To date, one of the main methods for diagnosing heart disease is echocardiography (ECCG). This is a non-invasive study that does not have a negative impact on the body, and therefore may be carried out by patients of all age categories, including children from birth.
What is an echocardiography, for which it is carried out, which types of this procedure exist, which can be a contraindication to its holding and how it is necessary to prepare for it, it will be discussed in this article.
Essence and purpose of echocardiography
Echocardiography or ECCG is a non-invasive method of heart survey using ultrasound. The echocardiograph sensor emits a special high-frequency sound that passes through the fabric of the heart, reflected from them, after which is recorded by the same sensor. Information is transmitted to the computer that processes the data obtained and displays them to the monitor as 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. With this procedure, it is possible to determine the dimensions of the heart and the thickness of the myocardium, check their integrity and structure, determine the size of the cavities of the ventricles and the atria, find out whether the reduction of the heart muscle corresponds to the norm, to learn about the state of the valve apparatus of the heart, examine the aorta and the 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 in heart chambers and find out what state is the outer sheath of the heart muscle.
This cardiological examination allows you to diagnose both congenital and acquired heart defects, learn about the presence of a free fluid in a heart bag, reveal the thrombus, changing the size of the cameras, thickening or thinning their walls, detect tumors and any disorders in the direction and speed of the blood flow.
Echocardiography has a number of advantages over other types of heart surveys.
First of all, it is an absolutely painless and non-invasive procedure that does not have any discomfort in the patient. She is held as the usual ultrasound. There are no injections or any other similar manipulations before the procedure.
In addition, the procedure is completely safe for patients of any age group. It can be held for both children and adolescents, and pregnant women, since there is no negative impact on the fruits of ultrasound.
EchoCG is distinguished by accessibility, since the equipment for its holding is present in almost any medical institution. The cost of Ehoche is much lower, in comparison with MRI.
And the most important advantage of this type of survey is excellent informativeness that will allow the doctor to get the maximum necessary information and correctly choose therapy.
Indications and Contraindications for EchoCG
Echocardiography can be recommended for patients in the event that the doctor will suspect the presence of any cardiovascular pathology and in the process of therapy to assess the effectiveness of the drugs used.
Indications for EchoCG are:
- Suspections for the presence of a congenital or acquired heart defect, including inheritance to this disease.
- Frequent dizziness, fainting, shortness of breath and swelling.
- Complaints on the "fading" heart, on "interruptions" in his work.
- Pains for the sternum, especially if they irradiate in the region of the left blade or left half of the neck.
- Myocardial infarction, angina diagnosis and cardiomyopathy, suspected of a tumor of the heart.
- Preventive examination of patients who are often experiencing emotional and physical overload.
- Changes to the ECG and X-ray of the chest, requiring refinement of morphological changes in the heart.
Separately, it is worth mentioning what cases of echocardiography recommend future mothers. Pregnant ECOCH should be held if:
- The future mother has pain in the precordial area.
- The patient has congenital or acquired heart defects.
- The weight gains stopped or a sharp weight loss occurred.
- There were unmotivated swelling of the lower extremities and shortness of breath with a slight load of anti-epileptic nature.
- Violation of hemodynamics during pregnancy.
It should be noted that absolute contraindications to the conduct of echocardiography practically does not exist. 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 specifically, the type of research is carried out, in each particular case, the cardiologist decides.
At the moment, this species of ECCG is rarely used, because it is considered less informative than others. During the procedure, the image of the heart is not generated. The data is displayed on the screen as a graph. With the help of M-echocardiography, the doctor can the volume of heart cavities and evaluate their functional activity.
During in-echocardiography, the data of all structures of the heart enter the computer and are displayed on the monitor in the form of a black and white image. The doctor is able to determine the dimensions of the heart, find out the volume of each of its cameras, the thickness of the walls, assess the mobility of the valve sesters and how ventricles are reduced.
As a rule, this study is carried out simultaneously with B-echocardiography. It allows you to track blood flow in large vessels, and on the heart valves, reveal reverse blood flow and its degree, which may indicate the formation of pathological processes.
This study makes it possible to more clearly visualize the internal structures of the heart. The patient intravenously introduces a special contrast agent, after which the procedure is carried out as usual. This procedure allows you to study the inner surface of the heart chambers. Contraindication for this study is the individual intolerance to contrast and chronic renal failure.
To diagnose hidden heart pathologies, which are manifested exclusively during exercise, a special type of study is used - stress echocardiography. It makes it possible to identify the disease in the early stages that do not remind themselves if the patient is in the state of resting . Also, the procedure is carried out in order to determine how effective the therapy of ischemic heart disease is and to determine further forecast in this disease.
In stress-echocardiography there are several contraindications. It can not be carried out by patients suffering from respiratory, renal, hepatic or heart failure in severe form. It is also contraindicated with the myocardial infarction, aortic aneurysm and the presence of thromboembolism.
This is a special type of study, during which the generating ultrasound sensor through the o'cloth on the esophagus is lowered to the necessary depth. Since the sensor has very small dimensions, in the esophage, it takes place without problems. Nevertheless, such a study is considered rather complicated and is carried out exclusively in specialized medical centers. In addition, there are special testimony to it. In particular, the percussion study is carried out in the case when a standard transducer study does not allow to assess the condition of the heart and its structures. In particular, when doubts arise in the correct functioning of the previously prosthetic heart valve, if the aortic aortic aneurysm and the interpreservation septum defect, and in the event that the patient was diagnosed with an infectious character and the doctor suspects the aorta root abscesses.
