So, you’re going to have an echocardiogram

I had an echo yesterday, so I thought I would share my experience for those readers who may have one down the road.

An echocardiogram is a simple, painless exam that uses ultrasound waves to create a picture of the live, moving heart and aorta. A probe sends ultrasound waves into the body and collects the reflected waves to make a picture. This method is identical to using an ultrasound to examine a fetus. It allows a doctor to examine the structure of the chambers and valves of the heart and to examine the heart while it is beating. The doctor also looks at the aorta artery for any abnormalities. The test is often done to look for heart problems or defects, such as murmurs or damage after a heart attack. The echocardiogram machine itself is basically a large computer with a keyboard and monitor that displays the live ultrasound.

You do not need to make any preparations, such as fasting, before the test. When you arrive, you will be asked to disrobe from the waist up only. Small patches with wires that connect to the echocardiogram machine will be attached above your right collarbone and on both left and right sides below your rib cage. These are used to obtain an electrocardiogram. The technician will use a probe connected to the echocardiogram machine to examine the heart and aorta. A cold gel is applied to the probe to help the probe receive ultrasound signals and to help it easily move around on the skin. Two probe sizes are commonly used, one with the diameter of a quarter and one that was slightly smaller than a golf ball. The technician will press the probe quite firmly against your chest in order to get a good reading. This may be uncomfortable, but should not be painful.

I was asked to remain very still in three positions throughout the exam. This allowed the technician to get pictures of my heart at various angles. I first started by lying on my left side. Here the technician used the probe on the top and bottom of my left rib cage. Next I was positioned on my back with my knees bent. Here the technician looked at the central abdomen region to look at the aorta. Finally I had to lie without a pillow and tilt my head up. The technician then took another look at my aorta by examining the center of my neck just above my collarbone. None of the positions were uncomfortable.

The technician continually worked on the computer throughout the exam. He would record movies of the heartbeat and use the mouse to outline various regions of the heart. He also would also examine the heartbeat pattern as a sine wave and outline various peaks. At several points the computer made various whooshing noises. These were the computer's interpretations of the heartbeat and blood movement throughout the heart.

You will breathe normally through most of the exam. However, there were a few places where I was instructed to either hold my breath or exhale completely and hold it for several seconds. This apparently helps the technician get a sharp picture of the heart without interference from the lungs.

The entire procedure took about 45 minutes. Afterwards the technician reviewed his findings with a cardiologist, who came in later to go over the findings with me and to report that everything was fine. All in all, a painless procedure, at least until the bill arrives.

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