Echocardiography of the heart: the principle of action, possibilities and indications for the passage of the study. Which examination is better to pass - ECG or echocardiography? Heart echo examination

Modern medicine offers a wide range of diagnostic methods for any structures and organs, but do not forget that brain diagnostics is a very serious procedure, and you need to approach it with all responsibility, choosing the most reliable methods. One of these is echoencephalography. However, not every patient knows what lies behind the complex name, how such an important study is carried out, and whether it is really necessary. So what is it? Why is this method better than others? And what do you need to know about it?

The essence of the survey

This method is fundamentally not much different from the traditional ultrasound known to every patient.

Echoencephalography is based on the ability of ultrasonic waves to reflect from the tissues of the human body. The wave reflected from the middle and superficial structures is transformed into an electrical signal with the help of sensors installed on the head, is recorded by technology and fixed, depending on the equipment used, either in the form of a diagram or in the form of a two-dimensional image. Thus, it is possible to accurately investigate the structures of the brain.

Different structures, due to their density, have a different type of reflected wave, which is why the specialist manages to assess the condition of the tissues and detect possible pathologies. Any deviations from the norm of the graph or any changes in the shape in the image, of course, indicate pathological processes.

Advantages

Echoencephalography is an exceptional diagnostic method that has enough advantages to choose it among many others.

It is absolutely safe for the health and life of the patient, because, firstly, the method is non-invasive (there is no penetration into the head), and secondly, the specifics of the equipment are such that it is impossible to cause harm. There is no radiation, no contrast agent is used, allergic reactions are excluded.

This diagnostic method is completely painless and requires absolutely no additional preparation, so you can do this procedure at any time if necessary. Also, there are no special contraindications (the only exception is open wounds).

This examination accurately and reliably detects a significant number of anomalies, which makes it an advantage in the examination of the brain. It is also worth noting that ECHO EG may well replace MRI and CT (unless, of course, we are talking about the diagnosis of extremely rare pathologies).

ECHO EG examination of the brain

Also, echoencephalography is a fairly affordable method of examination, both from a financial point of view, and in terms of the ability to do it in almost any clinic. The diagnostic equipment is quite compact, so in extreme cases it is even possible to call a specialist at home, and in an emergency you can call an ambulance, because specialists will definitely have a device.

Due to these advantages, this method is suitable for both adult and pediatric head examinations; there are no differences in either the research methodology, the results, or anything else.

Why do?

Echoencephalography provides very wide diagnostic possibilities, so it is difficult to underestimate its importance.

With its help, you can explore various structures of the brain, periosseous space, median pulsations (which is very important when measuring intracranial pressure). This method of research tells quite accurately how the brain structures function, whether there are dangerous pathologies, neoplasms (which is very dangerous), whether intracranial pressure is increased.

echoencephaloscopy

Due to its significant advantages, such an examination is used independently, since it is really very informative and reliable, but in severe pathologies, ECHO EG is also used as a preliminary research method before performing computed or magnetic resonance imaging.

Also, this diagnostic method is often used as an additional control over the ongoing treatment, already appointed by a specialist based on the results of previous studies.

Procedure

The diagnosis itself is carried out quite simply, without causing any discomfort and difficulties for patients.

The patient needs to lie on the couch on his back, relax, but at the same time remain in a motionless position. The specialist applies a special gel to the scalp where the sensors are installed, which improves conductivity, and then attaches the sensors accordingly. During the examination, if circumstances so require, the diagnostician can move the sensors to the desired position.

The procedure does not cause discomfort and takes an average of about 15 minutes.

During the study, an echogram is obtained, which the specialist then deciphers, interprets the results and makes a preliminary diagnosis.

At the end, the patient always receives a transcript with a diagnosis based on the results and an echogram.

Indications

In fact, there is a fairly wide list of indications for such an examination. This is due to the fact that any suspicions of brain pathology and alarming symptoms must certainly be checked by equipment, since the consequences can be extremely serious.

Typically, indications include the following:

Dizziness.
Nausea (often attacks and does not depend on meals).
Shake.
Increasing headaches.
Impaired coordination of movements.
Injuries and bruises of the head of any severity.
Noises in the ears.
Epilepsy.
Nervous tics.
Violation of vision.
Restless sleep (or even insomnia).
Sudden deterioration of memory.
Seizures.
Loss of consciousness.
Inability to concentrate.
Monitoring the effectiveness of already prescribed treatment.

Indicators

When assessing the state of the head structures, a specialist diagnostician always relies on certain indicators and their norms. These include the following:

M-echo (should take a position clearly in the middle, not be expanded and split, the ripple should not exceed 30%, the same number of symmetrical signals must be between the initial complex and the final signal).
The index of the medial wall (normally no more than 5).
Index of the III ventricle (within 22-25).