At the same time, this type of study has contraindications from the upper digestive tract, namely, with any tumor formations of the esophagus, bleeding from the upper sections of the gastrointestinal tract, the presence of a large diaphragmal hernia or expansion of the veins of the esophagus. You should not carry out permissive research by patients with severe osteochondrosis of the cervical spine, with the instability of the cervical vertebrae, in the perforation of the esophagus in history. Diagnostic may be complicated in patients with thyroid disease.
Preparation for echo-kg
As a rule, when conducting single and two-dimensional echocardiography, as well as dopplerhocardiography, there is no need for any particular preparation. In the event that a permanent study is assigned, there are a number of restrictions.
So, the last meal must be no later than six hours before the procedure. It is not recommended to drink. Immediately before carrying out the manipulation, dentures should be removed.
On the eve of the permissive research of persons with the labile nervous system, it is recommended to take a light soothing. After the procedure, the patient should be needed for a restoration for some time, so until the end of the day should not be overloaded with the work. It is also necessary to refrain from driving a car.
Methodology for research
To carry out the transducer echocardiography, the patient is placed in the position on the left side. When a person lies in such a pose, 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 imaging of the heart - as a result, all four cameras are visible on the monitor at once.
The doctor makes a gel sensor, thanks to which the contact of the electrode with the body improves. After that, the sensor alternately is installed first into the jugular fossa, then in the zone of the fifth intercostal, where the top of the heart can be controlled as clear as possible, and then under the sword-shaped process.
Of course, each doctor seeks to ensure that the results of the study are as accurate as possible. It should be noted that the way how informative will be the procedure depends on the three main factors.
First of all, the anatomical features of the patient should be taken into account. Serious obstacles for ultrasound are obesity, thoracic deformation and other similar factors. As a result, the resulting image may be fuzzy and interpreted it as it should not be possible. In order to clarify the diagnosis, doctors in such cases propose a percussion survey or MRI.
The quality of equipment should be taken into account. Of course, more modern equipment will provide a doctor more opportunities to get enough information about the patient's heart.
Finally, the competence of a specialist conducting a survey should be taken into account. At the same time, not only its technical skills are important (the ability to arrange the patient in the correct position and place the sensor at the desired point), but also the ability to analyze the data obtained.
When conducting stress-echocardiography, first the patient makes ordinary echoch, and then they impose special sensors that record indicators during physical exertion. For this purpose, cycheroometers, treadmill test, emergency electrical stimulation or drug drugs are used. In this case, the initial load is minimal, and then it is gradually increased, controlling the indicators of blood pressure and pulse. If the health of the patient deteriorates, the examination stops.
All this time, an electrocardiogram is continuously carried out, which makes it possible to respond promptly when any extreme situations occur. During the load, the patient can feel dizziness, pulse, discomfort in the heart. After stopping the load, the pulse slows down. Sometimes in order for the work of the heart to fully normalize, other medicines are required. In this case, the patient's condition is carefully monitored until fully recovery.
As a rule, the entire procedure lasts about an hour.
Conducting EchoCg begins with irrigation of the oral cavity and patient's pharynx with a solution of lidocaine. This is designed to reduce the vomit reflex during the introduction of the endoscope. After that, the patient is asked to lie on the left side, insert into the mouth of the throat and enter the endoscope, through which the reception and submission of ultrasound will be carried out.
It provides deciphering the results of EchoCG, the doctor who conducted a study. It obtained data or transfers the doctor, or gives directly to the patient.
It should be borne in mind that it is impossible to diagnose, based exclusively on the result of echocardiography. The data obtained are compared with other information available at the instrument of the attending physician: data of analyzes and other laboratory studies, as well as existing clinical symptoms in the patient. Consider echocardiography as a completely independent diagnostic method.
Where to make echocardiography
Conduct standard echocardiography both in public medical institutions (clinics and hospitals) and in private medical centers. To record, the examination should be given the direction of the attending physician or doctor cardiologist.
Specific varieties of Ehocheg - a percussion study or stress echocardiography - can be passed only in specialized medical institutions, since they require special equipment and personnel who have passed special training.
Echocardiography in children
As noted above, the indisputable advantages of EhCG is non-invasiveness, painlessness and complete safety of this methodology of cardiology research. Manipulation is not associated with radial load, no complications provokes. Therefore, in the presence of appropriate testimony, the study can be recommended not only to adults, but also to children.
Diagnostics will help in a timely manner to detect congenital pathology in children of early age, which, in turn, will make it possible to choose the most effective treatment. As a result, the child will be able to lead absolutely full life in the future.
Indications for holding echocardiography to the child are:
- Noise in the heart.
- The appearance of shortness of breath either during exercise, or at rest.
- Lip lip, nasolabile triangle zone, fingertips.
- Reducing or complete absence of appetite, too slow weight gain.
- Complaints on constant weakness and fatigue, sudden fainting.
- Complaints of frequent headache.
- Discomfort for sternum.
- Reducing or increasing blood pressure.
- The appearance of edema on the limbs.
