Echocardiogram: A transthoracic echocardiogram (echo) is a useful tool to evaluate the structure and function of the heart. It is a painless test that uses ultrasound waves to produce images of the heart. The test is performed by a specially trained technologist called a sonographer and is interpreted by the cardiologist. There are many reasons that your physician may request that you have an echo procedure. Physicians use it to look for abnormalities on the large physical structure of the heart, including the heart chambers and valves, as well as blood flow through the valves. An echo may be used to look for the cause of an abnormal heart sound (a murmur), to check the size of the heart chambers, to check for fluid around the heart, or to inspect the pumping capability of the heart if a patient has shortness of breath or other symptoms during exertion.

There is no special preparation required for an echocardiogram. You should come as you are and eat or drink as you normally do. If you take medications, you should continue to take them as normal. You will be asked to remove your clothing from the waist up. It is easier to change if you wear a two-piece outfit. Women will be given a gown to wear during the procedure. Most of the test is performed with you lying on an echo bed on your left side. The imaging will take about 30 to 45 minutes. The results will be sent to your primary care physician and may be reviewed with you by the cardiologist.

 Bubble Echocardiogram: A bubble cardiogram is the same procedure as an echocardiogram (above), except with this test you will have an IV placed in your arm. During certain portions of the imaging, agitated saline is injected into the vein. This enables the cardiologist to see if there is a tiny hole between the upper chambers of the heart, known as a PFO or ASD.

 Stress Echocardiogram: An exercise stress echocardiogram, sometimes called a stress echo, is a tool used to evaluate heart function by combining an exercise (stress) test with a transthoracic echocardiogram. A stress echocardiogram uses ultrasound waves to produce images of the heart both before and immediately following exercise. Images of the heart at rest are compared with images of the heart after exercise to evaluate how the heart responds to exercise. Your electrocardiogram and blood pressure will also be monitored throughout the procedure. The test is performed by a specially trained technologist called a sonographer, and is interpreted by the cardiologist.

A stress echocardiogram is most often requested to check for good blood flow to the heart and to provide early detection of coronary artery blockage. It is also used to routinely follow-up patients that have known coronary artery disease. It is important that you let the sonographer know if you have been experiencing any chest pain or other symptoms, especially if you experience any symptoms during the procedure.

You should bring or wear comfortable walking shoes and suitable, loose fitting clothes for the test. You will be asked to remove your clothing from the waist up. It is easier if you wear a two-piece outfit. Women will be given a gown to wear during the procedure. You may be asked to temporarily hold off on taking some medications and to refrain from eating for a few hours before the test. The procedure will take about 45 minutes to one hour. The results will be sent to your primary care physician and will be reviewed with you by the cardiologist.

Patients that have physical limitations that cause them to be unable to exercise or walk on a treadmill may need to be scheduled for an Adenosine Thallium. Please let your physician or the person that is scheduling your test know if you are unable to walk on a treadmill so you can be scheduled for the correct test.

 Carotid Doppler: A carotid Doppler is an ultrasound procedure that produces images and measures blood flow in the carotid arteries, the major arteries on each side of the neck that carry blood to the brain. Carotid ultrasound can depict plaque that narrows the artery and may limit the free flow of blood to the brain. The test is performed by a specially trained technologist called a sonographer and is interpreted by a specially trained cardiologist.

The most frequent reason for a carotid ultrasound exam is to detect narrowing, or stenosis, of the carotid artery, which increases the risk of stroke. Your physician may have heard an abnormal sound while listening to your neck (a bruit), or you may have other risk factors calling for an ultrasound such as advanced age, diabetes, elevated blood cholesterol, and a history or family history of stroke or coronary heart disease.

There is no special preparation required for carotid ultrasound. You should come as you are and eat or drink as you normally do. If you take medications, you should continue to take them as normal. Wear a loose fitting, open necked shirt or blouse. You will be asked to remove any jewelry or other objects from around your neck. The test is performed with you lying on your back. The imaging will take about 30 to 45 minutes. The results will be sent to your primary care physician and may be reviewed with you by the cardiologist or sent to you by mail.

For more information on echocardiology, you may go to the following sites:
www.seemyheart.org
www.arrhythmia.org
www.brighamandwomens.org/cvcenter/Services/arrhythmia.asp
www.mayoclinic.org/arrhythmia-rst