ECHO (Heart Ultrasound)

By: Prof. Dr. Şükrü Akyüz

ECHO (Echocardiography / Heart Ultrasound)

ECHO is an imaging method that takes a film of the heart. It works with ultrasound waves, i.e. sound waves that cannot be heard by the human ear, produced by a device (probe) that touches the chest. These ultrasound waves pass through the chest wall and hit the heart layer by layer, return back with radar logic, are detected by the sensors of the device and processed in the main machine and converted into an image. Therefore, it is also called heart ultrasound.

ECHO is a fundamental examination for understanding the anatomy of the heart. It also gives us information about the physiology of the heart, i.e. how it works, by determining the speed and direction of blood flow. ECHO is very useful in detecting the following problems:

  • Reduced pumping power of the heart or hardening of the heart walls (heart failure)
  • Heart valve diseases (valve stenosis and leaks)
  • Fluid accumulation in the pericardium (pericardial effusion) or hardening (constrictive pericarditis)
  • Non-moving areas in the heart walls (myocarditis, heart attack, vascular occlusion, etc.)
  • High blood pressure in the blood vessel leading from the heart to the lungs (pulmonary hypertension)
  • Heart muscle diseases (CDC, ARVC etc.)
  • Heart holes and other congenital heart diseases (ASD, PFO, PDA, VSD etc.)
  • Ballooning at the beginning of the aorta (aortic aneurysm)
  • Other rare diseases (PVL, amyloidosis, tumour, cyst, etc.)

ECHO is usually performed at rest (while the patient is lying down) (Transthoracic ECHO; superficial ECHO). This is what is meant when only the word ECHO is used. However, some patients report that they feel fine at rest but have complaints during exertion. For this reason, the patient’s heart is sometimes accelerated with medication or exercise (treadmill or stationary bicycle), i.e. the heart is consciously stressed and an ECHO is performed immediately. This is called stress echocardiography. Stress ECHO is used to determine indirectly whether the heart vessels are blocked or not, or to determine the viability of certain areas of the heart after a heart attack. Sometimes the images obtained from superficial echocardiography are not clear (obesity, COPD, etc.) or some anatomical structures (e.g. the left atrial appendage) cannot be seen with superficial echocardiography. In this case, ECHO is performed through the oesophagus. Since the oesophagus is very close to the heart, it provides a very clear image. This is called transoesophageal echocardiography (TEE).