An echocardiogram , often referred to as echo heart or just echo , is a cardiac sonogram. (This is not abbreviated as ECG, because it stands for electrocardiogram.) Echocardiography uses two dimensional, three dimensional, and standard Doppler ultrasound to create heart images.
Echocardiography has been routinely used in the diagnosis, management, and follow-up of patients with known or suspected heart disease. This is one of the most widely used diagnostic tests in cardiology. It can provide a lot of useful information, including the size and shape of the heart (internal chamber size size), pumping capacity, and location and level of tissue damage. An echocardiogram may also provide doctors with other estimates of cardiac function, such as calculation of cardiac output, ejection fraction, and diastolic function (how well the heart relaxes).
Echocardiography can help detect cardiomyopathy, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and many others. The use of stress echocardiography can also help determine whether chest pain or related symptoms are associated with heart disease. The greatest advantage for echocardiography is not invasive (it does not involve breaking of the skin or entering the body cavity) and has no known risks or side effects.
Not only can echocardiogram make ultrasound images of the heart structure, but also can produce an accurate assessment of blood flowing through the heart with Doppler echocardiography, using pulsed or continuous-wave pulsed Doppler ultrasound. This allows the assessment of normal and abnormal blood flow through the heart. Color Doppler, as well as Doppler spectral, are used to visualize any abnormal communication between the left and right sides of the heart, any leakage of blood through the valves (valvular regurgitation), and estimate how well the valve is open (or not open in case of valvular stenosis). Doppler techniques can also be used for network movement and speed measurement, with Doppler echocardiography network.
Echocardiography is also the first subspecialty of ultrasound to use intravenous contrast. Echocardiography is performed by cardiac sonographers, cardiac physiologists (UK), or doctors trained in echocardiography.
Recognized as the "Father of Echocardiography", the Swedish physician Inge Edler (1911-2001), a graduate of Lund University, was the first of his professions to apply a heart disease diagnosis echo ultrasonic imaging technique, the Floyd Firestone acoustic physicist has been developed to detect defects in metal castings. In fact, Dr. Edler in 1953 produced the first echocardiographs using the Firestone-Sperry Ultrasonic Reflectoscope industry. In developing echocardiography, Edler worked with physicist Carl Hellmuth Hertz, the son of Nobel Prize winner Gustav Hertz and grandson of Heinrich Rudolph Hertz.
Video Echocardiography
Medical use
The health community recommends the use of echocardiography for early diagnosis when a patient's clinical status changes occur and when new data from echocardiogram will result in doctors changing patient care. The health community does not recommend routine tests when patients do not have clinical status changes or when doctors are unlikely to change care for patients based on test results.
A common example of excessive use of echocardiography when not indicated is the use of routine tests in response to a diagnosis of mild heart valve disease. In this case, the patient is often asymptomatic for many years before the onset of damage and the result of an echocardiogram will not result in a change in treatment without any other clinical status change.
Maps Echocardiography
Transtoracic echocardiogram
A standard echocardiogram is also known as a transthoracic echocardiogram, or cardiac ultrasound. In this case, echocardiography transducer (or probe) is placed on the chest wall (or thorax) of the subject, and the picture is taken through the chest wall. This is a non-invasive, highly accurate, and rapid assessment of heart health overall.
transcensophage echocardiogram
This is an alternative way of doing echocardiogram. A special probe containing an ultrasonic transducer at its end is passed into the patient's esophagus. This allows the evaluation of images and Doppler from the location just behind the heart. This is known as a transesofageal echocardiogram. Transesofageal echocardiograms are most commonly used when suboptimal transthoracic images and when clearer and more precise images are required for assessment. This test is performed in the presence of a cardiologist, registered nurse, and ultrasound technician. A conscious sedation and/or localized numb medicine can be used to make the patient more comfortable during the procedure.
Stress echocardiography
A stress echocardiogram, also known as a stress echo, uses ultrasound imaging of the heart to assess the movement of the wall in response to physical stress. First, the heart image is taken "at rest" to get the baseline of the patient's wall movement with resting heartbeat. The patient then walks on a treadmill or uses other exercise modalities to increase the heart rate to his target heartbeat, or 85% of the predicted maximum heart rate (220 - patient age). Finally, the heart image is taken "on stress" to assess the movement of the wall in the peak heart rate. A stress echo assess the movement of the heart wall; it does not, however, make a picture of the coronary arteries directly. Ischemia of one or more coronary arteries may cause abnormal motion of the wall, which may indicate coronary artery disease. The gold standard test for directly creating coronary artery images and directly assessing for stenosis or occlusion is cardiac catheterization. The stress echoes are not invasive and are performed in the presence of a licensed medical professional, such as cardiologist, and cardiac sonographer.