Taking into account the fact that the method is safe, it is possible to carry out the echocardiography of the kids not once to trace the development of the disease or evaluate how effective treatment is. In the event that some pathological changes were identified, a study is carried out at least once at twelve months.
Preparation and conducting procedure for children
Like adult patients, children do not need any preliminary preparation. It is desirable that during three hours before the study, the child did not eat anything, because with full stomach there is a high standing diaphragm, which can distort the result.
Parents should take with them the results made on the eve of the electrocardiogram, as well as the results of the studies that were previously conducted. In compulsory, the baby should psychologically prepare for the procedure, explaining that no one is going to hurt him.
In order to carry out the procedure, the baby is stripped to the belt and laid on the left side on the couch. After moving the sensor on the chest, the doctor examines the resulting image.
Echocardiography of fruit
There are models of echocardiographs, with the help of which a study of the fetus located in the uterus can be conducted. At the same time, neither the mother nor the future child will be caused by any harm. As a rule, echocrous fetal (prenatal or fetal echocardiography) is carried out between 18 and 22 of the week of pregnancy. Its main goal is timely identification of congenital heart disease in the fetus. The study makes it possible to check the intracardiac blood flow of a child in the maternal womb and ensure dynamic observation up to its appearance. As a result, the obstetrician gynecologist can plan the birth, and cardiologists get the opportunity to start the treatment of the child immediately after birth.
The echocardiography of the fetus is carried out if the congenital heart disease is available in close relatives of the patient, some diseases of the pregnant woman, in which the probability of congenital defects in the fetus increases (diabetes, systemic diseases of the connective tissue, epilepsy). The prophylactic goal is carried out echocating the fetus, if in the first trimester the mother took antibiotics or anticipant drugs. Diagnosis is also carried out, at the age of the mother older than 35 years. Also, the indication is revealed during a ultrasound study on the period of twenty weeks of deviation.
Medvedev Larisa Anatolyevna
Specialty: Therapist, nephrologist .
Common experience: 18 years .
Place of work: Novorossiysk, Nephro Medical Center .
Education: 1994-2000 Stavropol State Medical Academy .
- 2014 - "Therapy" Full-time training courses on the basis of the GOOS "Kuban State Medical University".
- 2014 - "Nephology" Full-time training courses on the basis of the GOOS "Stavropol State Medical University".
We will be grateful if you use the buttons:
The echocardiography of the heart is the essence of the method, its benefits, how is the procedure
There are several synonyms names: ultrasound or echo of the heart, echo-kg, echocardiography or echoogram of the heart. All these names are the same study. His holding and evaluation of the results can be engaged in doctors of ultrasound diagnostics, as well as cardiologists and cardiac surgeons who own this method.
Description of the method
Many patients who received the direction for electrocardiography are interested in what it is and what is the essence of the method. Echo kg is carried out in a hospital or home with special equipment. To do this, use the device emitting ultrasound, a special sensor and a converter transmitting the image of the studied area to the screen.
Passing through the heart, ultrasonic waves are absorbed and reflected by its fabrics. Due to this, the device displays an image to the screen, according to which the specialist can make a conclusion about the basic parameters of the organ.
Heart echocardiography is considered one of the most informative and safe methods for identifying pathologies.
Indications for use
Echocardiography (ultrasound of the heart) is used to diagnose various states in the patient. The following symptoms in humans may serve as a reason for the procedure:
- heart noises, rhythm violation;
- Signs indicating the development of heart failure, for example, edema extremities, liver pain;
- acute or chronic course of myocardial infarction;
- chronic fatigue, swelling, skin sinusiness;
- frequent colds or temperature raising without signs of ADVI;
- predisposition to cardiovascular diseases;
- Swimming, attacks of angina.
In addition, the testimony includes transferred rheumatism, frequent jumps of blood pressure, states accompanied by pain and numbness in the field of left hand, blades, forearm. The method is used to monitor the effectiveness of treatment with various pathologies of the heart, before the upcoming operational intervention. In order to prevent prevention, it is recommended to do ultrasound to persons whose labor activity is associated with frequent emotional or physical exertion.
Application among pregnant women
During pregnancy, women are subject to many diseases. In connection with the occurrence in the body, the load increases and on the heart.
Indications for echocardiography:
- Hereditary predisposition to heart diseases;
- If the patient during the tooling of the baby fell ill rubella, or a high concentration of tel to this disease was detected in the plasma;
- If in the first trimester, a woman took any potent drugs;
- If there are miscarriages in the history of the disease.
Ultrasound often spend a unborn child in the womb. The procedure is performed to identify heart defects in the early period, is carried out on July 18-22.
Are there any contraindications
Echocardiography does not have absolute prohibitions, but there are some recommendations that should be performed during diagnostics.
- Echocardiogram should be carried out 2-3 hours after meals. When the stomach filled with a stomach can put pressure on the heart, which will affect the accuracy of the data obtained;
- To transfer the procedure is recommended that patients who have open wounds or severe skin diseases in the chest area;
- When deforming the breast cell, the diagnostic results may be inaccurate.
If there is a percussive (PE) echocardiography, it is impossible to use it among patients with increased vomiting reflex, impaired psyche, pathologies of the esophagus.
