- Echocardiography is used to visualize and assess cardiac function, structure, and hemodynamic abnormalities. It is the most commonly used noninvasive cardiac imaging tool.
- A record of high-frequency sound vibrations that have been sent into the heart through the chest wall. The cardiac structures return the echoes derived from the ultrasound. The motions of the echoes are traced on an oscilloscope and recorded on film.
- Clinical usefulness includes demonstration of valvular and other structural deformities, detection of pericardial effusion, evaluation of prosthetic valve function, diagnosis of cardiac tumors of asymmetric thickening of interventricular septum, diagnosis of cardiomegaly (heart enlargement).
- Types include two-dimensional (2-D) and M-mode. The methods are complementary and are commonly used in conjunction.
- 2-D echocardiography provides a wider view of the heart and its structures because it involves a planar ultrasound beam.
- M-mode utilizes a single ultrasound beam and provides a narrow segmental view.
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CLASS I INDICATIONS
(Clear indications for stress testing)
- Suspected or proven coronary artery disease (CAD)
- Male patients who present with atypical chest pain
- Evaluate functional capacity and assess prognosis of patients with CAD
- Patients with exercise-related palpitations, dizziness, or syncope
- Evaluation of recurrent exercise-induced arrhythmias
CLASS II INDICATIONS
(Stress testing may be indicated)
- Evaluation of typical or atypical symptoms in women
- Evaluation of variant angina
- Evaluation of patients who are on digoxin preparations or who have a right bundle-branch block
CLASS III INDICATIONS
(Stress testing is probably not necessary)
- Young or middle-age asymptomatic patients who have no risk factors for CAD
- Young or middle-age asymptomatic patients who present with noncardiac chest pain
- Evaluation of patients for CAD who have complete left bundle-branch block
- Evaluation of patients for CAD who have pre-excitation syndrome
Nursing and Patient Care Considerations
- Advise patient that traditional echocardiography is noninvasive and that no preparation is necessary.
- Position patient on his left side, if tolerated, to bring the heart closer to the chest wall. Assist patient to clean chest of transducer gel after the test.
