Diseases of the cardiovascular system are the most frequent in the percentage structure of diseases. It is the leading cause of death and disability worldwide. People who are at high risk of such pathologies must undergo a targeted medical examination for early detection and prevention of complications. One such procedure is cardiac echocardiography. This is an ultrasound method that allows you to assess the work of the heart and its valve apparatus, to diagnose any changes in a timely manner.
Indications
Symptoms of diseases of the cardiovascular system are varied, they can be easily confused with problems of other organs. The patient must pay attention to:
- the appearance of interruptions in the work of the heart, increased heartbeat;
- shortness of breath, cough, pallor of the skin, the appearance of edema in the lower extremities at the end of the day;
- weakness, dizziness, frequent headaches, loss of consciousness.
All these signs should not be ignored, they should serve as a reason for contacting a specialist who will send you for an ultrasound of the heart.
The immediate indications for the study are an increase or decrease in blood pressure, the presence of pathological murmurs during auscultation of the heart, changes identified on the electrocardiogram, as well as pain in the heart or behind the breastbone (angina pectoris). Echocardiography is required periodically for patients who have suffered a heart attack or heart surgery.
But not only people with health problems undergo echocardiography. It is recommended for athletes, men over 55, women over 50, and pregnant women. Ultrasound of the heart is also performed:
- children in the neonatal period in order to exclude heart defects;
- adolescents upon reaching the age of 14, since during the intensive growth of the body, pathology of the heart muscle may occur.
Methodology
Unlike ultrasound examinations of other organs, ultrasound of the heart requires little or no preparation in terms of diet or medication, with the exception of avoiding alcohol. The traditional technique is called "transthoracic echocardiography" because it is done through the surface of the chest. The patient undresses to the waist and lies on the left side on the trestle bed. The areas of the body to which the transducer will be applied are treated with a special gel for better transmission of the ultrasound signal. Subsequently, the sound is converted into electrical signals and an echocardiogram is obtained.
When obstacles to the passage of ultrasound are identified (obesity, the presence of artificial valves) and in severe heart disease, a transesophageal echocardiogram is used, during which the sensor is inserted through the esophagus close to the left atrium. For 4-6 hours before the procedure, the patient should refrain from smoking, not consume food and water. Removable dentures, if any, should also be removed.
Stress echocardiography is a stressful ultrasound of the heart. Ischemic disease is the main indication for this method of examining the heart. For this pathology, this is the most effective diagnostic method. It allows you to detect myocardial ischemia at the earliest stages of occurrence.
As a result, each indicator of the examination will be described in the conclusion, which will be registered by the doctor of the ultrasound diagnostics office.
Decoding the results
When you get your hands on the result, where you see not entirely clear numbers and terms, the question will arise about decoding the echocardiography of the heart.
The conclusion about a possible pathology depends not only on the age and gender of the subject, but also on the goals that the doctor set when referring you to an ultrasound of the heart. During the study, both anatomical structures (chambers, valves, walls of the atria and ventricles, muscles and blood vessels, sac) and heart functions are analyzed.
When describing the valves, two variants of deviation from the norm can be distinguished:
- failure, in which the valve flaps do not close tightly, as a result of which there is a reverse blood flow;
- stenosis, in which the diameter of the valve lumen decreases.
Excessive formation of fluid between the layers of the pericardium (more than 30 ml) is possible, in the conclusion it will be described by the word pericarditis.
Normal cardiac echocardiography readings are as follows.
| Left ventricle | ||
| Indicator | Norm for men | Norm for women |
| Myocardial mass | 135-182 g | 95-141 g |
| Mass index (LVMI) | 71–94 g / m22 | 71–84 g / m22 |
| Resting ventricular volume (VVV) | 65-193 ml | 59-136 ml |
| Resting Size (CRD) | 4.6-5.7 cm | 4.6-5.7 cm |
| Shrinking Size (DAC) | 3.1-4.3 cm | 3.1-4.3 cm |
| Wall thickness | 1.1 cm | 1.1 cm |
| Ejection fraction (EF) | 55–60 % | 55–60 % |
| Impact volume (SV) | 60-100 ml | 60-100 ml |
- Right ventricle (RV): wall thickness - 3 mm; size index - 0.75-1.25 cm / m2; the value of diastole at rest is 0.8–2.0 cm.
- Description of the vessels: the diameter of the aortic root is 20–35 mm, the mouth of the pulmonary artery is 14–20 mm.
Even having studied all the parameters in detail, you can only compare them with the options for the norm. Only a cardiologist can make a diagnosis, who will not only be based on the results of sonography, but also take into account all complaints and symptoms.
Diagnostic value
Due to the rapid development of medicine, diagnostic methods have become available, which are distinguished by high reliability of results, accuracy, safety and painlessness. One of these methods is echocardiography.
Thanks to echocardiography, it is possible to identify diseases of the myocardium, pericardium, intracardiac tumors and heart defects. Ultrasound of the heart allows you to determine the first signs of ischemic disease, the presence of scars after necrosis of the heart muscle (myocardial infarction), as well as life-threatening conditions such as aneurysm, intracardiac and intravascular thrombi.
The accuracy of the test results also depends on the resolution of the device. A modern ultrasound machine must be equipped with a "Doppler" function. This gives more information about the blood flow inside a particular vessel, which is extremely important for the diagnosis of intrauterine development.
Doppler ultrasound can:
- determine whether the vessels of the fetus are sufficiently supplied with blood, including the vessels of the umbilical cord;
- diagnose fetal hypoxia and placental insufficiency;
- listen to the heartbeat.
This function is used when examining pregnant women and makes it possible to assess whether the future child is healthy. But if an ultrasound of the fetal heart is done in the second trimester of pregnancy, all expectant mothers are advised to undergo echocardiography in the first trimester in order to identify possible abnormalities that may not have appeared before pregnancy.
It is important to know that if the normal parameters of echocardiography of the heart muscle in adults are immediately recorded in the form of digital values, there are special tables for the interpretation of the child's indicators, in which the doctor compares the recorded data and the baby's mass-growth criterion.
Conclusions
Of course, the role of ultrasound of the heart is very important for the diagnosis of diseases of the cardiovascular system, but echocardiography should not be considered as the only method for detecting heart problems. It is also necessary to consult a specialist - a cardiologist, who will listen to complaints, conduct an examination, and, if necessary, send them for additional research. Only all this in combination will help to make the correct diagnosis and prescribe adequate therapy in order to maintain health.
