Cardiac ultrasound is a non-invasive examination widely used in cardiology which allows the functioning of the heart to be assessed using ultrasound. It is indicated in a large number of cardiac pathologies.
What is echocardiography?
L’Echocardiography is an imaging test performed by the cardiologist to assess the heart muscle, pericardium and valvular apparatus.
Cardiac ultrasound uses the ultrasound produced by a probe. When they come into contact with an obstacle within the cardiac structures, the ultrasound sends back an echo. The different echoes are picked up by the ultrasound machine, analyzed, and will make it possible to obtain cross-sectional images in real time in all planes. The ultrasounds are not audible.
The examination can be carried out in a cardiology consultation, in the emergency room or at the bedside of a hospitalized patient.
Cardiac ultrasound or cardiac doppler: which is the best examination for the heart?
On his side, cardiac doppler ultrasound consists of observing the vessels and blood flow inside the heart and through the valves on moving images, obtained through ultrasound.
Cardiac ultrasound and Doppler are therefore examinations with different objectives. One is not more accurate or “better” than the other. They are complementary. Thus, echocardiography can be coupled with echo-doppler in order to obtain more precise information on the state of health of the heart.
Indications: when to do an ultrasound of the heart?
Cardiac ultrasound is indicated in case of heart disease (or suspected heart disease): angina pectoris (angina), arterial hypertension, heart failure, breath assessment, heart rhythm disorder, follow-up after a myocardial infarction, etc.
What are the different types of cardiac ultrasound?
There are 3 types of echocardiography:
Transthoracic echocardiography
The patient sits on the examination table shirtless. No anesthesia is necessary. The cardiologist applies ultrasound gel on the patient’s chest and passes a sin in the area of the heart. Light pressure is required to obtain a quality image. This examination is completely painless and lasts only 10 to 30 minutes maximum.
Transesophageal echocardiography
The patient lies on an examination table. A intravenous sedation and an local anesthesia of the phaynx per XYLOCAINE® gel are necessary. The patient, on an empty stomach, must “swallow” the ultrasound probe. The ultrasound probe is introduced into the esophagus. The probe being very close to the heart, the images are much more precise when those obtained during a transthoracic echocardiography. The patient’s condition is monitored throughout the duration of the examination (on average 30 minutes). This technique is mainly used in overweight patients or to better study the atria.
Stress echocardiography (exertional echocardiography)
This is a transthoracic echocardiography but with effort. The patient is positioned on a bicycle or a treadmill and the analysis of the heart is done in three stages: at rest, during the effort and at the time of recovery. The effort can sometimes be achieved artificially by pharmacology by injecting products that will increase the heart rate.
How is an echocardiogram performed?
The examination can take place on an outpatient basis in the cardiologist’s office or during hospitalization (in the patient’s room).
The doctor asks his patient to go bare-chested. If it is a transthoracic ultrasound, the preparation is simply to apply ultrasound gel to the patient’s torso. If the ultrasound is done through the esophagus, the patient gargles with an anesthetic product in the back of the throat. He is also sedated intravenously.
Then the probe is passed over the chest (transthoracic method) or introduced through the mouth (transesophageal method) and the doctor can then view the heart on his screen.
The images are in black and white. But when ultrasound is coupled with Doppler, colored areas (usually red and blue) are added.
Echocardiography: how long?
The transthoracic ultrasound lasts between 10 to 30 minutes while the transesophageal ultrasound can last an average of 30 minutes. In the first case, the patient can resume his activities immediately after the examination. In the second case (transesophageal method), the patient rests in a recovery room (or in his bed in the event of hospitalization) before being discharged. A quick clinical examination (including the measurement of blood pressure) can be performed after the exploration.
Cardiac ultrasound: how to prepare for the examination?
The patient must be fasting to perform transesophageal echocardiography but not for transthoracic ultrasound. He must go to the meeting place with his prescription and his vital card. No other dietary measure is required before taking the exam.
What are the possible side effects?
No complication is linked to the practice of ultrasound, no irradiation being delivered. Fatigue can be felt in anxious patients (who dreaded the examination) and in those who received sedation in the event of a transesophageal ultrasound.
Ultrasound of the heart: how is the report going?
The report of the echocardiography includes a synthetic conclusion of the examination, specifying the possible evolution compared to previous examinations, and supplemented by a clinical interpretation for the attention of the corresponding doctor. The examination performed may be given to the patient and/or kept in a paper file or on a digital medium (for the institution and for the patient).
How much does a cardiac ultrasound cost?
The price of an echocardiography with or without Doppler is 96.49 euros. Reimbursement by Health Insurance of 70% is made on this basis of price provided that the coordinated care course has been respected. The remaining charge of 30% may be paid in whole or in part by your health insurance fund depending on the contract chosen. There may be fee overruns in private practices. Some mutuals cover these overruns.