Echocardiography is an important tool in assessing wall motion abnormality in patients with suspected cardiac disease.
It is a tool which helps in reaching an early diagnosis of myocardial infarction, showing regional wall motion abnormality.
The use of stress echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease.
The most important advantages of echocardiography are that it is not invasive (does not involve breaking the skin or entering body cavities) and has no known risks or side effects.
Recognized as the "Father of Echocardiography", the Swedish physician Inge Edler (1911–2001), a graduate of Lund University, was the first of his profession to apply ultrasonic pulse echo imaging in diagnosing cardiac disease, which the acoustical physicist Floyd Firestone had developed to detect defects in metal castings.
[7] A common example of overuse of echocardiography when not indicated is the use of routine testing in response to a patient diagnosis of mild valvular heart disease.
[8] Echocardiography has a vast role in pediatrics, diagnosing patients with valvular heart disease and other congenital abnormalities.
TTE utilizes one- ("M mode"), two-, and three-dimensional ultrasound (time is implicit and not included) from the different windows.
Images can be enhanced with "contrast" that are typically some sort of micro bubble suspension that reflect the ultrasound waves.
A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus via the mouth, allowing image and Doppler evaluation from a location directly behind the heart.
The entire esophagus and stomach can be utilized, and the probe advanced or removed along this dimension to alter the perspective on the heart.
A stress echo assesses wall motion of the heart; it does not, however, create an image of the coronary arteries directly.
A stress echo is not invasive and is performed in the presence of a licensed medical professional, such as a cardiologist, and a cardiac sonographer.
If the catheter is retraced in a controlled manner, then an internal map can be generated to see the contour of the vessel and its branches.
It has specific uses and has the benefit of very high temporal fidelity (e.g., measuring LV size at end diastole).
[13] Real-time three-dimensional echocardiography can be used to guide the location of bioptomes during right ventricular endomyocardial biopsies, placement of catheter-delivered valvular devices, and in many other intraoperative assessments.
All generic models refer to a dataset of anatomical information that uniquely adapts to variability in patient anatomy to perform specific tasks.
Built on feature recognition and segmentation algorithms, this technology can provide patient-specific three-dimensional modeling of the heart and other aspects of the anatomy, including the brain, lungs, liver, kidneys, rib cage, and vertebral column.
The ultrasound contrast is made up of tiny microbubbles filled with a gas core and protein shell.
This allows the microbubbles to circulate through the cardiovascular system and return the ultrasound waves, creating a highly reflective image.
The most commonly used application is in the enhancement of LV endocardial borders for assessment of global and regional systolic function.
Contrast echocardiography has also been used to assess blood perfusion throughout myocardium in the case of coronary artery disease.
There are several states in which Medicare and/or private insurance carriers require accreditation (credentials) of the laboratory and/or sonographer for reimbursement of echocardiograms.
Both CCI and ARDMS have earned the prestigious ANSI-ISO 17024 accreditation for certifying bodies from the International Organization for Standardization (ISO).
Under both credentialing bodies, sonographers must first document completion of prerequisite requirements, which contain both didactic and hands-on experience in the field of ultrasound.
Applicants must then take a comprehensive exam demonstrating knowledge in both the physics of ultrasound and the clinical competency related to their specialty.
Credentialed sonographers are then required to maintain competency in their field by obtaining a certain number of Continuing Medical Education credits, or CME's.