Pathologies

ECHO EG of the brain is a fairly informative diagnostic method and makes it possible to detect a fairly wide range of anomalies, which is extremely important for further treatment and more accurate diagnosis.

Most often, specialists diagnose the following pathologies:

Intracranial hematomas (occurs due to ruptures of blood vessels, are expressed in hemorrhage, compress tissues; differ in different localization).
Brain abscess (accumulation of purulent masses, most often due to infections).
Damage to brain tissue of varying degrees and localization.
Benign neoplasms.
VVD (vegetovascular dystonia).
Malignant tumors (equipment shows significant deviations of the M-echo).
Hydrocephalus (an anomaly caused by an abnormal accumulation of fluid in the cerebral ventricles, the more common name is dropsy).
Cysts (hollow neoplasms filled with fluid).
Circulatory disorders
Oxygen starvation.
Concussion.
Increased intracranial pressure.
Atherosclerosis (deposition of cholesterol on the vascular walls, difficulty in blood circulation, it is possible to create peculiar blood clots).
Stroke (acute pathology of cerebral circulation, can be expressed as a cerebral infarction or hemorrhage).

What's next?

For some reason, some patients tend to believe that the conclusion of ES is already a sufficient reason for prescribing self-treatment, but this is certainly a big mistake.

The specialist diagnostician, of course, accurately deciphers the echogram, but the conclusion made on the basis of the results of the examination still includes only a preliminary diagnosis. A more accurate diagnosis can only be made by the attending physician, who has a medical history, the results of other studies. You also need to take into account the fact that additional diagnostic methods and tests may be needed.

Thus, in no case should we forget that after ES, with its results, you need to contact your doctor, but definitely not draw up a treatment regimen for yourself.

As follows from the above, echoencephalography is a fairly reliable, informative, safe and certainly affordable method for studying the brain. There are no obstacles to its implementation, and therefore, in the presence of specific indications, it is worth giving preference to this particular diagnostic method.

The method of examination of the heart under consideration is based on the use of ultrasonic waves that cannot be heard or seen. After emitting these vibrations, they are recorded by means of a sensor that is applied to the body. All signals are processed by a special device - an echocardiograph. During the ultrasound of the heart, a picture appears on the screen, which displays the cardiac structures.

Main indications for cardiac echocardiography

Being a safe procedure that can timely identify and eliminate a number of serious diseases, ECHO KG is prescribed for adults in such cases:

Chest x-ray confirms the presence of pathologies: non-standard size / shape of the heart, vessels that supply the heart with blood.
In the process of listening to the heart, murmurs were detected.
There are complaints of regular dizziness.
Fainting.
Pain in the chest area.
There is a regular slight increase in body temperature.

Additional symptoms that could suggest the presence of colds are absent:

When diagnosing cardiomyopathy: to confirm the diagnosis, clarify the type of disease.
The results show deviations.
There are malfunctions in the work of the heart, which affect the lifestyle of the patient.
There is a suspicion of a tumor in the heart.
If the patient has angina pectoris. of the heart will help to find out the cause of this pathology, to investigate the work of the left ventricle.
After myocardial infarction.

The patient has a history of recent myocardial infarction.
Blood pressure is above normal.
Any of the close relatives had a heart defect.
The person is busy with active, extreme sports.
Work activity involves staying in stressful situations.

The procedure in question can be performed on small patients at any age, starting from the prenatal period. The factors, guided by which, the doctor prescribes an ECHO KG to a child are the same as in adults.

In order to detect heart defects in the fetus, pregnant women need to undergo echocardiography if:

The mother-to-be has diabetes.
In the early stages (1-11 weeks), the pregnant woman drank antibiotics / antiepileptic drugs.
There was a miscarriage in a previous pregnancy.
Among the relatives of the pregnant woman there are those who have.
During the period of gestation, the woman had been ill with rubella.

How is the procedure carried out with modern research methods?

Through this examination, it is possible to examine the speed of movement, the direction of blood in the heart and the vessels that depart from it. Measuring the speed of movement of blood will make it possible to determine the degree of narrowing of the radius of the vessels through which blood is driven.

There are several methods for performing ECHO KG:

Standard procedure. It can be prescribed to all patients, regardless of age, health status. The day before the procedure, you should stop taking energy drinks. Those who suffer from tachycardia, hypertension should consult a cardiologist before starting an ECHO KG. The doctor must decide on the need to lower the pressure / pulse before starting the examination. Such measures will help to interpret the results as accurately as possible.

