What is Echocardiography?

Echocardiography is the examination of the internal structure and functions of the heart by means of sound waves (ultrasound). It is done by means of an instrument (transducer) that transmits sound waves. By applying the transducer to different parts of the chest wall, the walls and valves of the heart are examined in different positions.

How Many Is the Echocardiography Method?

• Superficial (Transthoracic) Echocardiography (TTE)
• Esophageal (Transesophageal) Echocardiography (TEE)
• Stress Echocardiography
• Strain and Strain Rate Echocardiography

How to Perform Superficial Echocardiography

When performing Superficial Echocardiography; The patient is placed on the left side and the transducer, on which gel is applied on the patient's chest, is circulated to examine different parts of the heart. X-rays are not used in this examination. In fact, superficial echocardiography is ultrasound technology. Typically, the review is completed in 15 minutes.

It is a painless procedure and has no side effects. Heart valves, cross-sections and movements of great vessels (aorta, pulmonary artery) are displayed on the screen. The results are evaluated by the doctor who performed the test.

Why Superficial Echocardiography Is Performed?

• Find the source of the heart sounds (murmurs, etc.) heard through the stethoscope,
• Investigating the cause of heart enlargement, unexplained chest pains, shortness of breath or irregular heartbeats,
• Measuring the shape and size of the heart chambers,
• Checking the thickness and movements of the heart walls,
• Clear evaluation of heart valve structures and movements,
• Evaluation of the functions of the artificial valve,
• Assessment of heart functions,
• Diseases affecting the heart muscle (for example, cardiomyopathies) ) to detect,
• Evaluation of clots and tumors in the heart,
• Controlling congenital heart diseases or surgical interventions for this reason,
• Heart after heart attack for the evaluation of its functions,
• Evaluation of the amount and type of fluid in case of fluid accumulation around the heart, and evaluation of the structure and thickness of the pericardial membrane surrounding the heart,
• It is performed to evaluate the structure and diameters of tar vessels (aorta, pulmonary artery). In some cases, echocardiography may be required through the esophagus. It is an examination similar to gastroscopy. Transesophageal echocardiography because it is performed through the esophagus.

  Why Transesophageal Echocardiography Is Performed?

  • Crot within the heart detected by superficial echocardiography, mass or due to heart infection called endocarditis For a more detailed examination of diseases,
  • For a detailed examination of the functions of artificial valves,
  • When aortic vasodilation and ruptures are suspected,
  • To examine the holes on the membranes between the heart chambers,
  • Determining the severity of heart valve insufficiency,
  • Evaluation of the success of the procedure during and after heart valve repair or closure of heart holes,
  • Lung disease, obesity or chest structure, etc. TEE method is used in cases where superficial echocardiographic images of sufficient quality cannot be obtained due to reasons.

  How is the Patient Prepared Before Transesophageal Echocardiography?

  Transesophageal Echocardiography is performed after 4-12 hours of fasting . Patients with complaints such as allergies, asthma, high eye pressure, difficulty in swallowing, nasal congestion, new throat infection, and patients with problems with the esophagus and stomach should inform the doctor who will examine these conditions.

  How is Transesophageal Echocardiography Performed?

  Transesophageal echocardiography is a semi-invasive examination. Just before the procedure, vascular access is opened in order to provide intravenous drug administration when necessary. In order to suppress the nausea reflex and ensure the patient's compliance with the procedure, the mouth and soft palate area are locally anesthetized with the help of an anesthetic spray.
  A sedative drug is administered intravenously for the procedure and patient comfort. In cases where patient compliance cannot be achieved during the examination, the procedure is repeated under the control of the anesthesiologist with the help of additional sedative drugs.
  The cardiologist who will perform the procedure. explains how to swallow the tube. A mouthpiece is placed in the mouth so that the patient does not bite the tube. The gel-lubricated transesophageal echocardiography probe is slowly advanced through the esophagus. It is normal to have retching and nausea when swallowing the probe. This situation is temporary. In the meantime, the nose is breathed in. At the end of the procedure, your doctor will inform you about the findings. The average review time is 15-20 minutes. However, with the preparation time, this time reaches 30-60 minutes. Since the drugs used to calm down during the examination may cause drowsiness for a while, vehicles and machines should not be used until this situation is completely resolved. After the examination, there may be soreness and loss of sensation in the throat for 1 or 2 days. This is a temporary condition and does not require treatment.
  

