Ultrasound of the heart (echocardiography)

What is it about ?

An echocardiogram is a technique that looks at the heart through ultrasound. During a ultrasound, sound waves are sent through the body. They are reflected by the different fabrics they encounter. These reflected waves are then translated into an image on a computer screen. This technique allows you to see the size and function of the heart’s ventricles and atria, heart valves, veins and arteries that enter and leave the heart. This examination is said to be “non-invasive” because no syringes, catheters, contrast agents or rays are used). This test also gives an estimate of the pressure in the heart and in the blood vessels.

Echocardiography is offered to people withheart failure, those with abnormalities in the heart valves, in case ofinfection or in the presence ofheart muscle disorders (myocardium) and coronary heart disease.

If you have symptoms suggesting heart disease (heart disease), such as chest pain, chest pain, shortness of breath, from fainting, swelling of the ankles, etc., the general practitioner may refer you to a cardiologist for an echocardiogram. The examination can be done on an outpatient basis, which means that you do not need to be hospitalized.

Heart failure

In case of’heart failure, the heart can no longer pump enough blood to meet the body’s needs. There are two phases in the movement of the heart: the contraction phase (systole) during which the heart ejects blood to the rest of the body, and the relaxation phase (diastole) during which the heart relaxes and fills with blood. Normally, the heart, more exactly the left ventricle, ejects with each contraction more than half of the volume of blood it contains towards the aorta; we are talking about a ventricular ejection fraction of more than 50%. In heart failure, failure of the heart can affect its contraction and / or relaxation. Heart failure can be classified according to the amount of blood ejected from the left ventricle to the aorta.

• If the left ventricle ejects more than 50% of the volume of blood it contains towards the aorta, it is called left ventricular ejection fraction heart failure. preserved.
• If the left ventricle ejects 40 to 49% of the volume of blood it contains to the aorta, it is called left ventricular ejection fraction heart failure. moderately reduced.
• If the left ventricle ejects less than 40% of the volume of blood it contains to the aorta, it is called left ventricular ejection fraction heart failure. scaled down.

To establish this classification, one also takes into account, in particular, the capacity of relaxation of the heart (diastolic function).

Heart valve dysfunction

Echocardiography is used to diagnose and monitor the malfunction of the heart’s valves. It is also used to determine the ideal time to operate. After placing a valve prosthesis, it is possible to follow the evolution by echocardiography. This makes it possible in particular to visualize the speed with which the blood passes through the valves as well as the pressure difference in the blood before and after it passes through the valve.

Coronary heart disease

The coronary arteries supply the heart muscle with blood. Narrows in the coronary arteries can cause a lack of oxygen in the muscle of the heart (myocardium), which sometimes leads to abnormal movements of the heart wall. An echocardiogram performed at rest and immediately after a stress test can help make a correct diagnosis.

Echocardiography is also used in the diagnosis and treatment of heart attack (infarction). In the event of a heart attack, part of the myocardium dies and no longer functions properly. Ultrasound can assess the extent of the affected area.

Cardiomyopathies (diseases of the muscle of the heart)

Some conditions cause dilation and or thickening of the heart muscle. These problems often go hand in hand with a heart failure and arrhythmias. Echocardiography is used to assess the thickness of the heart wall.

Inflammation of the heart muscle (myocarditis)

The inflammation of the myocardium (muscle of the heart) are often due to viral infections. In the early stages of inflammation, decreased wall mobility may be seen on echocardiography, but examination may also give normal results. Fluid is also sometimes seen between the membranes around the heart.

Want to know more?

• Heart failure: when the heart is no longer enough… (image) – mongeneraliste.be – SSMG – Société Scientifique de Médecine Générale
• Trans-thoracic cardiac ultrasound – Erasme Hospital
• Cardiac echo effort – Hôpital Erasme
• Transesophageal cardiac echo – Erasme Hospital

Source

Foreign clinical practice guide ‘Ambulatory echocardiography’ (2000), updated on 08.03.2017 and adapted to the Belgian context on 23.10.2019 – ebpracticenet