The algorithm for performing ECHO KG provides for the position of the patient on the back / on the side. The echocardiograph probe is placed at various points on the axes of the heart throughout the procedure. . This helps to accurately study the structure of the heart, its work, to identify existing anomalies.

With a standard ECHO KG, the sensor is alternately installed in the following areas:

Near the jugular cavity, above the sternum.
Near the 5th intercostal space, which is to the left of the sternum. This is where heartbeats are felt.
In the area where the sternum ends.

Transesophageal echocardiography of the heart. This procedure is assigned if:

An operation is planned to implant an artificial valve.
Before starting electrical impulse stimulation.
The doctor suggests a violation of the structure of the septum, which is between the atria.
The patient has pathologies associated with the chest wall, which interfere with the standard ECHO CG.
Doctors suspect the patient has infective endocarditis.

It is unacceptable to refer to the indicated type of ECHO KG if the patient has been diagnosed with errors in the work of the esophagus in the past / at the time of the procedure: bleeding, tumors, frequent vomiting, perforation of the walls of the esophagus.

Algorithm for performing transesophageal ECHO KG:

A few hours before the start of the procedure (4-5), you should refrain from food and water.
In order to relieve pain, the patient's oropharynx is irrigated with painkillers.
The patient should lie on his left side, after which the doctor inserts an endoscope through the mouth into the esophagus.
Ultrasound waves are received/received through the endoscope.

Transesophageal ECHO KG often takes no more than 20 minutes.

Stress-ECHO KG

The decision on the importance of this procedure should be made by the cardiologist, taking into account the patient's health status. Stress ECHO KG helps to identify errors in the work of the heart, which will not manifest themselves at rest.

It is unacceptable to prescribe stress-ECHO KG:

Those who survived acute myocardial infarction - the first 30 days.
If the patient has a history of a tendency to form blood clots.
With heart, kidney, liver failure.
There are pathologies of the respiratory system.

The procedure itself should take place under the supervision of an experienced specialist.

The sequence of performing Stress-ECHO KG:

A standard ultrasound procedure is performed;
The patient is put on sensors on the body, which contribute to fixing changes at the time of physical activity;
A person who is being examined is given a certain physical activity. It can be a variety of simulators, exercises on which it is possible to carry out sitting / lying down. The strength of the load on such simulators is set taking into account the indicators of blood pressure, the patient's pulse.

Interpretation of cardiac echocardiography data

Through this type of survey, you can evaluate:

Parameters of the cavities of the heart.
The degree of modification of the walls.
Quality of contraction, pumping capacity of the left ventricle.
Valve performance.
Myocardial contractility.
The nature of the passage of blood through the large vessels of the heart, valves.
The presence / absence of scars, blood clots, tumors, their parameters, the impact on the ability of the walls.

Norm ECHO KG of the heart:

Echocardiography is a non-invasive examination using ultrasound waves. An echocardiographic study is performed using a transducer that produces sound waves that pass into the same transducer. Information is transferred to a computer and displayed as an image on its monitor.

Ultrasound of the heart is a completely painless procedure

Echocardiography or ultrasound of the heart allows you to determine and evaluate the following parameters:

the structure of the heart and its size;
the integrity of the walls of the heart and their thickness;
the size of the atria and ventricles;
contractility of the heart muscle;
valve operation;
condition of the pulmonary artery and aorta;
heart circulation;
condition of the pericardium.

Echocardiography is carried out in relation to all categories of patients suffering from diseases of the cardiovascular system. In addition, such a study is used for diagnostic purposes for the primary detection of cardiac disorders.

The procedure has many advantages that allow us to call it the main method for detecting the condition of the heart and its diseases. This is a painless and extremely informative diagnostic method, which is also distinguished by efficiency and safety.

During the Echo KG, cardiologists analyze the indicators of muscle contraction, and then make a timely conclusion. The advantage of the method is that during the diagnosis, all indicators are displayed by an ultrasound device so accurately that an experienced cardiologist can suspect the development of heart and vascular disease at an early stage.

Echocardiography, abbreviated as EchoCG, is a method of examining the heart based on ultrasound scanning of the chest cavity. Using this method, the diagnosis of various diseases of the "engine" of the body is carried out.

This research method makes it possible to assess the overall dimensions of both the heart itself and its individual structures (ventricles, septa), the thickness of the myocardium of the ventricles, atria. Echocardiography can also determine heart mass, ejection fraction and other parameters.

Another name for this diagnostic method that people hear more often is ultrasound, that is, ultrasound.

