Echocardiogram (fetal, with doppler): how is the test done?

What is Echocardiogram and what is it for?

The echocardiogram is an exam that, using high frequency sound waves and images of the muscles and heart valves, evaluates the functioning of the heart, in addition to identifying the direction and speed of blood flow inside the cardiac cavities.

Its principle is similar to that of ultrasound, that is, a transducer is slid over the patient’s chest and directs waves to the heart’s structure. The examination can also be performed on the fetus, during pregnancy, allowing interventions for any anomaly, even inside the uterus.

The process is painless, easy to operate, has excellent diagnostic reach and has no side effects. The risks are extremely rare, in addition to not exposing the patient to radiation.

What is the average price for this exam?

The average price for an echocardiogram is between R $ 135.00 and R $ 170.00. The amount, however, may be higher if a fetal examination is requested, and is in the range of R $ 200.00 to R $ 400.00.

Most agreements cover the cost of the exam.

Types of Echocardiogram

There are some types of echocardiogram that can be ordered, according to the information that the doctor seeks to obtain.

Unidimensional

This type is mainly used to measure the diameters of the cardiac chambers and the thickness of the myocardium.

Bidimensional

This type allows the images provided to be in dimensional shapes, which facilitates anatomical evaluation.

Three-dimensional

In this type, both transthoracic and transesophageal echocardiography can be used to create a 3D image of the heart. This occurs from different images at different angles.

It is most used for the analysis of the heart valve and for diagnosing heart problems in children.

Fetal

Fetal echocardiography is performed on pregnant women to diagnose a heart problem in the fetus. Usually done between the 18th and the 22nd week, the transducer is slid over the woman’s abdominal wall and the waves directed to the fetus’ heart, thus allowing to assess the intra-uterine heart.

Transtoracic

It is the most common type of echocardiogram, in which the transducer is slid through the cardiac regions of the chest or through the patient’s abdominal wall.

If your lung or rib is blocking your view, you may need to inject a small amount of fluid into your vein, as this will make your heart’s structure appear more clearly on the monitor.

Transesophageal

In the transesophageal echocardiogram, the transducer, through a probe, is positioned orally in the esophagus, allowing clearer images of the heart, due to the proximity, which provides a more accurate diagnosis of some specific structures.

This procedure is done with sedatives and anesthetics.

Under stress

This type of ultrasound can be done in two ways: through pharmacological stress or physical effort (exercise test). If the patient is unable to practice physical activities, a number of intravenous cardiac stressing drugs will be administered, they are:

  • Dobutamine ;
  • Dipyridamol .

The test will be done before and shortly after the stress stimulus, the aim is to find out how the heart works under stress, usually to diagnose whether blood flow decays or not, during these stimuli.

Doppler

This type of echocardiogram is done to observe how blood flows through the heart’s cavities. It is effective for diagnosing problems with blood flow and blood pressure, which ordinary ultrasounds cannot.

The blood circulation reflects the sound waves to the device, and then the computer measures the directions and the speed with which the blood flows. Sometimes the flow appears colored on the monitor to help the doctor find any problem.

When should the echocardiogram exam be done?

Each type of echocardiogram can be ordered by the doctor to diagnose and / or monitor different types of diseases. Some examples are:

Transtoracic

  • Congenital heart disease and observe the effects of surgery done to treat this disease;
  • Pericardial diseases;
  • Check the functioning of the heart after a heart attack;
  • Identify causes of heart failure;
  • Monitor the fetus during pregnancy.

Transesophageal

  • Pulmonary thromboembolism;
  • Endocarditis;
  • Cardioembolic disease;
  • Aortic dissection;
  • Look for intracardiac masses and tumors;
  • Check the functioning of the heart valves;
  • Monitor the functioning of the heart during surgery;
  • To serve as a guide during a cardiac catheterization.

Doppler

You can complete other types of tests to assess your blood pressure and the speed at which blood flows through your heart cavities.

