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Cardiovascular Imaging

Echocardiography

The test can measure the heart and produce sophisticated images.

What is an Echocardiography?

An echocardiogram is a test in which high-frequency sound waves (ultrasound) are aimed at the heart.

The ultrasound waves bounce back to the ultrasound machine, which interprets it as data and as information about the heart. The test can provide data based on size and density, measure the heart chambers and produce sophisticated images of the beating heart chambers, valves and the major blood vessels of the ventricles.

Echocardiography may be performed while you are still, known as a “resting echocardiogram,” or while you are performing exercise on a treadmill, commonly known as a “stress echo”.

For a resting echocardiogram, you will remove clothing from your upper body, put on a gown or cover up with a sheet if you wish, and lie on an examination table. No special preparation is necessary. Before administering the ultrasound, you will be connected to the EKG machine, which helps in the timing of various cardiac events (filling and emptying of chambers). The technician will apply a gel wherever he or she will place the echo transducer, make recordings from different parts of the chest, and collect several views of your heart.

Ultrasound echocardiogram computer monitor in heart clinic

A monitor will show images of your heart during the test, and these images are also as photographs 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.

During the echocardiogram, ultrasound also provides information about how blood is flowing through and out of your heart. This aspect of the test is called the Doppler test, and it can reveal crucial information, such as blood leakage or regurgitation occurring in heart valves.

Echocardiography with Doppler testing normally takes about 40 minutes and is extremely safe.

TTE vs. TEE

The standard echocardiogram is also called a transthoracic echocardiogram, or TTE. The transducer will be placed on the chest wall (thorax), and images will be taken through the chest wall.

Sometimes, the patient’s body structure makes it impossible or impractical to get a good image through the chest wall. In these cases, a transesophegeal echocardiogram, or TEE, may be necessary. In this procedure, the transducer is passed down the throat into the patient’s esophagus.

To schedule an appointment, contact the location most convenient to you.

Real-time 3-D Echocardiography

Real-time 3-D echocardiography provides critical views of the beating heart as it actually appears. Live, full-volume images are rendered instantly, for a more accurate, close-up assessment of both complex anatomical structures and valvular function.

Real-time 3-D echocardiography can help speed the diagnosis of certain problems. Precise “surgical” views of the heart offer advantages for both pre-surgical planning and post-surgical monitoring. With 3-D echo, spatial relationships are more easily discerned, and size, shape and volume can be more accurately quantified.

Benefits of live, 3-D echocardiography
  • Clearer orientation of anatomical structures.
  • Improved measurement of heart function.
  • Instant, full-volume rendered images.
  • Non-invasive procedure.
  • No radiation exposure.

Preparing for an Exercise Stress Echocardiogram

If you are scheduled for an exercise stress echocardiogram:

  • The test will take 2 to 2.5 hours, unless it is just a routine stress test, which will take 1 hour.
  • Wear comfortable clothes and walking shoes.
  • Do not eat or drink anything with caffeine for 24 hours prior to test. This includes coffee, cola, teas, chocolate milk, chocolate pudding and chocolate candy. This also includes decaffeinated coffee, cola and tea, because these beverages still contain some caffeine.
  • Do not eat or drink anything for at least 4 hours before the test. If you are diabetic, you may have juice and toast, cereal or graham crackers 2 hours prior.
  • Remain on all medications unless otherwise directed by your physician. Bring a list of these medications with you.
  • This test may not be appropriate if you are pregnant, suspect you may be, or are a nursing mother. Please discuss with your doctor before having this test.
  • Request that a copy of your most recent EKG and prescription be sent or faxed to your appointment location by your doctor.
  • We will need to know your weight before starting this procedure.
  • An IV will be started for this procedure.
  • If your test will include Dobutamine, please also refer to Preparing for a Dobutamine stress echocardiogram.

Before the Test

  • You will be asked to sign a consent form giving permission to do the test.
  • An IV will be put into your arm.
  • Electrodes will be placed on your chest to monitor your heart rate.
  • A cuff will be put on your arm to check your blood pressure.