Differences between ECG and echocardiography

The first abbreviation stands for electrocardiography.

EchoCG means nothing more than echocardiography. What is this procedure in and how does it differ from the first? In another way, it is also called an ultrasound of the heart. The differences are:

Types of ECHO-KG

Most often, an ultrasound of the heart is done through the chest, this method is called "transthoracic echocardiography". Depending on the method of obtaining information, transthoracic echocardiography is divided into one-dimensional and two-dimensional.

With a one-dimensional study, the data obtained are displayed on the monitor of the device in the form of a graph. Such a study provides accurate information about the size of the ventricles and atria, in addition, the functioning of the ventricles and valves themselves is assessed.

In a two-dimensional study, the transformed information is presented as a gray-white image of the heart. This type of study gives a clear visualization of the work of the organ and allows you to quite clearly determine its size, the volume of the chambers and the thickness of the walls of the organ.

There is also such a study of the activity of the cardiac system as Doppler echocardiography. With the help of this study, the features of the blood supply to a vital organ are determined.

In particular, during the procedure, the doctor can observe the movement of blood in its various sections and vessels. Normally, the blood should move in one direction, but if there is a malfunction of the valves, then the reverse flow of blood can be observed.

In addition to revealing this fact, its severity and speed are determined. Doppler study is prescribed in combination with one-dimensional or two-dimensional echocardiography.

In addition, there are other methods of examining the heart:

If a clear visualization of the internal structure of the heart is necessary, then a study with a contrast agent is done - this is contrast echocardiography.
If the purpose of echocardiography is to reveal hidden pathologies of the heart, then the examination should be carried out during physical exertion, since at rest the symptoms of disorders may not appear. Such a study is called "stress echocardiography" or stress echocardiography.
Ultrasound of the heart can be performed through the esophagus and throat - transesophageal echocardiography or PE-EchoCG.

Transesophageal echocardiography is another highly informative diagnostic method for examining the heart.

When you figured out the echocardiography of the heart: what it is, it remains to understand the types of research.

And there are three of them.

The first is a one-dimensional echocardiography in M-mode.

The second type refers to a two-dimensional procedure. There is also a Doppler Echo KG method.

How do ultrasonic waves behave in M-mode? The sensor feeds them only along one axis, which allows the doctor to check the heart, thanks to the “top view” image. In addition, M-mode echocardiography reveals the state of the left ventricle and the aorta, which exits from it and supplies all organs with blood and oxygen.

The two-dimensional method allows you to check the condition of the heart in two planes. This type of Echo KG is necessary for the analysis of the movement of the components of the organ.

The blood flow velocity is determined using a Doppler study. As a result of this diagnosis, it is possible to check the filling of the left ventricle.

When the Echo KG is done, the cardiologist can only describe the result in the protocol. In other words, a decryption of the procedure is required.

It is difficult for the patient to independently understand the indicators and determine whether everything is normal, but it is necessary to have a general idea. Medical interpretation involves entering into the protocol mandatory indicators that display the parameters of the right and left ventricles, the partitions between them, the state of the pericardium, and the valves of the organ.

The indicators that determine the functioning of the ventricles are the main ones. The state of the left is determined by parameters such as myocardial mass, myocardial mass index, volume and size of the ventricle when it is at rest, as well as its size during contractions.

Also indicators are the wall thickness of the organ during its work, but not at the time of contraction. The state of the left ventricle is also determined by the ejection fraction, that is, the volume of blood that the heart ejects with each contraction.

It must be at least 55%. If the indicator is less than normal, a cardiologist can diagnose heart failure.

During the echocardiography, a study of the right ventricle is also performed. The doctor looks at its wall thickness, size index and size at rest.

After the Echo KG, the cardiologist must also decipher the result of the norms of the heart valves and pericardium. If the indicators deviate from the norm, this indicates heart failure or stenosis.

During the procedure, the doctor may find that the valve has decreased in diameter. This makes the process of pumping blood for the whole body more laborious. If the opening is insufficient, the valve does not cope with its function, so the blood flow moves with a return.

During echocardiography, the cardiologist can check if the patient has pericarditis. In this case, adhesions form on the heart at the junction of the organ with the pericardial sac. Also, a large amount of fluid can accumulate in the heart, which will make it difficult to work.

Echocardiography in mobile M-mode

There are the following types of echocardiograms, most of which are carried out through the chest.

one-dimensional

This method is rarely used alone. During the study, a graph appears on the screen with a record from the examined parts of the heart. With its help, the size of the cameras and their functionality are accurately determined.