Under stress

Identify and monitor blood flow reduction.

Examination contraindications

Contraindications are rare, but transthoracic echocardiography may not be the best option for those who have severe diseases in the esophagus, such as cancer or esophageal stricture. The best option is to consult a doctor and follow his tips.

How to prepare for an echocardiogram?

In general, an echocardiogram does not require any prior preparation. However, in the transesophageal period, the patient must undergo the examination on a 6-hour fast and it may be necessary to remove dental prostheses. It is necessary to take a companion, because, because it is performed with sedatives, the patient will not be able to drive or leave the hospital alone.

As for the echocardiogram under stress, the patient can be instructed not to eat heavy foods before the exam, to avoid nausea and nausea. It is also recommended to wear comfortable clothes and shoes.

How is the echocardiogram exam done?

It is usually done at a cardiologist’s office or at a diagnostic exam clinic.

Common echocardiograms, such as transthoracic, Doppler and under stress, are performed by a trained ultrasound technician. The patient should remove his clothes and jewelry on his upper body, and lie down on a stretcher. The doctor glues electrodes at strategic locations on the chest to record the electrical activities of the heart, then applies small amounts of gel to the skin and passes a transducer to obtain the images.

The transesophageal echocardiogram must be performed by an endoscopy professional or cardiologist. In this case, the patient will receive an anesthetic in his throat before the exam, he may feel drowsy, but he will still be able to cooperate. During the examination, a tube is inserted through the mouth and it is installed in the esophagus, so that images can be taken.

The exam usually takes 30 to 60 minutes to complete.

Care after the exam

Because it is not an invasive test, most patients do not experience any adverse effects. However, on an echocardiogram under stress, the patient may experience headaches, nausea, dizziness and chest pains, this is due to the increase in heart rate. The effects of this examination will pass in a short time.

The transesophageal echocardiogram can dry out the throat and cause symptoms such as coughing and irritation. Possibly the patient will be instructed not to drink alcoholic beverages for at least 24 hours after the exam.

If the patient experiences difficulty swallowing or speaking, chest pains or short, rapid breaths, contact a doctor.

Echocardiogram exam results

The results of an echocardiogram are ready quickly, available after one day. If the exam was done by a cardiologist, the results can be ready immediately after the exam.

Nomal results

  • Normally sized and thick chambers and walls of the heart that move normally;
  • Heart valves working normally, with no leaks or narrowing, and no signs of infection;
  • Amount of blood pumped from the left ventricle with each normal heartbeat;
  • No excess fluid in the bag that surrounds the heart;
  • The tissue around the heart is not thickening;
  • There are no tumors and blood clots in the cardiac chambers.

Abnormal results

  • Very large cardiac chambers;
  • Heart walls thicker or thinner than normal;
  • One or more heart valves do not open and close properly or do not appear to be normal;
  • Shows signs of infection;
  • Amount of blood pumped from the left ventricle with each heartbeat less than normal;
  • It has liquids around the heart;
  • The lining around the heart is very thick;
  • A tumor or blood clot was found in the heart.

What can affect the results?

Some causes can prevent a patient from having the test or even influence the results. These causes are:

  • Overweight or obesity;
  • Busty;
  • COPD (chronic obstructive pulmonary disease);
  • Not being able to lie down during the test;
  • Not being able to have a tube in the throat during the exam.

Echocardiogram risks

Transthoracic echocardiograms do not present any risk and the patient may experience, when the professional removes the electrodes placed on the chest, some discomfort similar to when taking off an adhesive bandage.

If a transesophageal echocardiogram is performed, the tube may scrape inside the throat, causing mild discomfort. Already during stress echocardiography, exercise or the drug administered may cause an irregular heartbeat, temporarily.

Serious complications, such as a heart attack , are extremely rare.


The echocardiogram is a non-invasive test capable of diagnosing several diseases. Share this text with your friends and family so that they also know the possible diagnoses that can be made through it!

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