Echocardiography

Seventeen people die from cardiovascular illnesses every day in Singapore, according to the Ministry of Health. In 2017 alone, it has been reported that heart-related illnesses accounted for 30.1% of deaths in the country. Such conditions are chronic and progressive in nature, yet there’s still no telling when a stroke, heart failure or cardiac arrest may occur.

Fortunately, you can take simple steps to prevent cardiovascular illnesses, or if you’re already diagnosed with one, slow its progression and improve heart health. For high-risk and diagnosed patients, this includes having an echocardiogram.

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What is an Echocardiogram for?
An echocardiogram, also known as a cardio echo, is a test that uses ultrasound to capture images of the heart. It is done to assess the heart’s overall condition and detect any problems concerning its function and structure. As a diagnostic tool, an echocardiogram can be performed to find the root cause of symptoms like palpitations, chest pain or shortness of breath. It can identify the type and progression of heart diseases in all ages, even congenital defects in fetuses. The test may also be ordered post-treatment to evaluate its outcome and effectiveness.
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When does a doctor advise for an Echocardiogram to be done?

An individual who is healthy and has no medical or family history of cardiovascular illnesses is not required to undergo an echocardiography during routine check-ups. However, a cardiologist may order an echocardiogram for those who are at risk of developing heart diseases or are exhibiting symptoms indicative of such conditions. This may include heart murmurs, high blood pressure, chest pain or breathing difficulties. Factors like age and lifestyle are also considered to assess the need to undergo this test.

Those who are already diagnosed with a heart illness need to have an echocardiogram more regularly to monitor the overall condition of the heart before and after treatments. The frequency will also depend on the cardiologist’s recommendation.

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What are the different kinds of Echocardiogram?
Various types of echocardiography are available in a heart clinic, all of which use ultrasound. Which method is best for you will be determined by your cardiologist.
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Transthoracic Echocardiogram
The most standard type, transthoracic echocardiogram is non-invasive and works similar to an X-ray and a regular ultrasound. In this method, a handheld transducer will be placed on your chest over the heart. A transducer is a device that transmits ultrasound waves to capture live images (sonogram) of the heart’s chambers and vessels, which can be viewed from a monitor. Transthoracic echocardiogram is done to check for structural heart defects and evaluate cardiac function and blood flow.
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Transesophageal Echocardiogram
In cases where high-resolution images of a specific part of the heart is required, or if a transthoracic echocardiogram is unable to provide clear images of the heart’s structures, a transesophageal echocardiogram is recommended. It involves a thin, flexible tube equipped with a small transducer, which is inserted down the throat, and into the esophagus behind the heart. This method gives more access to the heart and reduces sound wave interference from the lungs, ribs and chest. It is performed while the patient is sedated.
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Doppler Echocardiogram
The Doppler echocardiogram is done to measure and evaluate the amount, speed and direction of blood flow to the heart’s chambers and vessels. Performed alongside transthoracic or transesophageal echocardiograms, this method is used to detect abnormal blood flow and pressure indicative of issues in the heart’s valves or walls.
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Stress Echocardiogram
Coronary artery problems can be detected and assessed through a stress echocardiogram. In this method, the patient undergoes a standard echocardiogram before and after exercising on a stationary bike or treadmill. This test helps the cardiologist determine the effects of stress on the heart, as well as the amount of stress that the heart can handle.
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How should you prepare before an Echocardiogram?
No special preparations are required for transthoracic and Doppler echocardiograms.
For a transesophageal echocardiogram, however, you will be instructed to refrain from eating or drinking for several hours before the procedure. Since this test involves you being sedated, you are strictly prohibited from driving home afterwards. Make sure to have someone pick you up from the hospital afterwards.
Aside from wearing comfortable clothes and footwear suitable for exercising, no additional preparations are needed for a stress echocardiogram.
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What results does an Echocardiogram usually show?
An echocardiogram may reveal issues concerning:
  • Heart Defects - The test can be done to check for structural and congenital heart problems that are either a result of age, infection or injury, or causing symptoms indicative of an underlying illness.
  • Heart Size - Cardiomegaly (enlargement of the heart) may be congenital, or caused by high blood pressure, cardiomyopathy (disease of the heart muscle), heart valve disease and arrythmia (irregular heartbeat), all of which can be detected through an echocardiogram.
  • Damaged Heart Muscles - An echocardiogram can show if all areas of the heart wall and the heart muscles are intact, working properly and getting sufficient oxygen to support the organ’s blood-pumping function.
  • Pumping Strength - As a diagnostic tool, an echocardiogram can measure and evaluate the percentage of blood being pumped per heartbeat (ejection fraction) and volume of blood being pumped per minute (cardiac output). A heart that pumps blood inadequately and irregularly is at risk of sudden failure or a stroke.
  • Heart Valve Issues - An echocardiogram helps show whether there are problems with the structure and function of the heart’s four valves in regulating blood flow.
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If you have a high risk of developing cardiovascular illnesses, or have been diagnosed with a congenital or an acquired one, an echocardiogram is crucial to stop the progression of such conditions and promote the rehabilitation of your heart.
EH Heart Specialist is a Singapore heart clinic that provides a full range of services for the diagnosis and treatment of all cardiac problems. Headed by Dr Eric Hong, the clinic also offers tests such as electrocardiography, echocardiography, cardiac stress testing, coronary angiography, and blood and urine investigations.
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