2D

An image of the heart is generated on the computer monitor, this screen displays the contraction and relaxation of the heart muscle and valves. Echocardiography allows you to determine the exact size of the heart and its chambers, their mobility and contractility.

Doppler echocardiography

This study is often combined with a two-dimensional ultrasound. This method allows you to monitor blood flow in the chambers of the heart and large vessels.

In a healthy person, the blood moves in one direction, but if the functionality of the valves is disturbed, regurgitation (reverse blood flow) is observed. On the screen, the movement of blood is shown in red and blue.

If reverse blood flow is present, then the cardiologist studies the following indicators: the speed of direct and reverse blood flow, the diameter of the lumen.

Contrasting

This study allows you to clearly visualize the internal structure of the heart. A contrast composition is injected into the patient's bloodstream and examined according to the standard method.

Stress echocardiography is a combination of two-dimensional echocardiography and physical activity. This way you can detect heart disease at an early stage.

Indications for stress-ECHO-KG:

suspected ischemia;
to evaluate the effectiveness of ischemia therapy;
to identify the prognosis of coronary disease;
to assess the patency of blood vessels;
to determine the risk of complications before heart or vascular surgery.

This method of research is contraindicated in liver or kidney dysfunction, protrusion of the aortic wall or infarction.

transesophageal

This type of ultrasound is carried out through the esophagus, while the sensor that emits ultrasound is lowered down the digestive tube. Transesophageal ECHO KG is prescribed for suspected dysfunction of the prosthetic valve, the presence of a blood clot in the heart, protrusion of the aortic wall, etc.

The choice of diagnostic method depends on the patient's condition and age.

Research in relation to pregnant women

A safe and versatile method for diagnosing heart problems is called echocardiography. What does it mean? Only one thing - it can be carried out in relation to all categories of the population, both adults and children.

This study is even assigned to pregnant women. And it is done in order to detect cardiac pathology in the fetus and take the necessary measures in order to save the baby.

Echocardiography is absolutely harmless for both mother and baby.

- If the woman in labor had heart defects in her family.

- Previous pregnancy ended in miscarriage.

- If a woman has diabetes.

- During pregnancy, the expectant mother had rubella.

- If the woman took antibiotics or antiepileptic drugs in the 1st or 2nd trimester.

Contraindications

Having an idea of what EchoCG is, we can say with confidence that absolutely everyone can undergo this study. However, given its high cost, this method should be carried out with strict indications and recommendations from a specialist cardiologist.

Doctors will definitely refer the patient to undergo an echocardiogram of the heart if the following symptoms were revealed during the examination:

Pain in the region of the heart or in the chest.
Auscultated heart murmurs and arrhythmias.
Chronic ischemia or acute myocardial infarction.
Signs indicating heart failure (swelling of the legs or enlarged liver).
Shortness of breath, fatigue, lack of air, frequent blanching of the skin, cyanosis around the ears, lips, arms or legs.

— If the cardiologist detects a heart murmur.

- There are changes on the ECG.

- If a person feels interruptions in the work of the heart.

- The patient has a fever, which is not a sign of SARS, problems with the throat, nose, ears or kidneys.

- According to the results of the radiograph, an increase in the size of the heart or a change in its shape, the location of large vessels is visible.

- Patients with high blood pressure.

- Those patients who had heart defects in their family.

- When a person complains of pain in the left side of the chest.

- With shortness of breath, swelling of the limbs.

- With fainting.

- In the event that a person is often disturbed by dizziness.

- If there is a suspicion of a heart tumor.

- With angina pectoris.

- After a heart attack, etc.

Echocardiographic diagnostics is necessary for people who already suffer from heart and vascular diseases or are at the stage of their detection.

This procedure is prescribed in the following cases:

Arterial hypertension.
Suspicion of congenital or acquired malformations (for example, to detect abnormal pulmonary venous drainage).
risk of birth defects.
Frequent dizziness and loss of consciousness.
Respiratory disorders, edema.
Frequent fading or interruptions in the work of the body.
Pain behind the sternum, which radiates to the left side of the body (arm, shoulder blade, part of the neck).
Postinfarction period (to assess myocardial contractility).
Angina pectoris (to assess ventricular contractility).
If you suspect the presence of neoplasms in the heart.
True or pseudoaneurysm of the heart.
Cardiomyopathy (to identify a variety of the disease).
Pericarditis (to determine the volume of fluid).
With excessive psycho-emotional or physical stress.

An echocardiogram is necessary if changes are found on the ECG or the radiograph shows a violation of the structure of the heart (the shape, size, location, etc. has changed).