Echocardiography (Echo kg) is an ultrasound examination of the heart. It is used to quickly and painless information, which allows cardiologists to establish an accurate diagnosis, carry out adequate therapy and prevention of complications of diseases of the cardiovascular system. The cost of echo-kg in Moscow varies from 6,000 to 7000 rubles. You can make echocardiography in Yusupovskaya hospital. Ultrasonic heart examination Doctors of functional diagnostics are performed using modern expert class devices.
Deciphering the results of echo kg is carried out by qualified specialists who have undergone special training in leading domestic and European diagnostic centers. For patients in the therapy clinic, chambers with a European level of comfort are equipped. Cardiologists conduct comprehensive treatment of patients with modern efficient and safe drugs registered in the Russian Federation. Heavy cases of diseases of the cardiovascular system of professor, associate professors, the doctors of the highest category are discussed at the meeting of the Expert Council. Leading cardiologists and arrhythmologists collegiates develop patient tactics.
Opportunities and feasibility of echocardiography
When conducting the echocardiography of the heart, the functional diagnostic doctor not only conducts an assessment of the condition of large vessels and the heart itself, but also has the ability to monitor blood movement, identify pathological changes in heart valves and diagnose pathological changes in myocardium. These Echo CG Hearts allow cardiologists to quickly and correctly diagnose most heart disease at the initial stage of development. This survey method is most secure as possible. You can do echo kg during pregnancy and children. As a result of the study, patients are not subject to radiation load.
During echocardiography, you can define the following changes:
- Heart noise;
- Congenital and acquired heart defects;
- Heart neoplasms;
- Violations of the functionality of the heart in professional athletes;
- The results of surgical intervention at heart defects.
Patients do not need special preparations for heart echocardiography. There are no contraindications for research. Echo kg can be made an unlimited number of times. Echo kg during pregnancy allows you to carry out antenatal diagnosis of malformations of the fetus. You can make Echo kg in Moscow in the Yusupov Hospital.
Indications for Echo kg
Many diseases of the cardiovascular system proceed without a pronounced clinical picture, so at certain signs of the pathology of the heart, the doctors strongly recommend passing echocardiography. Echo kg is performed if patient has shorts, regular dizziness, high sweating and edema. It is necessary to immediately appeal to the cardiologist of the Yusupov hospital and perform echocardiography in the presence of strong compressive pains for the sternum, which are given in the left hand, under the blade or into the lower jaw, and at high arterial pressure.
The echocardiography of the doctors of the Yusupov hospital are carried out with significant lifting of blood pressure, noise in the heart, varicose veins of the lower extremities, thrombophlebitis. Echo kg do in the presence of patients pain in the heart of obscure origin, heart rate disorders. Cardiologists monitor the state of the heart of patients who are in the restorative period after myocardial infarction or heart operations.
How do echo kg hearts
Before studying the patient, they offer to undress to the belt, remove the decorations and lie on the couch. The functional diagnosis doctor when performing transducer echocardiography is performed on certain points of the chest special sensors. They transmit ultrasound into a powerful computer, in which the waves are converted into the image. The doctor on the monitor sees a movable, real image of the heart.
The duration of the echocardiography of the heart is 20 minutes. Deciphering Echo kg holds a cardiologist, a functional diagnostic doctor. It compares normal indicators with the resulting survey results. During the procedure, the patient lies motionless, because ultrasonic equipment is very sensitive and responds to active movements of non-venerable results, distorted image.
Modern methods of echocardiography
Cleaning echocardiography - an innovative non-invasive method of studying the heart, which cardiologists are used to diagnose the pathology of valves and neoplasms in the heart cavity. 6 hours before the visit to the doctor, the patient is recommended to stop reception. Immediately before the study, dentures are removed. Patient intravenously introduces special drugs that help it easier to transfer the procedure.
The study is carried out using a special sensor, which the doctor enters the esophagus. To reduce the vomit reflex before the study, the surface anesthesia of the pharmacies of a 10% solution of lidocaine is produced. When the sensor is introduced into the esophagus, the patient lies on the left side. In order to avoid damage to the endoscope, the thugs put on it. The probe is slowly promoting to the throat until an obstacle on his way appears. Then the patient makes a sip, and the endoscope tube is almost freely introduced into the esophagus. It is in the esophagus 5-15 minutes.
The doctor then deals directly the percussion ultrasound of the heart according to the protocol. With the appearance of vomit, cough reflexes or discomfort, the study may be discontinued. Cleaning Echo CG is terminated if the tolerability of the procedure exceeds the physical possibilities of the patient.
In time, the patient may feel discomfort, pain in the chest. Sometimes patients occur in violations of the heart rhythm, angokard attack is extremely rarely developing. During the implementation of the study, the Yusupov hospital doctor closely monitors all changes in the patient's condition, thus reducing the risk of complications. The Yusupov Hospital is equipped with the necessary equipment for solving emergency situations. In the event of non-standard situations, the patient has emergency assistance to a resuscitation.
The results obtained during the study will help assess the state of the vessels and hearts:
- Valve apparatus;
- The presence of formations, heart defects;
- Contact function.