  What is Stress Echocardiography?

  Stress echocardiography (SE) is an echocardiography application performed with exercise methods or drugs that accelerate the heartbeat. Exercise echocardiography is performed in the form of recording echocardiographic images at every stage of exercise with the help of bicycle exercise test, just before and immediately after the application of the exercise protocol in the treadmill effort test.
  In cases where the exercise test cannot be performed (leg vascular disease, musculoskeletal limitation), medicated stress echocardiography is performed by using intravenous drugs such as dobutamine, adenosine, dipyridamole to increase heart rhythm and contraction at certain intervals with increasing doses.
  
  Permanent. It is applied when it is difficult to evaluate heart diseases with other methods due to the presence of pacing, left bundle branch block on ECG, left ventricular thickening and some special findings on EKG (pre-excitation). In order to determine the myocardial blood supply disorder and its severity, in order to determine the risk after acute heart attacks and interventional procedures on coronary vessels,
  It is applied for the pre-operative cardiac risk assessment in patients who will undergo surgical intervention other than cardiac surgery.
  The purpose is to observe the contractility of the heart, coronary artery disease. your findings of disability and to help the surgical decision in some valve diseases.
  An average of 4-6 hours of fasting is required for stress echocardiography. In addition, it is necessary not to smoke in a 6-hour period and not to take food containing caffeine (tea, coffee, chocolate, cola, etc.) or medication (as some pain relievers may contain caffeine). Some medications should be discontinued 24 hours before this test. This will be decided by the doctor who ordered the test. It is okay to swallow the drugs that are allowed to be taken with a small amount of water 3-4 hours before the test. Food can be eaten immediately after the SE test is over. Preparation for the test consists of attaching electrodes to the chest and opening the vascular access. Test duration is approximately 1 hour. This examination is done by recording from certain points on the chest. Resting images of the heart are recorded. Depending on the preferred stress management, exercise test or medicated application is performed. Exercise images are taken. Recovery period images are then recorded. Heart rhythm, blood pressure are monitored, ECG recordings are taken.
  The rapid and strong beating of the heart is perceived as palpitations during the test. This is normal. During the Medicated Test (Dobutamine administration), it is normal to have a feeling of warmth and redness in the cheeks, and tingling in the scalp. When pain and discomfort are felt in the chest, arm and jaw during the procedure, the doctor performing the procedure should be informed immediately in cases of dizziness, blackouts and shortness of breath.
  The patient is kept under observation in the rest room for half an hour after the procedure. The interpretation of the test is made by comparing the contraction strength of the heart on images taken in different phases. The findings obtained in the stress echocardiographic examination are explained to the patient by the doctor and a written report is given to him within one hour.

  Stress echocardiography is a reliable method. During medicated stress echocardiography, drug-related side effects are rarely seen. These are headache, sweating, palpitations, chest pain, shortness of breath, and nausea.

  Rarely, sudden drop and rise in blood pressure, heart arrhythmia and ventricular Unattended sudden rhythm disturbance, slowing of heart rate, chest pain of cardiovascular origin may be seen during the procedure
  

  Strain Ratio and Vector Velocity Imaging What is Echocardiography?

  Strain, Strain ratio and vector velocity imaging echocardiography is the most sensitive, new and modern method developed to measure the contraction and relaxation functions of the heart in the most accurate way in various planes using tissue Doppler ultrasound method. This method is especially applied to evaluate the strength and contractile functions of the heart muscle. Various regions of the heart muscle are selected and the dimensions and movements of these regions during stress and rest are measured with different planes.
  It is painless and has no side effects. No preparation is required before the procedure. No contrast agent is used. The procedure takes an average of 15-30 minutes.
  The results are evaluated by the doctor who performed the test and conveyed to the patient. After the procedure, the patient can immediately stand up and continue his daily life. In this way, the cause of heart failure is detected much earlier than a normal eye can distinguish, and the most appropriate treatment option is determined. It is one of the most important methods used in the evaluation of cardiac muscle functions before the cardiac operation to be applied to the patient. It provides the most reliable way to detect the inflammation of the pericardium and to differentiate its types in the most reliable way.

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