It is important for pregnant women to conduct an ECHO of the heart in the following diseases and conditions:

Diabetes.
The woman is at risk for heart defects.
The expectant mother had been ill with rubella during the gestation of the fetus.
Reception of antibacterial or antiepileptic medicines up to 13 weeks.
Previous pregnancies ended in miscarriage or the baby was born prematurely.

This study is carried out even to the embryo, which is in the womb. The procedure is prescribed from 18 to 22 weeks, it is necessary to identify organ defects.

The cost of the procedure

Estimated cost for echokg is in a fairly wide range - 1400-4000 rubles. At the same time, the price for echocardiography depends on the qualifications and reputation of the specialists conducting the study, as well as the level and location of the medical institution.

After all, the decoding of the information received is available only to qualified specialists who, on its basis, can make the correct diagnosis and prescribe adequate treatment. Attempts to figure it out on your own will almost certainly lead to erroneous conclusions and incorrectly chosen treatment tactics.

To date, one of the main methods for diagnosing heart diseases is echocardiography (EchoCG). This is a non-invasive study that does not have a negative effect on the body, and therefore can be performed on patients of all age categories, including children from birth.

This article will discuss what echocardiography is, why it is performed, what types of this procedure exist, what can become a contraindication to its implementation, and how to prepare for it.

The essence and purpose of echocardiography

Echocardiography or EchoCG is a non-invasive method of examining the heart using ultrasound. The echocardiograph sensor emits a special high-frequency sound that passes through the tissues of the heart, reflects from them, and then is recorded by the same sensor. The information is transmitted to a computer, which processes the received data and displays them on the monitor in the form of an image.

Echocardiography is considered a highly informative research method, since it makes it possible to assess the morphological and functional state of the heart. Using this procedure, it is possible to determine the size of the heart and the thickness of the myocardium, check their integrity and structure, determine the size of the cavities of the ventricles and atria, find out if the contractility of the heart muscle is normal, learn about the state of the valvular apparatus of the heart, examine the aorta and pulmonary artery. Also, this procedure allows you to check the level of pressure in the structures of the heart, find out the direction and speed of blood movement in the heart chambers and find out what condition the outer shell of the heart muscle is in.

This cardiological examination allows diagnosing both congenital and acquired heart defects, finding out about the presence of free fluid in the heart sac, detecting blood clots, changing the size of the chambers, thickening or thinning of their walls, detecting tumors and any disturbances in the direction and speed of blood flow.

Benefits of echocardiography

Echocardiography has a number of advantages over other types of cardiac examinations.

First of all, it is an absolutely painless and non-invasive procedure that does not cause any discomfort to the patient. It is carried out like a conventional ultrasound. No injections or any other similar manipulations are carried out before the procedure.

In addition, the procedure is completely safe for patients of any age group. It can be performed on children, adolescents, and pregnant women, since ultrasound does not have any negative effect on the fetus.

EchoCG is affordable, since the equipment for its implementation is present in almost any medical institution. The cost of echocardiography is much lower compared to MRI.

And the most important advantage of this type of examination is its excellent information content, which will allow the doctor to get the maximum necessary information and choose the right therapy.

Indications and contraindications for echocardiography

Indications for echocardiography are:

Hypertension.
Suspicion of the presence of congenital or acquired heart disease, including with a hereditary predisposition to this disease.
Frequent dizziness, fainting, shortness of breath and swelling.
Complaints about a "fading" heart, about "interruptions" in his work.
Pain behind the sternum, especially if they radiate to the region of the left shoulder blade or the left half of the neck.
Myocardial infarction, diagnosis of angina pectoris and cardiomyopathy, suspicion of a heart tumor.
Preventive examination of patients who often experience emotional and physical overload.
Changes on the ECG and chest x-ray, requiring clarification of the morphological changes in the heart.

Separately, it is worth mentioning in which cases echocardiography is recommended for expectant mothers. Pregnant women should have an echocardiogram if:

The expectant mother has pain in the precordial region.
The patient has congenital or acquired heart defects.
Weight gain has stopped or there has been a sudden weight loss.
There were unmotivated edema of the lower extremities and shortness of breath with a slight load of an antiepileptic nature.
Violation of hemodynamics during pregnancy.

It should be noted that there are practically no absolute contraindications to echocardiography. At the same time, certain types of this study are not recommended in certain situations, which will be discussed below.

Types of echocardiography

To date, there are several types of echocardiography. What specific type of research to conduct, in each case, decides.

one-dimensional

At the moment, this type of echocardiography is rarely used on its own, because it is considered less informative than others. During the procedure, no image of the heart is generated. The data is displayed on the screen as a graph. With the help of M-echocardiography, the doctor can measure the volume of the heart cavities and evaluate their functional activity.