For maximum safety and effectiveness of the study, the doctor updates the procedure on the eve of the procedure, whether an operational intervention has been conducted by the patient over the past 6 months, whether it has suffered a stroke, does not suffer from epilepsy, mental health disorders, digestive diseases. Do not perform percussive echocardiography at elevated body temperature, and the pathology of the esophagus, osteochondrosis of the cervical spine, the diaphragmal hernia. The price of the perch of the Echo kg is slightly higher than the classic transk-cultural echocardiography.
New surgical treatment techniques require more advanced diagnostic methods, which allow control of minimally invasive intracardiac interventions, evaluate small anatomical structures, complex circulation changes, monitor the functional state of the cardiovascular system at the present level. For this purpose, an intracardiac echocardiography is performed.
With the help of a multi-freedom ultrasonic vector catheter sensor, the cardiac surgeons analyze the anatomy and the function of the cardiovascular system. Endocardial echo kg is an invasive procedure. Doctors introduce a sensor through a subclavian or femoral vein in the right heart chambers. It allows cardiologists of the Yusupov Hospital to receive an ultrasound image of high quality.
Introdial echographic catheters are rigid and introduced without bending in the heart under fluoroscopic control. Ultrasonic mapping begins when the catheter is located in the middle of the right atrium. With the proper installation in this position, the intracardiac echoch catheter is located in parallel to the spine, and the part of the catheter with the sensor is facing a three-dimensional valve. In this position, the doctor who conducted the study sees the following heart structures:
- Three-rolled valve;
- Patch and output of the right ventricle;
- Long axis of the pulp;
- Aortic valve (short axis).
The partition in this position is visible badly. In some cases, the doctor can see the arterial part of the partition, and, if the color doppler mode is turned on, reset blood (if available). This provision is used to evaluate the function of the trilateral valve.
Turning the front-length handle slightly backwards, and the right-left slightly right sensor from the neutral position is rotated to the interdestrian partition. This is a septal view. In such a position, the interpresentation partition, a bemark sinus and pulmonary veins are clearly visible. Depending on the accuracy of the location of the sensor, pulmonary veins can be visible more or less detailed.
After the doctor promotes an intracardial echocardiographic catheter in a more craneal (toward head) position in relation to the upper vein, it receives a long-axial view. In this plane, the sensor is addressed to the interduded partition. On the echo kg, the attitude of the upper hollow vein to the right atrium is seen. As the echoch of the catheter is further advanced in the curved position towards Vienna with a bend slightly to the right, large sections of the upper hollow vein are visible. A more clear image of the lower part of the inter-subsensudual partition can be obtained from the deviation of the intracardiac echoch of the catheter towards the lower hollow vein. With the help of the above positions of the catheter, the following pathological education may be well reflected:
- Oval pocket;
- Oval window;
- Defects of the interdestrian partition.
After the doctor contains Echokg catheter in a closed position, the minimum adjustment of the front-length and right-left handle shows the view along the short axis. In this position, the aortic valve in the short axis and the interpresentation partition becomes distinguishable.
Additional species are obtained by the advancement of the catheter through the defect of the interpidential partition or the open oval window into the left atrium. These are the so-called "types of left-hearted heart." EchoCG images from this location are equivalent to transtorcal and perch-water echocardiographic four-dimensional species. Anatomical structures that are determined in this position include a mitral valve, left and right ventricle. To see the left atrium's ear, the catheter is managed further, then move it back to the right atrium. The cost of this type of echocardiography is higher than trans-worked echoc.
The latest achievement of science is the integration of a four-dimensional ultrasonic intracardiac image. Wrapped around catheter Matrix sensors with side scanning space scanned anatomical structures in three-dimensional space. Furning four-dimensional sensors are used to provide intraconductural control of the operation in the dynamics in real time.
Computer sensor operates in experienced mode. It is equipped with electrodes to integrate the installation field of the installation. Such a sensor can scan conical items to display surfaces inside the heart measuring from 4 to 7 cm. The device has an internal lumen size5F. It is used for a laser, radio frequency electrode or electrophysiological ablace catheter. At the same time, doctors have the opportunity to observe their placement and movement in real time. Currently, cardiac surgeons use intracardiac echocrium as an important additional method during radio frequency ablation operations in various rhythm disorders to control possible complications and to improve the effectiveness of the procedures.
To pass the echocardiography of the heart at an affordable price in Moscow, sign up for the reception to the cardiologist online or by phone. Specialists Contact Center will offer you a convenient time to perform the procedure. The doctor will determine what kind of echoca is more suitable for the patient. After installation of an accurate diagnosis, cardiologists will carry out comprehensive therapy or, if there is indications, prompt intervention will be offered.
Medical editor: Strokin O.A. - Therapist, doctor of functional diagnostics. Iyul, 2019.
Synonyms: Heart ultrasound, echocardiography, echocardioscopy, ehox, echoc.
Echocardiography - ultrasound examination of the heart, allowing to evaluate all the structures and functional state of the organ.
The survey is carried out by a physician of functional diagnostics in outpatient or inpatient conditions for 15-30 minutes, rarely durability reaches 60 minutes, but only in very complex cases and together with the consultation of doctors.
Pathologies in which it is necessary to conduct echocardiography quite a lot, and they are all connected one way or another with a differential diagnosis of heart disease or aorta. Urgent readings for transstormical echocards include:
- sharp, stitching, cutting pain in the heart area, which the patient feels for the first time;
- Cutting, compressive pains that have arisen for the first time or intensified by intensity and duration;
- Suddenly having a shortness of breath.
