What Does An Echocardiogram Show?
An echocardiogram is used to show possible abnormalities of the heart structure and function that may be the cause for symptoms thought to be related to heart disease. An echocardiogram shows us the structure and function of the heart. It provides information on the heart pumping function and heart size. It shows us information on the heart valves and other structures in the heart. An echocardiogram also shows patterns of blood flow through the heart.
What Does An Echocardiogram Show – Who Needs An Echocardiogram?
Patients may be referred for an echocardiogram for a variety of different reasons. It may be due to symptoms concerning for heart disease such as shortness of breath, chest pain, palpitations, dizziness and other related symptoms. It may be to investigate a murmur heard on physical exam. It may also be to monitor existing heart conditions such as valve problems or heart failure.
What Does An Echocardiogram Show – Heart Pumping and Relaxing Function
An echocardiogram gives us accurate information on the pumping function of the heart. The echocardiogram will be used to calculate the ejection fraction of the heart, which is the percentage of blood that the heart pumps out with each beat. Normal ejection fraction is 50-60%. The echocardiogram also provides information on the relaxation of the heart. Heart failure can be caused by both pumping and relaxing abnormalities. Echocardiography will show information on both the left and the right side of the heart.
Measurements taken from an echocardiogram can show heart tissue characteristics.
What Does An Echocardiogram Show – Patients With Chest Pain
In patients with chest pain there are a number of different possible causes, some of which can be assessed by echocardiography. If artery blockages are suspected the echocardiogram may show abnormalities in the walls of the heart supplied by those arteries. These are known as wall motion abnormalities. In cases of pericarditis, which is inflammation of the lining around the heart there may be fluid accumulation around the heart known as a pericardial effusion.
What Does An Echocardiogram Show – Heart Valve Function
Echocardiograms show structure and function of the 4 valves in the heart. The aortic valve, the mitral valve, the tricuspid valve and the pulmonic valve. They can show abnormalities in valve function such as tight or leaky heart valves. A tight aortic valve is known as aortic stenosis. A leaky aortic valve is known as aortic regurgitation. A tight mitral valve is known as mitral stenosis and a leaky mitral valve is known as mitral regurgitation. Echocardiograms can be used to show the degree of tightening or leakiness of a heart valve and help us to make decisions regarding need for intervention.
What Does An Echocardiogram Show – Heart Size
Echocardiography is used to provide information on heart size. It can provide accurate dimensions of the chambers of the heart and also the thickness of the heart walls. It can therefore be used to detect heart chamber or wall enlargement known as hypertrophy. Echocardiography will provide information on both the left and right side of the heart.
Measuring Heart Chamber Size
What Does An Echocardiogram Show – Patterns Of Blood Flow
Doppler is a type of echocardiography that can show patterns of blood flow through the heart. Doppler can give us an idea of pressures inside the heart and detect those that may be abnormally high. Color Doppler may be used to examine for leaky or tight heart valves.
What Does An Echocardiogram Show – Advanced Analysis
Most newer generation echocardiography machines will incorporate 3D acquisition that can render the heart as a 3D image showing life like structure and function. Various characteristics such as heart strain can be examined to provide highly detailed information about the heart tissue function. These features are not typically reported on a standard echocardiogram.
What Does An Echocardiogram Show – Guidance Of Procedures
Echocardiography can be used to guide certain heart procedures such as the Mitraclip procedure, the TAVR procedure, paravalvular leak repair, mitral valvuloplasty, alcohol septal ablation and many others. In many cases advanced techniques such as 3D transesophageal echocardiography may be required. These techniques can provide real-time 3D lifelike images that can guide procedures remarkably well.
What Does An Echocardiogram Show – Surveillance Over Time
Many heart disorders will need to be monitored over time to ensure they stay stable and don’t worsen and to assess response to therapy. Echocardiography is a highly reliable way to show changes in heart structure and function over time.
Comments are purely for informational purposes and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Disclaimer
I just wish these Doctors could get their act together and give us the correct answers…..Is coconut oil good for us or not? That is the question…..
Why do some say it is when some say it is not ????? Just does not make sense to me….
