Echocardiography

Echocardiography is one of the most important methods used to examine the heart. It enables doctors to investigate the heart valves, the structure and thickness of the cardiac walls, as well as the heart’s size, volume, movements and pumping capacity.

Echocardiography is an ultrasound examination used to identify functional defects in the heart’s atriums and ventricles. It can reveal heart valve defects, heart defects, myocarditis, pericardial diseases, as well as scarring caused by a heart attack. The examination is also used to determine the ventricular ejection fraction, which is a measurement of the heart’s pumping capacity that plays a key role in the diagnosis of heart failure (cardiac insufficiency).

What preparations are carried out before the procedure?

No special preparations are required prior to an ultrasound examination of the heart. It is usually carried out transthoracically. This means that the ultrasound transducer is placed onto the patient’s chest and the sound waves are directed through the ribcage at the heart. Sometimes the transducer is inserted into the oesophagus in order to position it closer to the heart, for even more precise ultrasound images. This method is called transesophageal echocardiography. Transesophageal echocardiography examinations are usually carried out using a light sedative and patients must fast for at least four hours prior to the procedure.

How is the examination carried out?

The examination is usually performed on an outpatient basis. For transthoracical echocardiography, contact gel is applied to the chest and then the ultrasound transducer is placed onto the area under examination. The transducer is gently moved back and forth to create the best possible images of the heart from various perspectives. The duplex sonography method is used to display the blood flow through the heart. The various blood flow directions are shown using different colours. Sometimes it is necessary to investigate the heart during physical activity. This is called a stress echocardiography. Similar to an exercise ECG, the examination is carried out while the patient is exercising (e.g. riding an exercise bike). Patients who for physical reasons cannot be expected to perform a stress test on a bicycle receive a medication (dobutamine) instead, which stimulates the heart.

For transesophageal echocardiography procedures an ultrasound probe is inserted through the mouth and into the oesophagus – similar to a gastroscopy. The patient lies on their left side throughout the procedure, which takes around half an hour.

What is the success rate of this examination?

The examination is highly suitable for identifying functional defects of the heart, heart malformations and heart valve defects.

What are the possible complications and risks of this examination?

Transthoracical echocardiography is entirely risk-free and does not lead to any complications. Transesophageal echocardiograms occasionally cause minor damage to the mucus membranes in the oesophagus, as well as changes in blood pressure or temporary cardiac arrhythmias. Serious complications are exceptionally rare.

What happens after the examination?

Special follow-up treatment is not necessary. Patients who have been given a sedative are not allowed to drive a vehicle for 12 hours after the procedure. If abnormal changes in the heart are detected during the examination, additional examinations may be necessary.