Cardiac ultrasound examination (Echocardiogram) is a non-invasive imaging diagnostic technique that produces real-time images of the heart's structure and function using high-frequency sound waves. It is primarily used to assess structural abnormalities, blood flow dynamics, and cardiac function. Common applications include diagnosing heart diseases, monitoring treatment efficacy, or evaluating the causes of symptoms.
This procedure requires no anesthesia or incisions and can be performed in outpatient clinics or hospital wards, with an examination time of approximately 20-60 minutes. Its key advantage lies in the real-time display of cardiac dynamics, allowing precise analysis of ventricular contractility, valve function, and the presence of thrombi, making it an essential tool in cardiology clinical assessment.
Cardiac ultrasound mainly falls into three categories: transthoracic echocardiography (TTE), which uses a probe on the chest wall; transesophageal echocardiography (TEE), which involves inserting a probe into the esophagus for clearer imaging; and stress echocardiography, which combines exercise or pharmacologic stress to evaluate the heart immediately after stress. Different types are suitable for different locations and carry varying risks.
The mechanism involves using a ultrasound probe to emit sound waves, which are reflected by tissues and converted into three-dimensional images by a computer. Doppler effect measurements can assess blood flow velocity and direction, while color Doppler visualization helps identify turbulent or regurgitant blood flow, aiding in diagnosing valve stenosis or regurgitation.
Main indications include:
Other applications include suspected pericardial effusion, cardiomyopathies, or evaluating the function of artificial heart valves. Emergency uses commonly include assessing ventricular wall motion abnormalities after suspected myocardial infarction or immediate diagnosis of suspected cardiac rupture.
For transthoracic ultrasound, the patient needs to expose the chest, and the technician applies gel and moves the probe to scan. For transesophageal ultrasound, local anesthesia is required before inserting the probe into the esophagus, which requires fasting for 6 hours and cooperation with an anesthesiologist.
Dosage control mainly refers to the sound wave intensity and scanning duration, with modern equipment having built-in safety parameters. When using contrast agents to enhance imaging, strict adherence to drug concentration and injection speed is necessary. For example, when using ultrasound contrast agents (such as Definity), doses are calculated based on body weight.
This examination offers three core advantages: Real-time dynamic assessment: observing immediate changes in systolic and diastolic function; Non-invasive nature: avoiding radiation exposure, suitable for repeated follow-up; Multifaceted diagnosis: simultaneously evaluating anatomy, blood flow dynamics, and cardiac function.
The risk of transthoracic ultrasound is extremely low; potential discomfort includes skin irritation from probe pressure and allergic reactions to gel. Transesophageal ultrasound may cause laryngospasm or esophageal mucosal abrasion, with an incidence of approximately 0.5-1%.
When using ultrasound contrast agents, about 1-2% of patients may experience dizziness or rash, and very rarely, allergic shock. Severe allergic reactions require immediate treatment with antihistamines or epinephrine.
Contraindications include:
Before the examination, remove metallic objects from the chest area. Fasting for 8 hours is required before transesophageal procedures. Pregnant women should evaluate the necessity of the examination, as the effects of sound waves on the fetus are not definitively established, but caution is recommended during early pregnancy.
This examination does not directly interact with medications but requires attention to:
The results may influence subsequent treatment choices, such as surgical evaluation if valve stenosis is detected.
Multiple studies confirm that transthoracic echocardiography has a diagnostic accuracy exceeding 90% for structural abnormalities, with transesophageal echocardiography reaching 95% sensitivity for atrial septal defects or artificial valve function assessment. The 2020 European Society of Cardiology guidelines list it as the first-line examination for heart failure evaluation.
Clinical evidence shows that combining strain imaging can detect myocardial ischemia early and accurately predict cardiac events. Large retrospective studies confirm high reproducibility for follow-up assessments, making it suitable for monitoring treatment efficacy.
Alternative examinations include:
Cardiac magnetic resonance imaging (CMR) provides more detailed tissue characterization but is longer and more costly. The choice of examination depends on the severity of clinical symptoms and suspected lesions.
Generally, cardiac ultrasound does not require fasting or stopping medications. However, if a stress test (such as exercise-induced testing) is involved, the doctor may ask you to fast for 2 hours before the exam. If you have arrhythmias or hypertension, inform the medical staff beforehand for medication adjustment assessment.
Will the procedure cause pain or discomfort?Cardiac ultrasound is painless and non-invasive. It only involves applying gel to the chest and placing the probe, which may cause slight pressure discomfort, but most patients tolerate it well. If breath-holding or position changes are needed during the exam, staff will explain to reduce anxiety.
How long does it usually take to get the results?Initial results are typically available immediately after the exam, with detailed reports completed within 1 to 3 working days. If the exam involves complex analysis (such as 3D imaging or blood flow calculations), additional time may be required for specialist review.
Do pacemakers or metallic implants affect the exam?Implants like pacemakers or artificial valves do not interfere with the results but should be disclosed before the exam. If the implant is magnetic, the technician may adjust the probe angle or use special techniques to ensure image clarity. This information helps in planning the procedure.
How do different types of cardiac ultrasound compare in accuracy?Standard static echocardiography provides high accuracy for ventricular function assessment. For dynamic blood flow evaluation (such as regurgitation), Doppler techniques are used. Intravascular ultrasound (ICE) is more invasive but offers more precise stenosis measurements. The physician will select the most appropriate type based on symptom severity to ensure accurate diagnosis.
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