Not sure what this has to do with echocardiograms, however clearly an interesting topic. I had the same thoughts myself this week. I had started using coconut oil over the last few years and was very surprised to read the reports last week basically saying it is no better than other so called harmful saturated fats. It is extremely annoying how recommendations change so frequently and makes it hard to take many nutritional recommendations seriously. In my opinion, if part of a healthy diet with low carb in general, coconut oil is very reasonable.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
I’m learning but under what circumstances wouldn’t my echocardiogram be able to assess diastolic function??
The reason that a single advisory statement from the American Heart Association claimed that coconut oil was to be avoided was because it is mostly saturated fats. Saturated fats are bad because they increase LDL. Increased LDL is bad because it is associated with heart disease. So it’s really a chain of implications that lead to this report’s warning. This is known as the saturated fat-cholesterol-heart disease hypothesis advocated by Ancel Keys back in the ’50s and since pretty much disproven, but not discarded.
In fact, if you look at the many, many papers on LDL it turns out that LDL has little effect on heart disease for middle aged men; lowering it with statins produces an absolute beneficial effect of about 1% reduction in all-cause mortality after taking a statin daily for five years. In other words, it increases lifespan by a few days, and statins have significant side effects. On the other hand statins show no benefit for women. And it’s been known since Framingham that LDL is actually protective for older men (you know, the ones who would be concerned about heart disease).
There is ongoing controversy about whether saturated fats are harmful or lead to heart disease. My understanding of the best new research is that saturated fats are not harmful, but processed vegetable oils, especially those having trans fats, definitely are. All fdats are not equivalent. This is hard for nutritionists to swallow.
What are the practical consequences of eating saturated fats? Let’s look at a concrete example: a person who started out with total cholesterol well above 200, making them a candidate for statins. If they go on a well-formulated ketegenic diet they will eat just the carbohydrates that leak into their diet from vegetables, they’ll eat plenty of fatty, red meat as well as chicken and fish, and they will eat the bulk of their calories in the form of fat, mainly saturated fat including lots of coconut oil. After some months on this diet their total cholesterol will drop below 200, their HDL and LDL will increase maybe 25%, but their triglycerides will decline maybe 50%. Their ratio of Total Cholesterol to HDL will probably end up less than 3, meaning they would have about half the average risk for heart disease of someone their age.
The AHA advisory has been attacked for selecting only four studies that support its claim while rejecting many more that refute it, but this is typical of the confusion that classical nutritionists spew out. The many research papers and personal experience of Atkins-type dieters should reassure you that you can eat all the coconut oil you want. Bon apetite.
Thank you Tumblemark. Good info to prep for mrg wife’s Cardio next week about her ultrasound this morning. Too much white stuff on the screen for my liking.
I just saw a show on Dr Oz about this. Coconut oil is HIGHER in saturated fat (bad) . You need to find it WITH FIBER and then it’s ok.
But I remember years ago that they made the theaters STOP USING COCONUT OIL TO POP THEIR POPCORN BECAUSE IT WAS TOO FATNING! I THINK I’LLLL STICK WITH OLIVE OIL!
I can only speak from my experience. I stopped adding a teaspoon or two of Coconut Oil to my coffee each morning and stopped eating shrimp. My total cholesterol dropped from 226 to 200 in three months. For me, that answered my question because my PCP could not answer it for me.
Dear Dr. Mostafa
Greetings,,
I’m 41 years old female, staying in UAE
I have a regurgitation of mitral valve since 2000
The cardiologist advised me to do a Mitral Valve surgery
I want your opinion
I sent reports on email: info@myheart.net
please try vitalengine.com
What is the purpose of a stress echo? I saw a cardiothoracic surgeon yesterday. He told me that my aortic stenosis is in surgery range. We both agree I am not quite sick enough yet for surgery. My cardiologist is planning next echo in December or January. If there are any changes at all, it’s go time. This surgeon told me he is going to ask my cardiologist to do a stress echo the next time. What is the difference?
A stress echo may be used in aortic stenosis when there is ambiguity as to the severity of the disease or if the severity is borderline. The stress (exercise or dobutamine) may be used to see if the disease is pushed in to a clear severe range that may explain symptoms at time of exertion. It simulates the active state.
