Echocardiography (Echo, Heart Sonogram, Heart Ultrasonogram)

Norm of Echocardiography (Echo, Heart Sonogram, Heart Ultrasonogram)

No abnormalities.

 

Usage of Echocardiography (Echo, Heart Sonogram, Heart Ultrasonogram)

Atrial septal defect, aortic stenosis or regurgitation, atrial tumors, bradycardia, cardiac tamponade, cardiomyopathy, congenital heart disease, effusion (pericardial), embolization of artery, endocarditis, idiopathic hypertrophic subaortic stenosis, lymphoma metastasis, Marfan syndrome, mitral regurgitation or stenosis, mitral valve prolapse, myocardial infarction post evaluation for wall-motion abnormalities, myocarditis, panic disorder, patent ductus arteriosus, pericarditis, subacute bacterial endocarditis (SBE), transposition of the great arteries, tricuspid atresia, ventricular septal defect, and other cardiac defects.

 

Description of Echocardiography (Echo, Heart Sonogram, Heart Ultrasonogram)

Echocardiography is a noninvasive, acoustic imaging procedure that determines the size, shape, position, thickness, and movements of the heart valves, walls, and chambers during each cardiac cycle. It records the echoes created by the deflection of short pulses of an ultrasonic beam off the cardiac structures onto an oscilloscope. The time required for the ultrasonic beam to be reflected back to the transducer from differing densities of tissue is converted by a computer to an electrical impulse displayed on an oscilloscopic screen to create a two-dimensional picture of the heart in different projections. The resolution of the oscilloscope recording obtained is determined by the frequency of the beam. Lower frequencies penetrate further but provide less resolution than higher frequencies. Echocardiography can also be performed transesophageally (TEE) with the transmitter inserted into the esophagus similar to an endoscope. This gives a clearer view of the valves and endocardium, especially in the presence of obesity or severe chronic obstructive pulmonary disease (COPD).

 

Professional Considerations of Echocardiography (Echo, Heart Sonogram, Heart Ultrasonogram)

Consent form NOT required.
Preparation

1. The client should disrobe above the waist or wear a gown.

 

Procedure

1. With the client in a supine or recumbent position, conductive gel is placed over the third and fourth intercostal spaces to the left of the sternum.
2. A transducer is angled directly over the intercostal spaces or beneath the xiphoid process to direct ultrasonic waves that are displayed on the oscilloscopic machine and printed in the M (motion) mode on a recorder.
3. The client may also be placed on the left side to obtain a different view of the heart and may occasionally be asked to perform certain maneuvers or to inhale amyl nitrite (a gas with a slightly sweet odor) to record changes in heart function.
4. For a transesophageal echocardiogram, the throat is anesthetized with spray, and the transducer is passed orally into the esophagus. (See Transesophageal ultrasonography for more information.)

 

Postprocedure Care

1. Remove the conductive gel from the skin.
2. For a transesophageal echocardiogram, oral fluids must be held until the local anesthetic is no longer in effect and the gag reflex has returned.

 

Client and Family Teaching

1. The procedure takes 30–60 minutes, can be performed at the bedside, and is painless.
2. Remain as still as possible.
3. Results are normally available within 24 hours.

 

Factors That Affect Results

1. Thick chests, COPD, obesity, chest wall abnormalities or scar tissue, or dressings may alter the display of ultrasonic waves on the recorder.
2. Better resolution can be obtained for children than for adults because their thinner, less dense chest wall enables use of a higher-frequency, shorter-wavelength sound.
3. Improper placement of the transducer.

 

Other Data

1. Very sensitive test in detecting pericardial effusion.
2. Side effects of amyl nitrite, which has a short duration of action, are dizziness, flushing, and tachycardia.
3. See also Stress test, Pharmacologic; Transesophageal ultrasonography.