B-echocardiography (two-dimensional)

During B-echocardiography, data from all heart structures are entered into a computer and displayed on a monitor in the form of a black-and-white image. The doctor is able to determine the size of the heart, find out the volume of each of its chambers, the thickness of the walls, assess the mobility of the valve leaflets and how the ventricles contract.

Doppler echocardiography

As a rule, this study is carried out simultaneously with B-echocardiography. It allows you to track the blood flow in large vessels, and on the valves of the heart, to identify reverse blood flow and its degree, which may indicate the formation of pathological processes.

Contrast echocardiography

This study makes it possible to more clearly visualize the internal structures of the heart. The patient is injected intravenously with a special contrast agent, after which the procedure is carried out as usual. This procedure allows you to examine the inner surface of the chambers of the heart. Contraindications for this study are individual intolerance to contrast and chronic renal failure.

Stress echocardiography

To diagnose hidden pathologies of the heart, which manifest themselves exclusively during physical exertion, a special type of study is used - stress echocardiography. It makes it possible to identify diseases in the early stages that do not remind of themselves if the patient is at rest.

Conducting stress echocardiography is recommended to assess the condition of the vessels and their patency, to find out how high the risk of complications is before performing surgical interventions on the heart and blood vessels. Also, the procedure is carried out in order to determine how effective the therapy of coronary heart disease is and to determine the further prognosis for this disease.

There are several contraindications for stress echocardiography. It should not be performed on patients suffering from severe respiratory, renal, hepatic or cardiac insufficiency. It is also contraindicated in myocardial infarction, aortic aneurysm and a history of thromboembolism.

Transesophageal echocardiography

This is a special type of study, during which an ultrasound-generating probe is lowered through the oropharynx along the esophagus to the required depth. Since the sensor has very small dimensions, it passes through the esophagus without problems. However, such a study is considered quite complex and is carried out exclusively in specialized medical centers. In addition, there are special indications for it. In particular, a transesophageal study is performed when a standard transthoracic study does not allow assessing the condition of the heart and its structures. In particular, when there are doubts about the correct functioning of a previously prosthetic heart valve, if aortic aneurysm and atrial septal defect are suspected, and also if the patient has been diagnosed with infectious endocarditis and the doctor suspects an aortic root abscess.

At the same time, this type of study has contraindications from the side of the upper digestive tract, namely, in case of any tumor formations of the esophagus, bleeding from the upper gastrointestinal tract, the presence of a large diaphragmatic hernia, or dilated veins of the esophagus. A transesophageal examination should not be performed in patients with severe osteochondrosis of the cervical spine, with instability of the cervical vertebrae, and a history of perforation of the esophagus. Diagnosis can be difficult in patients with thyroid disease.

Preparation for echo-CG

As a rule, when performing one- and two-dimensional echocardiography, as well as Doppler echocardiography, there is no need for any special preparation. In the event that a transesophageal study is prescribed, there are a number of restrictions.

So, the last meal should be no later than six hours before the procedure. Drinking is also not recommended. Immediately before the manipulation, dentures should be removed.

On the eve of the transesophageal examination, persons with a labile nervous system are advised to take a mild sedative. After the procedure, the patient will need some time to recover, so you should not overload yourself with work until the end of the day. You must also refrain from driving.

Research methodology

For transthoracic echocardiography, the patient is positioned on the left side. When a person lies in this position, there is a convergence of the top of the heart and the left side of the chest. This makes it possible to provide the most accurate visualization of the heart - as a result, all four of its chambers are visible on the monitor at once.

The doctor applies a gel to the sensor, which improves the contact of the electrode with the body. After that, the sensor is alternately installed first in the jugular fossa, then in the area of the fifth intercostal space, where it is possible to control the apex beat of the heart as clearly as possible, and then under the xiphoid process.

Of course, every doctor strives to ensure that the results of the study are as accurate as possible. It should be noted that how informative the procedure will be depends on three main factors.

First of all, the anatomical features of the patient should be taken into account. Serious obstacles to ultrasound are obesity, chest deformity and other similar factors. As a result, the resulting image may turn out to be fuzzy and it will not be possible to interpret it properly. In order to clarify the diagnosis, doctors in such cases offer a transesophageal examination or MRI.

The quality of the equipment should also be taken into account. Of course, more modern equipment will give the doctor more opportunities to get enough information about the patient's heart.

Finally, the competence of the person conducting the survey should be taken into account. At the same time, not only his technical skills are important (the ability to position the patient in the correct position and place the sensor at the right point), but also the ability to analyze the data received.