Thank you so much. This makes a lot of sense. You explanation is very thorough. I was getting these every year, at the time it was thought I had BAV, but I had no stenosis yet. Last time was 10 years ago. Now they tell me it’s not BAV, but rather a very thick, stiff 3rd commissary that’s difficult to see.
Excelente información, muy agradecida. Mi pregunta: el año pasado (junio) me operaron del corazón accediendo vía torácica, me hicieron 4 by pass y cambio de válvula mitral. Me siento bien a pesar que se me indicó que tengo una hipertrofia ventrículo izquierdo y este tiene una función al 25 %. ¿por qué me siento bien si mi corazón bombea mal?
Agradecida por su comentario
I had an echocardiogram last year from the appearance of heart palpitations that take my breath away sometimes. All my test came back completely normal, but I still don’t know the cause to my palpitations. Would the echocardiogram show if something wasn’t working correctly 100%?
The echocardiogram is a good test, but needs to be read by a good operator.
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Dr. Ahmed,
I am a 51 year old female that in mid October went to my primary care doctor for visible swelling below my left rib cage. I was sent for two CT Scans, abdominal and chest and was told I had a mild pericardial effusion and gastritis. A few days later, I started feeling awful and started getting nauseated and stomach sick. My echocardiogram was normal and my effusion measured .4 cm and no one seemed worried. Since then, I have had an endoscope and two of those, colonoscopy, hiatal gallbladder scan, gallbladder sonogram, gastric emptying test and and MRI. My gallbladder is inflamed with a function of only 26% but surgeon feels there is an underlying problem going on that if treated will help the gallbladder. I still have the effusion witch measured 1 cm on MRI and a very inflamed stomach wall. My GI doctor has released me from GI issues and says I need a rheumatologist for a Lupus diagnosis even though my blood tests came back negative. I am getting upset and frustrated and don’t know where to turn. My swelling under the rib cage is larger, I am still nauseated and wondering if I should see a cardiologist before rheumatologist. My white count has dropped to 3000 the week of Christmas but was 4300 when all this began in mid October. Can you give a suggestion on a route to take? The swelling is bothersome as well as nausea. Oh, I have also lost 14 pounds since this started. Thank you
Melisa
If you are worried it will not hurt you to seek cardiology evaluation. The pericardial effusion is described as small and not likely related to the swelling on the chest wall. The situation sounds complex. I would ask your primary care dr if they feel a referral to a cardiologist is appropriate.
What do patients do when the MD says a echo really needs to be done but the pt. can not afford their copay they have with their insurance? My copay could be as much as $500.00 and I’m on disability! Is their another test that can be done that insurance would cover? My ekg shows some questionable changes such as QRS changes and a inverted T wave! It sucks being poor. Thank u
can an echo r/o widow maker,tear in aorta,problems w/LAD,etc
No
Hello i had an echo done and the results given to a cardiologist. The results show my measurements are in normal range but the technician put hypertensive heart disease. The cardiologist said I was just hypertensive and gave me meds but my symptoms are worrying me. What do I do? The cardiologist is very good though.
Hypertensive signs on an echo may include generalized wall thickening and the concern over time is that the function can depress. For this reason, the blood pressure control over time is key. That is the only real treatment.
you can follow my twitter at @MustafaAhmedMD
My question really is can the measurements of the heart and ecg readings show hypertensive heart disease. Can you tell the state of the heart from that as a cardiologist presented with those things.
https://myheart.net/articles/uncontrolled-hypertension-including-hypertension-emergencies/
You may find this useful
Hi there
I have question if I may :
I recently had an echocardiogram and the only thing that concerns me is the LVIdD that is 59 mm
Other parameters are fine (EF 70%, IVsd 11 mm ,Normal wall function, valves and anatomy normal).Am 33 years old very active (weightlifting running and basketball) for most of my life am 178 height and weigh in 84 kg.
Your answer would be greatly appreciated
The first thing to do is have the interpreting practitioner look at the study and determine the accuracy of the reading. Its also important to have them draw volumes if they feel there is any abnormal values. If the ef is 70% unlikely there are issues however have then check.
you can follow my twitter at @MustafaAhmedMD
Hi Mustafa
Is LVIDD parameter of 59 mm of very active 33 old male something to really worry about ?
