Echocardiography: Types, Procedure, Benefits and Side Effects

What is Echocardiography?

Echocardiography is a medical examination using sound waves to determine the movement of the heart. Through the results of the image, the doctor knows the size and shape of the heart whether it is normal or not. This examination can also be requested by the doctor to determine the performance of the heart chambers and valves.

Echocardiography can also determine which parts of the heart muscle cannot contract properly, due to inadequate blood flow or injury as a result of a heart attack.

This type of examination is also known as a Doppler ultrasound which can show how well blood flows through the chambers and valves of the heart. The sound waves will detect possible blood clots inside the heart, fluid buildup in the pericardium, or sac around the heart, and various problems related to the aorta.

The aorta itself is the main artery that carries oxygen-rich blood from the heart to the rest of the body. Usually, doctors use this examination to detect heart problems in infants and children.

Types of Echocardiography

There are different types of echocardiography, all of which use high-frequency sound waves. The most common types of echocardiography are:

1. Transthoracic echocardiography

This is the most common type. It involves placing an ultrasound device called a transducer on the outside of your chest, near your heart. The device sends sound waves through your chest and into your heart. Applying gel to your chest can help the sound waves travel better. The waves bounce off your heart and create a picture of your heart’s structure on a screen.

2. Transesophageal echocardiography

This type of exam uses a thinner transducer attached to the end of a tube or instrument. The patient swallows the tube, which is inserted into the esophagus, which connects the mouth and stomach and runs behind the heart.

Transesophageal echocardiography can provide more detailed images of the heart than previous types. Because it provides a closer look at the body’s organs.

3. Doppler USG

Doctors use Doppler ultrasound (US) to check blood flow. This test produces sound waves at specific frequencies and determines how the sound waves bounce off and return to the transducer.

Additionally, doctors sometimes use color Doppler ultrasound to map the direction and speed of blood flow through the heart. Blood flowing into the transducer appears red, while blood flowing out of it appears blue. Doppler ultrasound results can reveal problems with valves or holes in the heart wall and assess how blood flows through them.

4. Intravascular USG

This type is also known as intravascular echocardiography. This examination uses a transducer or probe to produce sound waves and produces images of the inside of blood vessels.

This examination uses a special catheter with a small ultrasonic transducer at one end.

5. Three-dimensional (3D) echocardiography

Three-dimensional echocardiography creates more detailed 3D images of the heart. Doctors can use 3D echocardiography to:

• Assessing valve function in people with heart failure.
• Diagnosing heart problems in infants and children.
• Planning structural interventional surgery.
• Assessing heart function in 3D.
• Produces images of complex structures inside the heart.

6. Stress Echocardiography

This type of echocardiography is part of a stress test. A stress test involves physical exercise, such as walking or jogging on a treadmill. During the test, your doctor will monitor your heart rate, blood pressure, and the electrical activity of your heart.

Doctors may use an echocardiography test to diagnose:

• Ischemic heart disease.
• Coronary heart disease.
• Heart failure.
• Problems affecting the heart valves.

7. Fetal Echocardiography

Doctors can use fetal echocardiography to look at an unborn baby’s heart. The exam usually takes place around 18-22 weeks of pregnancy. Echocardiography does not use radiation, so it is not harmful to the mother or the fetus.

Side Effects After Echocardiography

This supporting examination is considered very safe. However, there are some side effects that you need to be aware of, such as:

• If the examination uses injection with contrast dye, this condition can cause allergies. In addition, contrast should not be used in pregnant women.
• Transesophageal echocardiography examination tube can trigger irritation to sore throat.
• Consumption of drugs for stress echocardiography examination can trigger heart rhythm disorders.
• Stress echocardiography can cause nausea and vomiting.
• Disorders of the central nervous system, such as seizures and tremors.
• The use of contrast agents can cause headaches and dizziness.

Benefits of Echocardiography

This examination is usually performed by a doctor to monitor the condition of the heart. Heart monitoring can examine the structure of the heart to the condition of the blood vessels around it.

Echocardiography itself aims to detect heart disorders, a history of repeated heart infections, or to check for heart damage due to birth defects. That way, you can feel the benefits of this examination.

There are several benefits if someone with certain conditions undergoes an echocardiography procedure, namely:

1. Diseases and disorders can be detected earlier

Echocardiography will provide the information doctors need to determine if someone has a serious heart problem. In addition, echocardiography can also assess heart function, detect and follow the development of heart disease and heart mass. This can help doctors diagnose diseases, such as:

• Atherosclerosis.
• Cardiomyopathy.
• Congenital heart disease.
• Heart tumor.

Not only that, this examination can also help someone to detect several heart health problems, such as:

• Damage from a heart attack.
• Heart disorders due to birth defects that affect the normal functioning of the heart.
• Problems with heart valve control.
• History of infection of the lining of the heart.

Patients with mild heart valve problems also need regular monitoring with echocardiography. The goal is to find out if there is a change in status to moderate or severe. If you ignore the problem, someone could have a heart attack, stroke, or blood clot.

2. Monitor disease and drug effectiveness

Echocardiography can also be used by doctors to monitor disease and the effectiveness of treatment or surgery. For example, after someone has had heart surgery that requires a tube to be inserted into an artery, this examination will monitor its effectiveness.

