-D movies of the beating heart.
This test looks at what happens to the heart during a period of stress, produced either by medications or by exercise. Images of the heart are examined during periods of stress and compared to the resting echocardiogram.
Several diseases of the heart may be detected by echocardiography, including the following:
- Aneurysm, or a dilation or weakness of a part of the coronary arteries or the aorta (the large artery that carries oxygenated blood out of the heart to the rest of the body). In extreme cases, an aneurysm may rupture, which is an emergency, causing rapid blood loss out of the blood vessels.
- Cardiomyopathy, or 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, or a condition in which the heart muscle has become weakened to an extent that blood cannot be pumped efficiently. This causes a buildup of fluid (congestion) in the blood vessels, lungs, feet, ankles and other parts of the body.
- Pericarditis, or an inflammation of the membrane (thin covering) that surrounds the heart.
- Valve disease, or a condition in which one or more of the heart’s four valves becomes defective or may be congenitally (since birth) malformed.
The test may be done in the office of a cardiologist (heart doctor), in a clinic, at a hospital or medical center as an outpatient, or as an inpatient in a medical facility.
Depending on the results of the echo, additional tests or procedures may be scheduled to gather further diagnostic information.
The non-invasive cardiology department works closely with cardiologists to provide a full range of diagnostic studies on the heart.
- Echocardiograms (echo)
- Transesophageal echocardiograms (TEE)
- 12 lead electrocardiograms (ECG)
- Stress-test electrocardiograms (stress ECG)
- Holter monitoring (24-hour ECG)
- Event monitoring (ECG events)
These studies are extremely valuable in evaluating and diagnosing a wide variety of heart conditions or in planning the appropriate courses of treatments for those conditions.
Angiography uses X-ray pictures to show arteries, veins and heart chambers.