Other parameters fine (normal valve function, EF 70 % , normal wall function)
Am 178 and weight 84 kilograms
Your answer would be greatly appreciated
Many thanks for your answer the practitioner haven’t said that I should be concern with this
it’s just me as the norm for the LVidd is to 57 mm and am above 2 mm. In what time would you recommend for me to retake the exam ?
Once again many thanks for your time and help
I am a 43 year old male and I am overweight. Last year(June 2017) I had a stress echo done and everything had come back good. No issues what-so-ever. My question is this: It’s been about a year, what level of blockages does the echo read? Doe it show slight buildup of plaque or only major blockages. What if I had minor blockages during my testing and they were missed? Could they have dangerous build up now after a year has passed? Should I try to get an echo every year?
The echo would only pick up significant obstructive blockages, minor blockages are unlikely to progress to severe over a year. You may find this article linked helpful. https://myheart.net/articles/do-i-need-a-stress-test/
you can follow my twitter at @MustafaAhmedMD
I had an echo and holter monitor due to palpitations. Holter monitor just stated sinus rhythm with occasional pvc’s. Echo showed ef 60-65%. No wall abnormalities, no stenosis or regurgitation with any valves. Tricuspid peak gradient value of 17 mm hg, no pericardial effusion, but it does show “the right atrium is dilated”. I dont have high blood pressure. I am over weight with hypo thyroid. My pcp never referred me to cardiology she just said “we watch it”. Ive never been given an answer as to what causes right atrial enlargment. Any ideas
I’m 49. I had a stresstest and an echo but not a stress echo. My cholesterol even with exercise and not eating alot of fat is 210. My hdl is low at 38. Its been low 5 years. Triglycerides are 100. My stress and echo looked good. MY 67 yr old mother has significant cad. She had her widow maker Lad and the circumflex ( sorry if thats the wrong term)blocked and one other. Will the tests I have had be sufficient for me to rest at ease for now? . I do have palpitations but they weren’t concerned. MY mother’s doctor keep saying this is very hereditary. She always had great cholesterol levels and low blood pressure till arpund 50 just like .me. I can get a scan that would show calcification levels without a doctor referral. I want to to decide if I shpuld. I just keep hearing people say and doctors that women my age dont get severe Cad that Its mostly men. My friend died at 47 from a heart attack
If you don’t have symptoms and your stress test is normal and you have been evaluated by a Dr. then that is certainly reassuring. With your history the most critical thing is to manage risk factors such as blood pressure, lifestyle etc.
you can follow our twitter at @MustafaAhmedMD
Hi Dr Mustafa
I am a 47 year old female, non smoker, non drinker & slim. I have fairly severe palpitations. ECG showed bradycardia, holter showed constant irregular heartbeat (bi & trigeminy), echo showed aortic & mitral valve slight leaks. I have Ankylosing Spondylitis. My cardiologist says I can’t have beta blockers as they slow heart rate & I already have bradycardia. He says just to live with it which I don’t mind but the palpitations are stopping me sleeping & the past 10 days I have had chest pains like my heart is being squeezed. Do I need to get further investigation or just live with it please? Thank you in advance
If you are worried and have not been reassured by your evaluation and have symptoms, seek evaluation.
My recent echo seemed good (summary below)..Is it common to have trace regurgitation in 3 valves?….My first echo 10 years ago, i had trace mitral & tricuspid regurgitation…
“COLOR FLOW DOPPLER:
There is trace mitral regurgitation. There is trace tricuspid regurgitation.
There is trace pulmonic regurgitation.
FINAL IMPRESSIONS:
01) The left ventricle has normal systolic function. The estimated left
ventricular ejection fraction is 55-60%.
02) Normal right ventricle size. The right ventricle has normal function.
03) Normal diastolic function”.
Yes thats ok.
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I had mitral valve repair 6 months ago. In the last 3 months I have shortness of breath with any exertion and constant fatigue. In recent weeks, also have severe palpitations and headache. Last week ECHO shows trace regurgitation, 60% EF. Cardiologist says ECHO looks good. Is it possible to have some valve malfunction that doesn’t show up on the ECHO? I feel sicker than I did before the surgery.