In addition, patients with heart failure also benefit from routine echocardiography monitoring. This procedure also applies to routine monitoring of patients undergoing cancer therapy, where there is a risk of cardiotoxicity.

Echocardiography Indications

Echocardiography indications can adjust the type of echocardiography to be performed. Here are the indications of several types of echocardiography, namely:

1. Transthoracic echocardiography

Usually, doctors will use this type of examination to indicate several health disorders, such as:

• Heart health disorders.
• Heart valve disorders.
• Heart attack.
• Congenital heart disease.
• Infection of the heart valves.
• Heart muscle disorder.

2. Transesophageal echocardiography

This type is a follow-up examination when transthoracic echocardiography does not show good or unclear results. By doing this type of examination, the results described will be clearer and more detailed.

3. Three-dimensional (3D) echocardiography

Doctors may use 3D echocardiography to:

• Assessing valve function in people with heart failure.
• Diagnosing heart problems in infants and children.
• Planning structural interventional surgery.
• Assessing heart function in 3D.
• Produces images of complex structures inside the heart.

4. Stress echocardiography

Doctors may use an echocardiography test to diagnose:

• Ischemic heart disease.
• Coronary heart disease.
• Heart failure.
• Problems affecting the heart valves.

5. Fetal echocardiography

Doctors perform this echocardiography examination when they see several indications, such as:

• Heart disorders in the fetus.
• Heart conditions in pregnant women.

Echocardiography Warning

There are several conditions that you need to inform the medical staff or doctor about when you are going to have this examination, such as:

• Discuss this treatment with your doctor regarding the types and benefits you can get.
• Inform your medical team or doctor if you have a history of allergies.
• Please inform us if you are pregnant.
• The doctor needs to know what other treatments you are undergoing, both medical and traditional.
• Make sure the doctor knows your medical history. For example, such as the use of a heart ring, cancer in the throat area, or heart.
• Some types of echocardiography can trigger mild side effects such as damage to the teeth, mouth, or throat area. Make sure these areas are not experiencing health problems before undergoing this examination.
• Inform your doctor about the various types of medicines you are taking, both medical and herbal.

Echocardiography Procedure

The echocardiography procedure is a non-invasive procedure that is relatively quick and does not require much preparation.

1. Before the procedure

Before an external echocardiography examination, special preparation is usually not required. However, for people undergoing transesophageal echocardiography, the doctor will advise not to eat or drink anything at least 4 hours before the examination. You can eat and drink again about 1-2 hours after the procedure, or precisely after the effects of local anesthesia wear off.

2. During the procedure

The doctor will use an ultrasound device to obtain images and videos to make a diagnosis. During the procedure, you will need to remove your clothes.

After that, the doctor will instruct the person to lie down on a table. The doctor may inject a saline solution or a special dye into the blood vessels, which will make the image of the heart appear clearer on the echocardiogram.

Furthermore, the procedure may vary depending on the type of echocardiogram you are having. For example:

1. Transthoracic echocardiogram

If your doctor recommends a transthoracic echocardiogram, he or she will apply gel to your chest. The healthcare provider will then move the transducer around your chest to obtain images of your heart.

During the exam, your doctor may ask you to change positions, take a deep breath or hold it. Then he or she may press the transducer against your chest to get a better picture of your heart.

2. Transesophageal echocardiogram

Your doctor may recommend a transesophageal echocardiogram, which is a more detailed or clearer image of your heart than a transthoracic echocardiogram. During the procedure, you will receive a mild sedative to help relax the muscles in your throat and a local anesthetic to prevent the gag reflex.

After the sedative has taken effect, the doctor will guide a small transducer on the end of a long tube down your throat and esophagus, until it reaches the back of your heart. The healthcare provider will record images of your heart as the doctor moves the transducer around your esophagus.

3. Doppler ultrasound

The examination uses a tool that functions to send sound waves into the body. Then, the sound waves bounce off blood cells moving in the blood vessels.

This test may take 30-60 minutes. Depending on the examination you will undergo, you will generally lie down or on your side during the examination.

Before the examination, the doctor will apply gel, so that the device can work more optimally. The examination will not cause pain or discomfort to the body.

4. 3D Echocardiography

During this examination, the patient will be asked to lie down. Then, the medical team or doctor will apply gel so that the examination equipment can run smoothly.

The tool used will produce a more detailed real image for the part being examined. That way, the examination will be more accurate.

This examination is almost similar to transthoracic echocardiography, but the results are more accurate.

5. Stress echocardiography

A stress echocardiogram works similarly to a transthoracic echocardiogram. However, in this test, the doctor will take pictures before and after the patient does physical activity or takes medication that can speed up the heart rate.

6. Fetal echocardiography

The pregnant mother will lie down, then the transducer will be placed on her stomach. Next, the doctor will check the baby’s heart condition.

This examination occurs because the fetus cannot undergo other examinations that use radiation, such as X-rays.

3. After the procedure

You can resume your normal activities after an echocardiogram. However, some types of echocardiograms may require you to stay in the hospital or healthcare facility for several hours after the procedure.

You may have a sore throat at first, but it should improve within a few hours to a day. If you were sedated before the exam, you should not drive for a few hours after the echocardiogram.