When your doctor determines it necessary for you to have an ultrasound of your heart (an echocardiogram), it is important for you to take an active role in determining who should perform the test for you.
What is an Echocardiogram?
An echocardiogram is a non-invasive diagnostic test performed to evaluate the cardiac anatomy, function and haemodynamics and is a highly valuable diagnostic tool.
There are several types of echocardiography studies:
Transthoracic echocardiogram - images of the heart obtained through the chest wall whilst the patient is resting. Stress echocardiogram (Treadmill) - after a baseline transthoracic echocardiogram, images of the heart are obtained before and after physical exercise on a treadmill to assess the heart's function when it is put under exertion.
Stress echocardiogram (Dobutamine) - after a baseline transthoracic echocardiogram, images of the heart are continuously obtained while the heart rate is increased pharmacologically via a Dobutamine (adrenalin-type drug) infusion. Dobutamine is used to simulate physical exertion where the patient cannot tolerate exercising on a treadmill.
Transoesophageal echocardiogram - Clearer images of the heart are obtained via a transducer which is "swallowed" down the oesophagus (similar to an endoscopy). This provides clearer pictures as the transducer is closer to the heart. Contrast echocardiogram - after a baseline transthoracic echocardiogram an intravenous injection of sterile microbubble saline is administered to enhance detection of blood flow within or between cardiac chambers. Why would your doctor want you to have an Echocardiogram? An echocardiogram will help diagnose structural abnormalities in the heart muscle walls, evaluate the performance of the valves, and assess the blood flow through the heart. It can also detect tumours, clots or abnormal fluid (pericardial effusions) around the heart. Echocardiograms may also be used for diagnosing or monitoring congenital heart disease, cardiomyopathies or aneurysms.
Who performs the Echocardiogram?
The Echocardiography Technician performs the transthoracic echocardiographic study and the baseline echocardiographic study for the stress echocardiographic procedures.
The Echocardiography Technician plays an integral role in the procedure and must have the ability to obtain and integrate accurate diagnostic information. The technician is required to have a detailed understanding of cardiac and thoracic anatomy, physiology, and haemodynamics; and have the ability to recognise abnormalities, extending the scope of the examination to explore possible pathologic conditions. The technician must have a broad understanding of cardiovascular diseases and non-cardiac illnesses and have extensive experience in wall motion abnormalities and ischaemic heart disease. In order to gain the optimal image, the technician must understand the principles of ultrasound physics and instrumentation.
Should the Cardiologist perform the Echocardiogram?
It is not necessary for the cardiologist to perform the baseline transthoracic echocardiogram. However, it is important for the cardiologist to be available to clarify technical scanning issues or abnormalities detected by the Echocardiography Technician and also available to provide practical hands-on assessment to clarify ambiguous echo findings.
How long does the Echocardiogram take?
In order to obtain all the appropriate images and measurements, the echocardiogram scanning time should be no less than 45 minutes to an hour.
When should I expect the results?
The report should be forwarded to your doctor within at least 24 hours.
How long should I wait before I have my procedure?
If your doctor requests an echocardiogram, then it is important that you have the procedure done as soon as you are able to. There should be no more than a week's wait.
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