In addition, it is necessary to periodic heart examination in its chronic diseases and in the presence of risk factors:
Types of echocardiography
Ultrasound examination of the heart is carried out in different ways:
Photo: Classic body position when conducting a regular heart ultrasound.
Through the chest. The usual ultrasonic slight sensors are used, which specialist applies to the skin. This is the most common study in practice due to the simplicity of the procedure itself and the availability of equipment.
There are no contraindications to transstoracal echo-kg, but the survey may be difficult in the impossibility of conducting a study on the left side. For example, with a severe degree of heart failure, when the patient is not able to be in the position lying due to the expressed shortness of breath. Also, difficulties occur in the presence of patients with lung diseases, which increase their airiness (chronic obstructive pulmonary disease - COPD) and thereby prevent the penetration of ultrasound to the heart. There are also other pathological conditions that may complicate the survey.
After a transcular examination, there is no complication.
This is a specific procedure technique that allows you to appreciate the work of the heart in the conditions of increased human activity. To do this, at the beginning, there is a normal transducer study, and then give physical activity (squats, exercise bikes) or a pharmacological sample is carried out to simulate an increase in physical activity. The first option is more preferable, since more physiological and the likelihood of manifestation of any unwanted reaction is minimal. Naturally, next to the patient, the presence of a resuscitator and cardiologist, which will be able to adequately and to respond to acute situations in a timely manner (expressed pain syndrome in the heart, shock, loss of consciousness, stopping heart, arrhythmia, etc.).
When studying with exercise or pharmacological breakdown, it may appear:
- Allergy to the drug;
- pain in the heart;
- loss of consciousness;
- shock and others.
The listed reactions occur extremely rarely and quickly stop (cured) if there is a resuscitator or cardiologist.
Claspiece Echo-kg (ChPEHO)
The procedure is similar to FGDS - a special endoscope with an ultrasonic sensor is used at the end that the doctor enters through the mouth to the level of the heart (there are special marks with distance on the endoscope). The sensor is pressed against the esophagus wall and the image of the organ appears on the screen of the monitor of the device. This type of examination is carried out less often, as it is a more complex technology providing for the use of a separate sensor with an endoscope and a specially trained specialist of functional diagnostics and a medical sister.
ChPEO is spent when there is no possibility to carry out a transtorical study: a pronounced subcutaneously fatty tissue, serious pulmonary diseases, or simply due to the constitution of the person the lungs mostly cover the heart. In addition, access through the esophagus makes it with greater accuracy to identify the defects of interventricular and interpresentation partitions, as well as detect the thrombus in the left atrium ear, which is not visualized during transcular access. Such a procedure is obligatory to carry out before treatment (electrical thermal therapy - restoration of rhythm using a small defibrillator discharge) of certain types of arrhythmias.
Due to greater invasiveness of ChPEho, there are a number of contraindications for its conduct:
- extremely severe patient condition;
- Diseases of the esophagus - malignant neoplasms, strictures (narrowing), diverticulus, varicose veins of the veins of the esophagus, esophagitis 1.
During ChPEO complications are also extremely rare and are bound primarily with the introduction of the endoscope. These include perforation of the esophagus or damage to its wall and voice ligaments. In addition, the appearance of arrhythmia.
Photo: Diagram of the percussion ultrasound with contrast
Echo-kg with contrast (contrast ultrasound of the heart)
Also isolated with echocardiography with contrasting of the right chambers of the heart using a conventional physiological solution as a contrast agent and contrasting ultrasound of the whole heart using an innovative Sonovue preparation (Sonya). This drug is microbubbles with gaseous contents. Due to the property of ultrasound, it is reflected from the boundaries of media with different density (the greatest density difference on the border of the fabric gas), the contrast "glows". This technique appeared relatively recently and allows:
- more clearly determine the size of the heart cavities,
- reveal with greater accuracy minimal partition defects and other heart defects;
- More accurately determine the function of the left ventricle due to the penetration of the contrast inside the heart muscle.
Echo-COP with contrasting is used when accessing the chest, and through the esophagus.
Ultrasound with contrast is usually carried out to diagnose heart defects and to confirm myocardial break.
Conducting echocardiography with contrasting is contraindicated with:
- acute coronary syndrome;
- unstable angina;
- Myocardial infarction in acute stage;
- acute heart failure of III-IV degree;
- severe pulmonary hypertension;
- acute stages of neurological diseases;
- uncontrolled arterial hypertension;
- Finding a patient to IVL;
- pregnancy and breastfeeding;
- Allergies on the components of a contrast agent.
Complications in contrasting are limited to local reactions at the injection site of the drug in Vienna or artery and theoretically intolerance to the drug. The main danger in the study with contrastment is that it is more often carried out together with the physical activity or pharmacological breakdown, respectively, the same complications.
How is the ultrasound of the heart
During echocardioscopy, the doctor uses various modes of ultrasonic apparatus:
- one-dimensional (M-mode),
- two-dimensional (in-mode)
- Doppler mode (estimate of blood flow rate in chambers and vessels),
- Color Doppler - CDC (to determine the direction of blood flows and detecting pathological),
- Energetic Doppler (registers the fact of the presence of blood flow in vessels),
- Fabric Doppler (a deeper alignment of myocardial cuttlens based on the study of the nature of the walls of the walls from the sensor and to it),
- 3D-echocardiography (maximum benefits before surgery on valves - they are almost completely visualized before intervention, which is important for determining the surgeon tactics).
