Echocardiogram: Knowing the State of Your Heart

When you visit a cardiologist, you may be confused as to why you need an echocardiogram when you just had an electrocardiogram.

They are actually two different tests that provide somewhat different information. An electrocardiogram, or EKG, is printed on a sheet of paper and provides a snapshot of the electrical patterns of your heart or heart rhythm. In contrast, an echocardiogram, or “echo,” is a personalized, non-invasive, cardiac ultrasound exam of your heart that records both “real-time” photos and movies to assess the anatomy and physiology of the heart in motion. An echo provides a wealth of diagnostic information that enables us to diagnose and treat all forms of cardiovascular disease effectively.

Although other modalities can be used to evaluate the heart, such as cardiac MRI, cardiac CT scan, cardiac SPECT, cardiac PET scan, and cardiac catheterization, an echo is a relatively inexpensive, portable, and non-invasive exam that spares the patient from radiation, exposure to IV contrast agents, and discomfort.

One-dimensional Echocardiography

In 1953, Inge Edler and C. Hellmuth Hertz used ultrasound, or high frequency sound waves, to perform a one-dimensional echo examination of the heart.The echocardiogram itself has been through generations of innovation and refinement. In the 1880s, it was discovered that certain crystals could transmit and receive sound waves. During World War I, this concept was used to detect submarines underwater. In 1953, Inge Edler and C. Hellmuth Hertz used ultrasound, or high frequency sound waves, to perform a one-dimensional echo examination of the heart.

Two-dimensional Echocardiography

Two-dimensional echocardiography using Doppler technology (measuring the change in wave frequency relative to its source) soon became the modern standard for visualizing the heart, enabling cardiologists to accurately diagnose and treat the majority of cardiovascular disease.

Three-dimensional Echocardiography

The recent development of new transcatheter interventions (TAVI, Mitraclip, etc.) heralded an exciting era of three-dimensional echocardiography, which has enhanced our ability to diagnose, treat, and follow patients with cutting-edge interventions and to accurately measure the size and function of the heart. Finally, strain or myocardial deformation imaging allows cardiologists to identify subtle subclinical markers of heart disease in asymptomatic patients at risk before heart disease happens.

When the echocardiogram is both performed and interpreted correctly, clinicians can obtain significant information about their patient’s heart, thereby making a significant impact on their overall health. For instance, the 2014 AHA/ACC Guidelines recommend an echocardiogram as the first line diagnostic test for patients with valvular heart disease, and other modalities should be considered if the echocardiogram is inconclusive.

An echo can also be used to diagnose structural heart disease such as arrhythmias, cardiomyopathies, ischemic heart disease, congenital, pericardial, and aortic disease, and post-surgical/ interventional heart disease.

If you have ever wondered about the state of your heart or have a family history of heart disease, come in and talk to us to determine if you could benefit from an echocardiogram.

Joseph M. Lee MD MS FACC RPVI is a board-certified cardiologist, who is also Level III board-certified in comprehensive echocardiography and vascular ultrasound. He serves on the Echo Panel at the New York-Presbyterian Hospital/Columbia University Medical Center and at the ICAEL-certified ColumbiaDoctors echocardiography laboratory. He is a member of the American Society of Echocardiography and has given talks to the New York Echo Society and various hospital echo departments. He performs transthoracic, transesophageal, intracardiac, contrast, and stress echocardiography.

Posted in Blog, PROACTIVE / Living Healthy.

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