"Why did my doctor order an Echocardiogram?” by Dr. Thomas Leopold

Occasionally when patients see their cardiologist, they are sometimes advised to return for an ultrasound evaluation of their heart, referred to as an echocardiogram.

This test, which fortunately is always pain-free and has no associated risk, can provide a lot of information to determine the presence and severity of a variety of cardiovascular conditions.

Here are a few reasons that illustrate the usefulness of a cardiac ultrasound to helps us diagnose and manage our patients’ conditions:

Sometimes, patients have symptoms of shortness of breath and a possible diagnosis of congestive heart failure is considered. CHF, as it is often abbreviated, may be a chronic condition in which the heart doesn't pump blood as well as it should. Heart failure can occur if the heart cannot pump (systolic) or fill (diastolic) adequately.

Echocardiography is an excellent method of determining whether or not a patient has symptoms that might be explained by a diagnosis of congestive heart failure. The ultrasound images give us an idea of the size and contractility of the heart and measurements can be made to tell us whether the main problem is a failure of contractility or a problem of abnormal myocardial (heart muscle) relaxation. This is an important distinction because the treatment plans for these two etiologies is different.

Another common need for echocardiography is in the evaluation of a patient with a murmur. A common condition of the aortic valve that may occur as some of us age is calcification and valve narrowing - a condition referred to as aortic stenosis. Some of the symptoms related to this condition, such as shortness of breath on exertion and fatigue, are not specific for aortic stenosis and could be due to something as simple as not being in shape due to lack of regular exercise. Carefully listening to a patient's heart with a stethoscope and the addition of the information from an echocardiogram can tell exactly whether the valve is affected and its severity. This helps the doctor outline the proper treatment plan. Another type of heart murmur, mitral regurgitation, is readily detected by echocardiogram and the severity of the condition can be readily measured. Being able to tell what process is responsible for the mitral leak will help guide the management of the condition and help the doctor decide if mitral valve repair methods may be needed.

Finally another common need for echocardiography is in the diagnosis of pericarditis and pericardial effusion. This is a condition where there may be inflammation of the sac that surrounds the heart. Echocardiography is an excellent way of determining if there is an increase in the normal amount of fluid that surrounds the heart and an echo can help to determine whether there is any significant increase in the pressure around the heart that may need to be treated with methods other than medication.

After reading this blog post, you may be the one to suggest an echocardiogram at your next physician appointment!