Echocardiography through the chest is carried out in the office of ultrasonic or functional diagnostics. Sometimes in the hospital due to the severity of the patient and the impossibility of transportation for its surveys use a portable ultrasound apparatus. Nurse or doctor asking the patient to undress from above to the belt, including it is necessary to remove underwear to women. Next, the patient needs to lie on the couch to the left side and put the left hand under the head. In this case, the head end of the couch is slightly lifted - this is how the maximum distance of intercostal intervals is reached for better heart visualization.
The position of the patient with respect to the doctor may be different, it all depends on the preferences of the last and arrangement of the cabinet. The patient can be turned face or back to the doctor, head to the apparatus or from it.
The specialist lubricates the sensor by Uz-conductive gel for better contact with the skin, applies it to the left side of the chest, visualizes the heart, outputing the standard positions to the product.
Cleaning echo is carried out strictly on an empty stomach in an ultrasound office or functional diagnostics. Take the consent of the patient to conduct a study by explaining before this all its essence and the course of events. The throat is irrigated by lidocaine with the help of spray, they ask to remove dentures and lie on the couch to the left side, bending the legs in the knees and putting hands under the cheek or on the belly. The mouth is inserted into the mouth so that the patient does not bite the probe. The doctor then introduces the endoscope. At the beginning asks for a patient to make swallowing movements for easier promotion of the device. Briefing to a certain position, the doctor begins to the inspection itself. It lasts 10-20 minutes.
EchoCG with contrast
When using a contrast agent, it introduces it to one of the veins or arteries on the thigh - depends on the type of drug and the purpose of the study. In this case, the sensor remains on the patient in order to register all the data on time and carry out measurements.
During the study, the doctor estimates the linear dimensions and volumes of heart chambers, local and general (emission fraction) The reduction and speed of blood flow through the valves, in vessels.
Main factors 2:
|Index||Value for women||Meaning for men|
|norm||A minor violation||Moderate violation||Significant violation||norm||A minor violation||Moderate violation||Significant violation|
|The thickness of the interventricular partition||6-9 mm||10-12 mm||13-15 mm||more than 16 mm||6-10 mm||11-13 mm||14-16 mm||more than 17 mm|
|The thickness of the rear wall of the left ventricle||6-9 mm||10-12 mm||13-15 mm||more than 16 mm||6-10 mm||11-13 mm||14-16 mm||more than 17 mm|
|Miocardium mass of left ventricular (mmzh)||66-150 g||151-171||172-192||More than 193.||66-150 g||151-171||172-192||More than 193.|
|The MMLG index (more significant indicator - takes into account the growth of the patient)||43-95 g / m2||96-108 g / m2||109-121 g / m2||more than 122 g / m2||49-115 g / m2||116-131 g / m2||132-148 g / m2||more than 149 g / m2|
|Emission fraction||more than 55%||45-54%||30-44%||less than 30%||more than 55%||45-54%||30-44%||less than 30%|
In conclusion, the patient can detect the following terms:
- Akinesome - Lack of muscle cuts / walls;
- hypokines - minimal reduction;
- Discines - asynchronous wall cuts;
- hypertrophy - thickening;
- diastolic dysfunction - a violation of the relaxation of the heart muscle;
- Systolic dysfunction - violation of myocardial contractility;
- Dilatation - the expansion of the cavity.
What shows Ehokg
In the process of conducting the procedure, the doctor conducts structural visualization and hemodynamic (Doppler) 3.
Structural visualization includes:
- Pericardial visualization (for example, to eliminate pericardial effusion);
- Visualization of the left or right ventricle and their cavities (to evaluate ventricular hypertrophy, wall movement anomalies, as well as for the visualization of thromboms);
- Valve visualization (mitral stenosis, aortic stenosis, mitral valve prolapse);
- Visualization of the main vessels (dissection of aorta);
- Visualization of atrial and partitions between heart chambers (congenital heart disease, traumatic damage).
- Visualization of blood flow through cardiac valves (valve stenosis and regurgitation)
- Visualization of blood flow through heart chambers (Calculation of cardiac output, assessment of diastolic and systolic function of the heart)
EchoCG in heart failure
- Makes it possible to determine the causes of the development of chronic form (CHF)
- Left ventricle emissions fraction:
- Reduced (systolic XSN);
- Normal (diastolic xSN).
- Estimate of the diastolic function;
- Heart cavities;
- Systolic pressure of the pulmonary artery (standard up to 50 mm RT ST);
- Liquid in the pericardial cavity.
EchoCG with violations of the heart rhythm
Important! Tachycardia makes it difficult to conduct research and the accuracy of the evaluation of the results obtained.
A transducer Echocrine and PE Echocrine is used.
- Heart cavities, especially atrial
- The presence of thrombov
- Emission fraction assessment is not always reliable
EchoCG to assess the state of cancer patients
Heart damage at oncological patients:
- tumor intoxication;
- Cardiotoxicity of chemotherapy;
- Cardiotoxicity of radiation therapy.