Three-dimensional echocardiography
Three-dimensional echocardiography (also known as four-dimensional echocardiography when moving images) is now possible, using an array matrix ultrasound probe and an appropriate processing system. This allows detailed assessment of the anatomy of cardiac pathology, especially valve defects, and cardiomyopathy. The ability to slice a virtual heart in an infinite field in an anatomically precise way and reconstruct a three dimensional image of the anatomical structure makes it unique to understand a congenital heart defect. Real-time three-dimensional echocardiography can be used to guide the location of the bioptoma during right ventricular endomyocardial biopsy, catheter-catheter-valve catheter placement, and in many other intraoperative assessments.
Three-dimensional echocardiography technology can display anatomical intelligence, or use of organ-modeling technology, to automatically identify anatomy based on generic models. All generic models refer to a collection of anatomical information that uniquely adapts to variability in the patient's anatomy to perform certain tasks. Built based on feature recognition and segmentation algorithms, this technology can provide a special three dimensional modeling of the heart and other aspects of anatomy, including brain, lung, liver, kidney, rib, and vertebral columns.
Contrast echocardiography
Contrast echocardiography, or enhanced contrast ultrasound is the addition of ultrasound contrast media, or an imaging agent, to traditional ultrasonography. The ultrasound contrast is made up of tiny microbubbles filled with gas cores and protein shells. This allows microbubbles to circulate through the cardiovascular system and restore ultrasonic waves, creating highly reflective images. There are several applications where contrast-enhanced ultrasound can be useful. The most commonly used application is in increasing LV endocardial boundaries for assessment of global and regional systolic function. Contrast can also be used to improve the visualization of wall thickening during stress echocardiography, for the assessment of LV thrombus, or for other cardiac mass assessments. Contrast echocardiography has also been used to assess the entire blood perfusion of myocardium in cases of coronary artery disease.
Accreditation
Europe
At the European level, individual accreditation and laboratories are provided by the European Association of Echocardiography (EAE). There are three subspecialties for individual accreditation: Adult Transthoracic Echocardiography ( TTE ), Adult Transesophageal Echocardiography ( TEE ) and Congenital Heart Disease Echocardiography (CHD).
English
In the UK, accreditation is regulated by the British Society of Echocardiography. Radiographers, sonographers, or other accredited professionals are required to pass the required exams.
United States
"Intersocietal Accreditation Commission for Echocardiography" (IAC) sets the standard for echo labs throughout the US. Cardiologists and sonographer who want their laboratory accredited by IAC must comply with this standard. The purpose of accreditation is to maintain quality and consistency throughout the echocardiography labs in the United States. Accreditation is offered in transthoracic and transesophageal echocardiography of adults and children, as well as adult stress and fetal echo. Accreditation is a two-part process; first each facility will conduct a detailed self-evaluation, taking into account IAC standards and Guidelines. The facility will then complete the application and submit an actual case study to the board of directors for review. After all requirements are met, the lab will receive IAC certification. IAC certification is an ongoing process and should be maintained by the facility, this may include an audit or site visit by IAC. There are some states where Medicare and/or private insurance companies require laboratory accreditation and/or sonographer for replacement echocardiograms.
There are two credentialing bodies in the United States for sonographers, Cardiovascular Credentialing International (CCI), established in 1968, and the American Registry for Diagnostic Medical Sonography (ARDMS), established in 1975. Both CCI and ARDMS have been awarded the prestigious accreditation of ANSI-ISO 17024 for the certification body of the International Organization for Standardization ( ISO ). Accreditation is provided through the American National Standards Institute (ANSI). The recognition of the ARDMS program in providing credentials has also earned ARDMS accreditation with the National Commission for Certification Bodies (NCCA). NCCA is an accreditation of the National Organization for Competency Assurance (NOCA).
Under the second sonographers the first credentialing agency must document the completion of the prerequisite requirements, which contain both didactic and experience in the field of ultrasound. Applicants must then take a comprehensive exam that demonstrates good knowledge in ultrasound physics and the clinical competencies associated with their specialty. Competent sonographers are then required to maintain competence in their fields by obtaining a number of Continuing Doctor Education credits, or CME.
In 2009, New Mexico and Oregon became the first two states to require sonographers license.
American Society of Echocardiography (ASE) is a professional organization consisting of doctors, sonographers, nurses, and scientists involved in the field of echocardiography. One of the most important rolls that ASE is playing provides their recommendations through ASE Guides and Standards, providing educational resources and opportunities for sonographers and doctors in the field.
See also
- Angiogram
- Calculate the area of ​​the aortic valve
- Electrocardiogram
- fetal echocardiography
References
External links
- American Society of Echocardiography
- British Society of Echocardiography
- An interactive learning site for 3D Echocardiography
- The International Society for Cardiovascular Ultrasound
- European Echocardiography Association
- VIRTUAL TEE - self-learning and online learning resources
- VIRTUAL Transthoracic Echocardiography - self study online and teaching resources
- Echobasics - free online echocardiography tutorial
- Algorithms and Systems for Digital and Suede Video Echocardiogram Indexing
- CT2TEE - transesofageal echocardiography simulator
- Wikiecho - Free Echocardiography encyclopedia by the European Association of Cardiovascular Imaging (EACVI)
- Basic ultrasound, echocardiography, and Doppler for doctors
Source of the article : Wikipedia
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