What Is Echocardiography? Understand the Test Results

Echocardiogram vs Echocardiography: The Differences

The terms echocardiography and echocardiogram are closely related and are often used interchangeably in everyday clinical settings.

• Echocardiography refers to the ultrasound-based technique used to examine the heart.
• Echocardiogram generally refers to the resulting images and recorded findings from the examination.

In practice, a doctor may use either term when discussing the test.

What Does an Echocardiogram Show?

An echocardiogram can provide information about several aspects of the heart, including:

• Size and structure of the heart chambers
• Thickness and movement of the heart walls
• Heart-valve structure and function
• Pumping function
• Blood-flow patterns
• Fluid around the heart
• Certain structural abnormalities

Depending on the clinical question, you may use different echocardiographic techniques. For example, Doppler imaging can provide information about blood-flow velocity and direction, while tissue Doppler and other measurements can provide additional information about cardiac function.

However, an echocardiogram does not fully assess every aspect of heart health. Some conditions require ECG, blood tests, CT, cardiac MRI, stress testing, coronary angiography or other investigations.

Role of Echocardiography and the Cardiology Department

Cardiologists use several types of tests because different investigations provide different information.

Here are the tests that patients can access at the echocardiology and cardiology department in a hospital:

ECG

An electrocardiogram records the heart’s electrical activity. It can help assess:

• Heart rhythm
• Heart rate
• Electrical conduction
• Certain patterns associated with previous or current cardiac problems

Echocardiography

Echocardiography primarily provides information about the heart’s structure and mechanical function.

For example, it can help assess:

• Chamber size
• Wall motion
• Valve function
• Pumping function
• Certain structural abnormalities

The two tests can therefore provide complementary information, but neither test alone can identify every cardiac condition. The choice of investigation depends on the symptoms, suspected condition and clinical circumstances.

What Is Color Doppler Echocardiography?

Color Doppler is a technique used during echocardiography to assess blood flow. It uses the Doppler principle, in which ultrasound signals change when reflected from moving blood cells. The resulting information can be displayed using colours over the ultrasound image.

The colors generally represent the direction of blood flow relative to the ultrasound beam and probe, rather than simply meaning that red always represents one particular physiological direction and blue another. Doppler measurements can help clinicians assess blood-flow velocity and identify patterns that may be associated with conditions such as:

• Valve narrowing
• Valve leakage
• Abnormal blood flow between heart chambers
• Certain congenital heart abnormalities

However, color Doppler alone does not diagnose every structural problem or guarantee normal blood flow. Lab technicians must interpret the images and Doppler measurements alongside the rest of the echocardiographic examination and the patient’s clinical information [1].

Understand The Normal Values of An Echocardiography

An echocardiography report includes multiple measurements, not a single number, to determine whether the heart is healthy.

Reference ranges can vary according to the following factors:

• Age
• Sex
• Body size
• Measurement technique
• Clinical setting
• The specific parameter being assessed

What Is Ejection Fraction?

One commonly reported echocardiogram measurement is the left ventricular ejection fraction (LVEF). LVEF estimates the percentage of blood in the left ventricle that is ejected during each contraction. In a study, the pooled mean normal LVEF across healthy adults is 62.8%, with a general normal range of 52.2% to 73.5% [2].

Importantly, do not interpret EF in isolation. A lower EF can indicate impaired left ventricular systolic function, but its clinical meaning depends on the degree of reduction and the broader clinical picture.

Besides, a person can have a normal or preserved EF and still have heart disease. For example, heart failure with preserved ejection fraction can occur despite a normal or near-normal EF. Valve disease, coronary artery disease, rhythm disorders and other conditions may also be present without a reduced EF.

Therefore, interpret an EF result alongside symptoms, examination findings, other echocardiographic measurements, and relevant investigations.

What Does an Echocardiography Report Usually Include?

An echocardiography report may contain information about several structures and functions of the heart.

Depending on the examination, it may describe:

Heart Chambers

The report may provide measurements of the:

• Left atrium
• Right atrium
• Left ventricle
• Right ventricle

Heart Valves

The four main valves are:

• Mitral valve
• Aortic valve
• Tricuspid valve
• Pulmonary valve

The report may describe valve structure and whether there is evidence of stenosis or regurgitation.

Stenosis means narrowing of a valve opening. Regurgitation means backward leakage of blood through a valve. The severity and clinical significance of these findings vary. A small degree of valve regurgitation, for example, may have a different significance from severe regurgitation [3].

Pericardium

The pericardium is the sac surrounding the heart. An echocardiogram can help identify an abnormal fluid collection around the heart, known as a pericardial effusion.

Wall Motion and Pumping Function

The report may also describe how different sections of the heart wall move and provide measurements related to ventricular function. These findings can help clinicians evaluate particular cardiac conditions, but they must be interpreted in the appropriate clinical context.