Much has changed in recent years in cardiovascular imaging and in particular in heart ultrasound. State-of-the-art machines with modern software combined with new methods and techniques have made the ultrasound study essential for patients with heart problems.

THE 3D ultrasound it has now been established in daily clinical practice for the more precise measurement of the dimensions and the ejection fraction, i.e. the “power” of the heart, as well as for the more thorough study of the valves. The advantage of the method is the possibility of studying the area of ​​interest from any angle.

The use Contrast agent has contributed significantly to the imaging of cardiac structures in patients with difficult “auditory windows”, such as obese or with severe respiratory problems. The main indication of the method is the dynamic ultrasound and the detection of a clot or mass in the heart.

THE dynamic ultrasound (Stress Echo) is one of the most modern methods for early detection of coronary artery disease, patient prognosis and clinical decision-making. It is most commonly performed by administering dobutamine, a drug that gradually increases the heart’s beating and contractility, as is done in physical exercise without radiation or radioactivity. It is based on the sequential acquisition and comparison of real-time digital images with monitoring of the electrocardiogram and blood pressure. It is safe, painless, affordable, while the patient is immediately informed of the result. Suitable patients are those with an intermediate risk of coronary heart disease, such as diabetics, hypertensives or with a hereditary history of coronary heart disease, smokers or those with high cholesterol. It is also useful for those who have suspected chest discomfort and need to investigate its etiology. In addition, it is applied in the context of pre-operative control in patients who are unable to exercise adequately.

THE dynamic exercise stress echo (Exercise Stress Echo) it is also a modern method of reliable diagnosis of coronary artery disease and is performed on a supine ergometric bicycle or treadmill using ultrasound. It is the test of choice for the detection of myocardial ischemia in those who can exercise, while providing prognostic information about their functional capacity. At the same time, the hemodynamic response is evaluated, i.e. blood pressure and heart rate, while valve dynamics, such as mitral regurgitation, can also be studied. Suitable patients are those with chest pain or shortness of breath with fatigue or asymptomatic patients with risk factors as well as athletes with intense physical activity in the control context.

THE bubble study has helped uncover communications in the heart that are present from birth but can produce symptoms much later. It is a simple method in which stirred saline is administered along with a little blood of the patient and by taking appropriate images the diagnosis is made.

THE esophageal ultrasound provides detailed imaging of the heart valves and is performed using a flexible transducer that is passed through the esophagus. The method is painless since it is performed under mild sedation (intoxication). Combined with 3D imaging, high-definition images are obtained, providing the ability to accurately study cardiac structures in real time. Applications of cardiac ultrasound have gone beyond the narrow confines of the laboratory. When performing many invasive procedures and hybrid surgeries, such as cardiac surgery or percutaneous valve repair or replacement operations, the combination of 3D transesophageal ultrasound with fluoroscopy promises excellent results while minimizing complications.

Finally, newer techniques based on the calculation of myocardial deformation parameters are applied in cardio-oncology to patients undergoing or have undergone chemotherapy for the early detection and early treatment of possible cardiotoxic damage.

Modern ultrasound, with its leaps and bounds in recent years, is a bloodless, safe and affordable diagnostic method, as well as an invaluable tool in the treatment of most cardiovascular diseases.