What was the gradient across the valve, sometimes the valve can be tighter than usual after a repair rarely leading to symptoms. If there is supporting evidence such as a murmur and concern for the valve itself a TEE may be the next step of choice.
you can follow our twitter at @MustafaAhmedMD
I don’t understand anything about this. To many big words that I don’t understand. What are the colors?
A sibling had an echo two months ago at the VA. Normal. After being in emergency and having 5 stents and further surgery in 2-3 weeks for the left side, WHY wasn’t this seen at time of echo?
Resting echo does not predict the possiblity of a heart attack in most cases, it simply tells you the function at that time.
you can follow our twitter at @MustafaAhmedMD
Pericardial effusion 12mm.tap done
2 mnts back.Weather it is recurr 2 mnts.Is it curable.Test shows all negetive.
I am a 58 year old male and have stable moderate aortic regurgitation 2-3/4 which is monitored annually by echo. My LVEDV is 155 mls and ejection fraction in the range of 50-55. I have a mildly dilated left ventricle and left atrium but no adverse remodelling. QST – are my LVEDV and EF in the normal range and is there anything I can do to slow progression of the regurgitation?
In general medical therapies are not there for aortic regurgitation, blood pressure control and such are important. The best thing to do is ensure regular follow up.
you can follow our twitter at @MustafaAhmedMD
I am a 59 year old male and have long term moderate aortic regurgitation which is monitored through annual echos.
I would have thought that with chronic moderate aortic regurgitation (2-3/4) this would result in volume overload and progressive left ventricular enlargement. While my latest echo shows I have very mild left ventricle hypertrophy I am a little curious why many of my overall heart measurements have improved since last year:
IVS d – up from 0.9cm to 1.1 cm
LVPW d – up from 1cm to 1.1 cm
LV volume – reduced from 155 to 140 ml
LVID d – reduction in size from 5.6cm to 5.4cm
Normal overall left ventricular systolic function – improved from low normal
Ejection fraction – 55-60 percent – improved from 50-55 percent
Left Atrium – reduction in size from 25cm2 to 18cm2
Right Atrium – reduction in size from 21cm2 to 19cm2
Generally speaking could these measurements represent improved heart function ie I have lost about 5kgs and increased my exercise to 13000 steps a day at moderate to fast pace?
Is the chronic moderate aortic regurgitation likely to be the cause of mild concentric LV hypertrophy?
Gary
Unless done in a very tightly controlled lab im not sure of the accuracy of the echo although the trend is reassuring. MRI would be more accurate. Chronic AI indeed can lead to concentric hypertrophy.
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Comparison of Dec 2018 echo to March 2019 echo shows “marked decline in EF from 69% in 12/18 to 40% in 3/19. What could cause such a rapid decline in 3 months
Many possible causes, it requires investigation.
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Dr Mustafa,
I am 45 and my 2D Echo report says
Aortic valve Calcific Tricuspid
Left Atrium 3.8 cm
Left Ventricle ESD 2.9 cm EDD 4.8 cm PW 1.0 cm EF 69% FS 39%
Aorta 3.5 cm
IVS 1.1 cm
Mitral flow E > A
Aortic flow 2.4 m/sec
Pulmonary flow 1.0 m/sec
Tricuspid flow TRJV 2.7 m/sec RVSP 38 mmHg
Please advice.
Very interesting and helpful article on using the Echo for detection of heart disease and poor functioning. I recently had an Eye Stroke that caused partial blindness in one of my eyes. The ER Doctors scheduled me for many tests including the Echocardiogram.
They said that the piece of cholesterol that caused an occlusion in a branch artery of my retina. Why would they order an Echocardiogram to seek the cause of my issue? My docs noted that the CAT SCAN of my brain and neck showed normal results,
Please enlighten me. Thanks!
You need a full embolic work up including carotid, echo shunt testing with bubble study, and other, a neurologist, cardiologist and ophthalmologist should be involved.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
is playing tennis one hour before TRANSTHORACIC ECHO COMPLETE TEST OKAY?
In general, yes.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.