Indications for specialized echocardiography for determining cardiotoxicity:
- all patients with oncological diseases before starting treatment;
- receiving chemotherapy or radiation therapy (after each course);
- Received chemotherapy or radiation therapy in the past (regularity depends on the treatment regimen).
Comparative characteristics of ECCG with other methods
Echocardiography Despite their enormous benefits still remains a subjective method. Dimensions are carried out differently and interpreted some indicators. Sometimes one echo-kg is not enough or carried out it is impossible due to any causes. Then other methods of heart research will come to the rescue:
- Electrocardiogram is the easiest way to identify heart problems. ECG devices are equipped with all therapeutic and preventive institutions of the country and ambulance. The ECG reveals the violation of the rhythm and gives the probability characteristic of the local contractility (change in myocardial infarction), but with echo-kg everything can look completely different.
- Radiography of the chest organs allows you to determine the boundaries of the heart and identify cardiomegaly. For accurate diagnosis of reasons, the organ visualization is necessary.
- Magnetically resonant tomography is used to refine these echocardiography, the study of morphology, heartcard functions, valves. Now it is increasingly used to diagnose non-corona myocardial diseases, various cardiomyopathy.
- Computed tomography with contrasting is very effective in the study of coronary arteries. Its cost is less than kAg (coronaryography) You can also determine all the sizes and volumes of the heart, but will not give the opportunity to see its work in real time.
- Coronary angiography (kA) is the "gold standard" in the study of coronary arteries with a contrast agent with the detection of stenosis and subsequently possible stenting (a way to expand the lumen of the vessel). Its disadvantages are very high cost and invasiveness of the procedure.
- Positron-emission tomography is a rare study with the introduction of a radiopharmaceutical. Perfectly visualizes areas with insufficient blood supply (ischemia) myocardium
Echocardiography is the main and most affordable method of visualization of the heart, allowing to put an accurate diagnosis, timely treatment, as well as assess its effectiveness. Despite the subjectivity of the method, with constant training, advanced training, exchange of experience with colleagues, a specialist increases its literacy in the survey and minimizes the possibility of errors.
Echocardiography does not stand still. Attempts continue to supplement the method with new visualization capabilities, some of them allow us to objectively to conduct research and minimize interpretation differences between different specialists.
Proshin Dmitry Evgenievich
Echocardiography - This is an ultrasound examination of the heart and the surrounding fabrics. Modern cardiology uses echocardiography (ultrasound of the heart) as one of the main diagnostic methods. The study is carried out with the help of special equipment - echocardographer. The echocardiograph generates an ultrasonic signal, which is directed through the chest wall to various parts of the heart. Reflected signals are perceived by a special sensor. A computer is connected to the echocardiograph, which increases the diagnostic capabilities of the device. The study is safe for the patient's health and can be assigned as needed.
With echocardiography, the doctor sees the image of a working heart. This allows you to study both its structure and functional state. Such a study helps to detect diseases of the cardiovascular system in the early stages, which facilitates their subsequent treatment.
Indications for echocardiography (ultrasound of the heart)
Echocardiography is carried out in the case of:
Children echocardiography are shown in case of suspicion of a congenital heart disease.
Echocardiography is also done in monitoring the state of the heart:
in the case of treatment with antibiotics during cancer;
after myocardial infarction;
after transferred operations on the vessels and the heart;
Athletes (with professional sports, the survey should be carried out at least once a year).
What shows echocardiography (ultrasound of the heart)
Echocardiography allows you to evaluate:
the thickness of the walls of the heart;
How much matches the norm of the reduction of the heart muscle;
work and condition of the valve apparatus of the heart;
blood pressure level in heart chambers, as well as in large heart vessels - aorta and pulmonary artery;
speed and direction of blood flow in heart chambers;
state of aortic and pulmonary artery;
Pericardial state (cardiac bag) - the outer shell of the heart.
With the help of echocardiography (heart ultrasound) can be detected:
changes in the size of the heart chambers, the state of the valves and the structure of the heart muscle (myocardium);
changes in the nature and speed of blood;
intracardiac blood clots;
The presence of fluid in the heart area (in the heart bag).
The echocardiography method helps to diagnose such diseases and pathological conditions as:
Congenital heart defects, and heart vessels - aortic and pulmonary artery;
acquired heart defects and heart vessels;
coronary artery disease;
elevated or reduced blood pressure (hypertension or hypotension);
chronic heart failure;
Other diseases and heart pathology.
Conducting echocardiography (ultrasound of the heart) in the "Family Doctor"
Make echocardiography (ultrasound of the heart) In Moscow, you can at the Family Doctor JSC. In the clinics of the "Family Doctor", there is a survey (including with Doppler Analysis) in comfortable conditions. Doppler-echocardiography allows you to evaluate the speed and direction of blood movement in each of the heart chambers, which makes it possible to use the diagnostic possibilities of heart ultrasound in the maximum possible amount.
Special preparation for echocardiography (ultrasound of the heart) is not required. However, it is desirable that echocardiography be carried out no earlier than three hours after the last meal, since the high position of the diaphragm may interfere with some aspects of the study. The procedure is carried out in the lying position or on the left side. The duration of the study on average is no more than half an hour.
Do not self-medicate. Contact our specialists who correctly put the diagnosis and prescribe treatment.
Rate how much material is useful.