When conducting stress echocardiography, the patient is first given a regular echocardiogram, and then special sensors are applied that record indicators during physical activity. For this purpose, bicycle ergometers, treadmill test, transesophageal electrical stimulation or medications are used. At the same time, the initial load is minimal, and then it is gradually increased, controlling blood pressure and heart rate. If the patient's condition worsens, the examination is terminated.

All this time, an electrocardiogram is continuously carried out, which makes it possible to quickly respond in the event of any extreme situations. During the load, the patient may feel dizzy, increased heart rate, discomfort in the heart. After the cessation of the load, the pulse slows down. Sometimes, in order for the work of the heart to completely normalize, it is necessary to introduce other medications. In this case, the patient's condition is carefully monitored until full recovery.

As a rule, the whole procedure lasts about an hour.

Conducting a transesophageal echocardiography begins with irrigation of the patient's oral cavity and pharynx with a solution of lidocaine. This is intended to reduce the gag reflex during endoscope insertion. After that, the patient is asked to lie on his left side, a mouthpiece is inserted into his mouth and an endoscope is inserted through which ultrasound will be received and delivered.

Deciphering the results

The doctor who conducted the study deciphers the results of echocardiography. He either transfers the received data to the attending physician, or gives directly to the patient.

It should be borne in mind that a diagnosis cannot be made based solely on the result of echocardiography. The data obtained are compared with other information available to the attending physician: data from analyzes and other laboratory tests, as well as the patient's clinical symptoms. It is impossible to consider echocardiography as a completely independent diagnostic method.

Where to do echocardiography

Standard echocardiography is carried out both in public medical institutions (clinics and hospitals) and in private medical centers. To make an appointment for an examination, you must provide a referral from your doctor or cardiologist.

More specific types of echocardiography - transesophageal examination or stress echocardiography - can only be done in specialized medical institutions, since they require special equipment and personnel who have received special training.

Echocardiography in children

As noted above, the indisputable advantages of echocardiography are non-invasiveness, painlessness and complete safety of this technique of cardiological examination. Manipulation is not associated with radiation exposure, does not provoke any complications. Therefore, if there are appropriate indications, the study can be recommended not only for adults, but also for children.

Diagnosis will help to timely detect congenital pathology in young children, which, in turn, will make it possible to choose the most effective treatment. As a result, the child will be able to lead an absolutely full life in the future.

Indications for echocardiography in a child are:

Noises in the heart.
Shortness of breath, either on exertion or at rest.
Cyanosis of lips, nasolabial triangle zone, fingertips.
Decreased or complete lack of appetite, too slow weight gain.
Complaints of constant weakness and fatigue, sudden fainting.
Complaints of frequent headache.
Discomfort in the chest.
Decrease or increase in blood pressure.
The appearance of edema on the limbs.

Taking into account the fact that the method is safe, it is possible to conduct echocardiography in babies more than once in order to track the development of the disease or evaluate how effective the treatment is. In the event that any pathological changes have been identified, a study is carried out at least once every twelve months.

Preparing and conducting the procedure for children

Like adult patients, children do not need any prior preparation. It is desirable that the child does not eat anything for three hours before the study, because with a full stomach, a high standing of the diaphragm is observed, which can distort the result.

Parents should take with them the results of the electrocardiogram made the day before, as well as the results of studies that were carried out earlier. Without fail, the baby should be psychologically prepared for the procedure, explaining that no one is going to hurt him.

In order to carry out the procedure, the baby is undressed to the waist and laid on the left side on the couch. After moving the sensor along the chest, the doctor examines the resulting image.

Fetal echocardiography

There are models of echocardiographs that can be used to examine the fetus in the uterus. In this case, neither the mother nor the unborn child will be harmed.

As a rule, a fetal echocardiogram (prenatal or fetal echocardiography) is performed between 18 and 22 weeks of pregnancy. Its main goal is the timely detection of congenital heart disease in the fetus. The study makes it possible to check the intracardiac blood flow of a child in the mother's womb and provide dynamic monitoring until the child is born. As a result, it can plan the delivery, and cardiologists get the opportunity to start treating the child immediately after birth.

Fetal echocardiography is performed if close relatives of the patient have a congenital heart disease, some diseases of a pregnant woman in which the likelihood of congenital malformations in the fetus increases (diabetes mellitus, systemic connective tissue diseases, epilepsy). For prophylactic purposes, fetal echocardiography is performed if the mother took antibiotics or anticonvulsants in the first trimester. Diagnosis is also carried out, with the age of the mother over 35 years. Also an indication is the deviations detected during an ultrasound examination for a period of twenty weeks.