Ultrasound of the heart (echocardiography ) - Causes, Symptoms and Treatment .MF .
What is echocardiography?
doctor can not always with absolute certainty the exact diagnosis based on clinical examination alone, as in the process of auscultation (listening) of the chest and heart area it can only suspect any disease.But for this to confirm or disprove the suspicion, and appointed echocardiography.
Echocardiography - this instrumental method of study that allows to visualize the heart and evaluate its structural features and basic hemodynamic parameters.Its essence consists in the use of ultrasonic waves can be reflected from body tissues with different acoustic densities.Apparatus for the study includes an ultrasound source that is reflected from the heart tissue is converted into electrical impulses.These electrical signals are processed by the computer and fed to the monitor apparatus as a specific image.Sonography provides a two-dimensional image of the heart in real time.
Here is the graphic image of the heart on the machine's monitor.
study carried out through the fro
also emit stress echocardiography , which under certain stress tests (with the use of medications or physical exertion) to evaluate myocardial contractility various departments to the load on the heart and beyond.Especially important to use this method in conjunction with other instrumental methods of examination for the diagnosis of coronary heart disease.
There is a method to complement ultrasound of the heart based on the Doppler effect - the ability of ultrasound to change the frequency depending on the speed of movement of the object (in this case, the echo - signal is reflected from moving blood cells).When heart ultrasound with Doppler turns color blood flow image in the atria and ventricles.
heart ultrasound with Doppler (Doppler ultrasound, Doppler ultrasound, DRC).Fetus.A heart.
directly echocardiography allows visualization of the heart, to see its anatomical features, size, increase or decrease of the heart chambers (atria and ventricles) to evaluate myocardial contractility and the availability of post-infarction scars and Doppler helps to see the doctor blood flow to the heart (hemodynamics) and determinewhether there is a violation of the right of blood flow in the heart cavities (eg, regurgitation - return throw blood).
Indications for ultrasound
cardiac echocardiography What is needed?ultrasound cardiography method is widely distributed in cardiology and cardiac surgery because of its accessibility and non-invasive (no mechanical penetration into organs and tissues).
indications for ultrasound of the heart are:
1. Routine inspection:
- newborns - is necessary for the diagnosis of congenital anomalies or malformations of the heart;
- teenagers - is conducted to detect functional abnormalities of the heart, that is, to the period of intensive growth of the musculoskeletal system of the heart may be delayed growth, and therefore increases the load on the cardio - vascular system..;
- pregnant women - is conducted to assess the activity of the cardiovascular system with a subsequent decision on the possibility of self-delivery (if necessary, for example, when not diagnosed earlier diseases of the heart and great vessels)
- athletes - to analyze the structural and functional changes that occurin the heart of persons who are professionally engaged in sports
2. Diagnosis of diseases endocardial (inner shell) and heart valves:
- bacterial endocarditis, as well as diseases that could lead to its development - a sore throat, rheumatic fever, scarlet fever, intravenous drug use, bacteremia;
- congenital and acquired heart defects;
- blood clots in the cavities of the heart
3. Diagnosis of diseases of the myocardium (heart muscle):
- CHD (coronary heart disease), including myocardial infarction;
- rhythm and conduction disturbances (cardiac arrhythmia);
- cardiomyopathy (endocrine, toxic, alcoholic origin);
- heart tumor
4. Diagnosis of diseases of the pericardium (heart "bag", lining of the heart):
6. Chronic heart failure
7. malformations or pathological condition of the great vessels (aortic aneurysm).
8. Evaluation of the heart condition and cardiac activity after medical treatment of the above diseases
9. Evaluation of the heart valves and the status of the heart muscle as a whole after surgery (prosthetic valves or restoration, establishment of an artificial pacemaker, cardiac surgery treatment of myocardial infarction, etc.).
Contraindications to echocardiography
contraindications for ultrasound of the heart do not.There are technical difficulties when carrying out ultrasound of the heart can not be due to the following reasons: if the patient has a high degree of obesity, severe chest trauma, the presence in patients with severe chronic obstructive pulmonary disease with increased airiness of lung tissue (which is why the heart is covered with light and is not availablefor the penetration of ultrasound).