During the Test

  • A baseline heart rate and blood pressure recording will be done. Then, an echocardiogram at rest will be done.
  • Dobutamine will be put into your IV in several stages over 20 minutes, and an echocardiogram will be done. Your heart rate and blood pressure will increase, and you may feel pounding in your chest, warmth in your body, tingling or numbness in the arms or legs, headache, chest discomfort or nausea. Tell the doctor if you have any of these symptoms.
  • When your heart rate and blood pressure return to normal, another echocardiogram will be done. The doctor can compare the two sets of images (before and after Dobutamine) to see how your heart responds to stress.

After the Test

  • the Dobutamine has no lasting effects in your body
  • the doctor will talk with you about the test results

To schedule an appointment, contact the location most convenient to you.

Exercise Stress Echocardiogram

An exercise echocardiogram stress test combines an ultrasound study (echocardiogram) of the heart with exercise to learn how the heart functions when under stress. This test helps show areas of the heart that are not getting enough blood.

During an echocardiogram, a transducer (a small microphone-like device) is held against your chest and takes pictures of your heart. These pictures can be recorded on videotape or printed on paper.

Dobutamine Stress Echocardiogram

A Dobutamine stress echocardiogram combines an ultrasound study of the heart with the injection of the drug Dobutamine to learn how the heart functions when under stress (similar to exercise). This test helps show areas of the heart that are not getting enough blood.

During an echocardiogram, a transducer (a small microphone-like device) is held against your chest and takes pictures of your heart. These pictures can be recorded on videotape or printed on paper.

Preparing for a Dobutamine stress echocardiogram

  • The test will take two hours.
  • Do not eat or drink anything with caffeine for 24 hours before the test. This includes coffee, cola, tea, chocolate milk, chocolate pudding and chocolate candy. It also includes decaffeinated coffee, cola and tea, because these products still contain some caffeine.
  • If your test is scheduled before noon, do not eat anything after midnight the night before. If your test is scheduled in the afternoon, do not eat or drink anything after you eat breakfast on the day of the test. If you are diabetic, you may have toast, cereal or graham crackers two hours before the test.
  • Remain on your medications unless your doctor has told you otherwise. Bring a list of these medications with you.
  • We will need to know your weight before the test.
  • An IV will be started for this procedure.

To schedule an appointment, contact the location most convenient to you.

Transesophegeal Echocardiogram (TEE)

A transesophageal echocardiogram, or TEE, is a test used to take detailed pictures of your heart. During TEE, a small ultrasound probe is passed through your mouth and into your throat (esophagus). Sound waves pass through the probe, letting your doctor see your heart.

Your doctor may order a transesophageal echocardiogram if a regular (chest) echocardiogram does not show enough detail. A TEE may also be ordered for patients who have:

  • Congenital heart disease.
  • Heart valves that have been replaced.
  • Suspected blood clots in the heart.
  • Had open-heart surgery.

If you have ever had problems with food getting stuck in your throat or have had bleeding from the esophagus or stomach, it is important to tell your doctor.

Preparing for a Transesophageal Echocardiogram

  • If your test is scheduled before 2 p.m., do not eat or drink anything after midnight the night before. If you test is scheduled after 2 p.m., you mean eat or drink a light breakfast before 7 a.m. You may take your morning medications at 6 a.m.
  • You will be unable to drive for eight hours after this procedure.
  • Please bring a list of your current medications with you.
  • An IV will be started for this procedure.

Before the Test

  • When you get to the procedure room, you will be asked to take out your dentures or partial plate, if you have them.
  • An IV will be placed in your arm. Medicine will be given through your IV to help you relax.
  • You will be hooked up to heart-rhythm, blood-oxygen and blood-pressure monitors.

During the Test

  • Your doctor will numb the back of your throat with a spray. You will be asked to lie on your left side. A small ultrasound probe will be placed into your mouth and down your throat. Pictures of your heart will be taken.
  • The test takes about an hour, but the probe will be in place for less than 20 minutes.

After the Test

  • The back of your throat will be numb for a few hours.
  • Wait at least one hour before you try to eat or drink anything. Sip a small amount of water to be sure that you can swallow without gagging.
  • You may have a sore throat, but this should go away within a day. If your sore throat lasts for more than a day, call the doctor who did your procedure.
  • Someone else must drive you home. You may not drive for eight hours after the test.

Transesophageal Echocardiogram Risks

TEE is a relatively safe procedure. There is a small risk of injury to the esophagus or stomach that could cause bleeding or infection.

Contact Us

To schedule an appointment, contact the location most convenient to you.

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