An ultrasound of the heart is an imaging test in which the structural elements of the heart are studied. It is a dynamic study meaning that while the heart is beating inside the chest, the sonographer aims and sends sound (ultrasound) through the transducer, which is reflected and converted into an image (via a computer) and so we can see the contraction of the heart muscle, the behavior of the valves, the pericardium, the great vessels, etc.

Heart ultrasound complements and enhances the cardiac examination that includes auscultation through a stethoscope and an electrocardiogram. The two above check the cardiac function with indirect data, while with the ultrasound we can see the heart’s function live. In this way, various diagnostic problems can be addressed immediately.

The following may sound simple, and that is the point here, but it takes a painstaking specialization process that takes years after qualification to reach a satisfactory level of proficiency.

There are different types of heart ultrasound such as:

Transthoracic echocardiogram

It is a painless examination that takes advantage of ultrasound waves reflected from the heart to create an image of it and the great vessels.

Transesophageal study

It has exactly the same technical logic as transthoracic echocardiography. However, in the case of the transesophageal study, the special transducer is advanced from the oral cavity into the esophagus and stomach (a procedure similar to a gastroscopy) from where it is only a short distance from the organ under study, i.e. the heart. In other words, it is a mildly invasive test, for which appropriate preparation is required (the patient must fast for 6-8 hours before the examination) and mild intoxication or even anesthesia is administered in more difficult cases.

Contrast Echo

It is an ultrasound technique that uses microbubbles (saline or artificial contrast agent) and is applied to clarify the boundaries of the endocardium and to assess in real time the intracardiac and myocardial blood flow with the use of contrast agent or to find a defect in the wall of the heart cavities allowing communication between them by an abnormal route.

Color Doppler echocardiogram

It can be performed either transthoracic or transesophageal as required. It makes it possible to mark blood flow more precisely thanks to color Doppler technology.

Dynamic ultrasound (Stress Echo)

This is a highly diagnostic test that is used mainly to check the functionality and detect significant narrowings in the coronary vessels. It is a specialized technique used for the early and reliable detection of coronary artery disease and for the assessment of cardiac function. It is one of the most popular methods.

Three-dimensional (3D) Echocardiography

It is a specialized test that uses ultrasound to visualize the heart in 3 dimensions (3D) in space. This method reveals the complete anatomy of the heart in detail. We can investigate in detail the exact anatomy in space in relation to neighboring tissues, the more complete architecture and function of the heart valves and other cardiac structures, providing images necessary for the diagnosis, etiology of the condition and its therapeutic management. High-quality imaging often sets the plan for patient management even during surgery.

I will focus on dynamic ultrasound (stress echo), which, together with contrast ultrasound, is one of the main methods for bloodless diagnosis of coronary artery disease.
It has developed greatly since the 90s and has essentially replaced the classic treadmill fatigue test for several years because it has a much better sensitivity in finding significant disease than the classic fatigue test. Of course, it requires special skills and great experience from the specialized cardiologist to be performed safely and with high imaging quality. Which, of course, the Heart Ultrasound Department of HYGEIA provides to the fullest.