Preparing for heart ultrasound
special training heart ultrasound requires.The patient on the eve of the procedure can observe normal daily routine.In contrast to the study of other organs, there is no need to perform a study on an empty stomach or modify drinking regime.
How is echocardiography?
Typically, the procedure is carried out in outpatient (ambulatory), if the patient has not been previously sent to a doctor in a hospital with medical-diagnostic purposes.It should be noted that ultrasound of the heart has nothing to radiation, very safe and harmless, and can therefore be used repeatedly.
At the appointed time the patient comes to the clinic and the nurse invites him to the office of ultrasonic diagnostics.Further, the study is placed on a couch in the supine position or on the left side (depending on the doctor's recommendations), the doctor puts on the skin of the chest clear gel in the projection of the heart (the conductor, providing a better passage of ultrasound through the skin) and "glides" sensor skinin various points of access to the heart.Access points on the chest - parallel to the sternum on the left of the sternum in the jugular fossa, under the breastbone near the left upper quadrant, in the apex of the heart under the left nipple.
The data are processed by a computer and displayed on a monitor in the form of a graphic image and performance of the heart, then the doctor all analyzes and gives its opinion.
During the study, the vast majority of people's discomfort is observed.The whole process takes 20 - 30 minutes, after which the patient is given the conclusion, and he can go home (if, of course, did not reveal serious diseases of the heart, requiring immediate hospitalization).This conclusion must provide your doctor.
Explanation heart ultrasound results
Of course, a patient who has no medical training, it is difficult to understand written in prison.But still try to understand a little bit at least in the main indicators of the heart obtained by ultrasound.Normal values of these parameters may vary depending on the equipment in a particular hospital.So, these include:
- aortic root - 20-40 mm.
- right ventricle - 7-23 mm;
- right atrium - 27-45 mm;
- left atrium - 19-40 mm;
- the left ventricle: EDV (end diastolic volume, the volume of blood in the relaxed ventricle at the time of diastole) - 65-123 ml;KDR (end-diastolic dimension) - 46-57 mm;CSR (end-systolic dimension, ventricular size at the time of ejection of blood into the aorta - the systole) 31-43 mm;
- interventricular septum thickness - 7-11 mm;
- pulmonary trunk (diameter) - 16-25 mm;
- ejection fraction (EF) - 55-60%;
- stroke volume (SV) - volume of blood ejected by the left ventricle into the aorta in a single heartbeat;
- also evaluated the number and mobility of the valve leaflets, their thickening or narrowing of the difference;the presence or absence of regurgitation (reverse blood in the atrium of casting);total myocardial contractility and the presence of zones of akinesia and hypokinesia (lack or decline in myocardial contraction in certain areas);state of the pericardium (the presence or absence of the pericardial effusion in the cavity - cavity between cardiac muscle and the outer sheath of the heart, the pericardium).Changes in
occur in various diseases.Thus, changes in the aortic root may indicate aortic atherosclerosis or aneurysm;an increase in the atrial cavities and / or the presence of ventricular dilated cardiomyopathy, congestive heart failure, heart valve insufficiency with regurgitation.
thickening of the heart muscle (myocardial hypertrophy) is characteristic of hypertension;decrease myocardial general or in specific areas of acute myocardial infarction, or post-infarction scar formation.
ejection fraction and stroke volume as a whole allows to evaluate the heart, it can be reduced in many pathological processes in the cardiovascular system.Changes valve leaflets, different directions of their movement, contraction or expansion may indicate the patient has heart disease (stenosis or insufficiency of atrioventricular valve openings).
In any case, the only physician in the internal survey will decide on whether there is a malfunction of the heart, they are comparable with the clinical symptoms, need for additional methods of diagnosis, whether the treatment is necessary and where - in a hospital or clinic in theresidence. Independent analysis conclusion ultrasound of the heart without the participation of the attending physician is fraught with the threat of life and health, when it comes to serious diseases of the survey.
whether complications are possible during the ultrasound of the heart?
Due to security procedures, no complications during echocardiography.The only disadvantage is the occurrence of an allergic reaction called on-site application to the skin the gel - the conductor in individuals predisposed to allergies.But this is very rare and significant clinical value has not, as the benefits of the research outweigh the risks of developing allergies.
therapists Sazykina OJ