The transthoracic echocardiographic examination.
Transthoracic echocardiography is a diagnostic imaging methodology that utilises ultrasounds, that is the transmission of high frequency ultrasound waves (2-10 MHz), which cannot be heard by humans, and which are transmitted by a transducer which is positioned by the operator on the thorax of the patient. Ultrasound waves are reflected by the structures of the heart, picked-up by the transducer, and processed by the ultrasound equipment, which creates real-time bi-dimensional images of heart sections, as selected by the operator. On the other hand, the Doppler technique analyses with ultrasounds the blood flow within the cardiac chambers and connected vessels. The echocardiographic examination is the sum of different imaging modalities: the bi-dimensional (2D) exam, the mono-dimensional (M-mode) exam, the color Doppler examination, and the continuous wave, pulsed wave and tissue Doppler examinations; as a whole, these informations constitute a complete echocardiographic exam, which provides antomical, functional and hemodynamic informations of the complex structure represented by the heart.
In specific situations, when requested, the echocardiogram may be implemented with:
- A three-dimensional (3D) echocardiogram. In this case, the heart is represented in three dimensions. The increased spatial information is obtained at the expense of a decreased capacity to describe a number of cardiac structures (those smaller and thinner).
- Contrast echocardiography. A saline solution or a specific contrast agent is infused after puncture of a vein in the arm, with the aim to visualise small congenital intracardiac defects (as a patent foramen ovale or anomalous pulmonary return).
The echocardiographic examination represents, together with the electrocardiogram, the basic diagnostic methodology to study any type of heart disease.
This type of technology is non invasive and does not cause any kind of tissue damage (unlike the radiations utilised in diagnostic radiology), may be performed quickly and with relative ease in expert hands, and thus is easily repeatable within the limits of prescription appropriateness (established by scientific associations: American Society of Echocardiography
). As a matter of fact, it is not convenient to perform this examination without a specific request by a physician. It is very important that the results, be them quantitative (the Measurements) or qualitative of this exam, as described in the report (the Comments and Conclusions), be interpreted for the patient by the physician that has requested the examination, which takes into consideration the patient's clinical situation and complaints. Finally, the echocardiographic examination is a diagnostic imaging technique that acquires moving images, and thus the eventually enclosed photographic pictures only partially represent specific portions of the examination.
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