An echocardiogram can help diagnose and monitor many heart conditions by checking the structure and function of the heart and blood flow through the heart valves and surrounding blood vessels. By using high frequency sound waves ( Doppler) it is possible to assess how the blood flows through them and to assess the pumping action of the heart.
An echo cannot show the coronary arteries that supply the heart, as they are too small to be imaged by ultrasound.
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An echocardiogram can help detect:
- Myocardial damage from an M.I or angina: where the supply of blood through the coronary arteries to the heart muscle is reduced or interrupted, resulting in impaired myocardial contraction. During an echo the operator is looking at all regions of the myocardium and by moving the transducer to different areas of the chest can produce various images to evaluate myocardial segments/ areas that are supplied by the coronary arteries.
When an area of heart muscle has no blood supply and is effectively scar tissue, that area does not move and is called akinesis. Reduced motion is called hypokinesis. - Heart failure: where the ventricles of the heart fail to pump enough blood around the body at the right pressure. The echo can measure the ‘pumping’ capability of the ventricles by using the LV dimensions in systole and diastole and translating it into an ejection fraction (E.F) – that is the difference in chamber size in systole and diastole expressed as a percentage. Depending on other physiological factors, heart rate, rhythm and ease of measuring images, an EF below 50% may be considered abnormal and below 30% the patient may be a candidate for CRT/ ICD ( Cardiac resynchronisation device- a type of pacemaker/ implantable defibrillator).However an ejection fraction alone cannot be solely used as a judge of overall heart function and must be used as part of the whole examination and patient medical evaluation.
- Thrombus: often occurring in poor heart function for example after a major M.I. or in A.F
- Congenital heart disease: complex birth defects that affect the normal function of the heart. For example VSD – ventricular septal defect, ASD- atrial septal defect.
- Valve disease: abnormalities affecting the valves that control the flow of blood circulation within the heart : for example Aortic stenosis, mitral regurgitation or mitral valve prolapse.
- Cardiomyopathies: such as HOCM ( hypertrophic obstructive cardiomyopathy), where the heart walls become thickened and fail to contract properly or DCM – dilated cardiomyopathy – where the LV cavity becomes dilated and the myocardial walls become thinned and fail to contract properly.
- Left ventricular hypertrophy (LVH) – where the heart walls become thickened and stiff often secondary to hypertension.
- Endocarditis – an infection of the heart valves.
- Pericardial effusion – an abnormal collection of fluid within the pericardial sac.
Page last reviewed: 30 Jul 2020
