Ecocardiograma O ecocardiograma uma das tcnicas mais utilizadas para o diagnstico das doenas cardacas, dado que no invasiva,

va, no utiliza raios X e proporciona imagens de uma excelente qualidade. Esta prova inofensiva, indolor, pouco dispendiosa e amplamente exequvel. O ecocardiograma permite a visualizao das estruturas cardacas, paredes cardacas e a velocidade com que o sangue flui para certos pontos do corao. A tcnica uma extenso da examinao por ultrasons, usando feixes de som em frequncias de 2,5-5 MHz. Para o ecocardiograma utilizam-se ondas ultra-sonoras de alta frequncia, emitidas por uma sonda de gravao (transdutor), que chocam contra as estruturas do corao e dos vasos sanguneos e, ao serem refletidas, produzem uma imagem mvel que aparece num ecr de vdeo e que se pode gravar numa fita ou imprimir-se. Mudando a posio e o ngulo da sonda, observam-se o corao e os principais vasos sanguneos a partir de vrios ngulos para obter uma imagem pormenorizada das estruturas e da funo cardacas. Para obter maior clarificao ou para analisar estruturas na parte posterior do corao, possvel introduzir um transdutor no esfago e gravar os sinais provenientes da parte posterior do corao; conhece-se este procedimento como ecocardiograma transesofgico. O ecocardiograma deteta anomalias no movimento das cavidades cardacas, o volume de sangue bombeado em cada batimento, a espessura e as doenas do saco que envolve o corao (pericrdio) e a presena de lquidos entre o pericrdio e o msculo cardaco. Os tipos principais de exames com ultra-sons so o modo M, bidimensional, Doppler e Doppler a cores. Para a prova com ultra-sons em: Modo M, a tcnica mais simples, dirige-se um feixe simples de ultra-sons para a parte desejada do corao. Ecocardiograma bidimensional a tcnica mais utilizada e produz imagens bidimensionais reais, maneira de seces geradas pelo computador. A tcnica Doppler deteta o movimento e a turbulncia do sangue e pode criar uma imagem a cores (Doppler a cores). O Doppler a cores permite determinar e mostrar no ecr a direo e a velocidade da circulao nas cavidades do corao e nos vasos. As imagens permitem observar se as vlvulas cardacas se abrem e fecham corretamente, se se escapa sangue quando estas se fecham, qual a quantidade e se o fluxo sanguneo normal. Podem tambm detetar-se comunicaes anormais entre os vasos sanguneos ou entre os compartimentos do corao e determinar tambm a estrutura e o funcionamento dos vasos e das cavidades.

Estruturas visualizadas com o ecocardiograma Valves. Four chambers of the heart. Wall thickness. Amount of muscle contraction. Pericardium. Intracardiac masses. Ascending aorta.

Transthoracic echocardiography (TTE)

TTE is performed with the patient lying on their left side with their left arm behind their head and the transducer placed in the intercostal spaces to the left of the sternum and in the anterior axillary line.

TTE is the preferred investigation in valvular heart disease because all four cardiac valves can be seen and tested by Doppler, and other abnormalities in ventricular performance can also be assessed.

Interpretao de um ecocardiograma Scan the echocardiogram results for irregularities in the size and movement of the heart. Measurements are taken to ensure the heart has not enlarged, which would indicate stress on the organ. If you have had echocardiograms before, you can compare the echocardiogram results of each test to determine whether there have been changes in the overall size of the heart as well.

Measure the strength of your heart's ability to pump blood through the chambers. Pumping action is typically described as "ejection fraction" and should be between 55 and 65 percent. A lower ejection fraction could indicate systolic heart failure, while a higher percentage could mean diastolic heart failure. This test can also determine the reason for the abnormal number, such as an area of the heart that has been weakened by a heart attack or a genetic condition that could raise the risk of heart problems later on.

Evaluate the thickness of the heart muscle wall with the echocardiogram results. A thickened wall around the heart means that the heart is not as able to relax and fill with blood. A stretched heart wall indicates that the heart could be weakening, due to an underlying medical condition. When the muscle is the right size and working properly, the heart is able to easily fill up with sufficient blood to meet all of the body's needs and then pump the blood out again.

Examine the four heart valves to determine if each is working properly. When doctors learn how to interpret echocardiograms, they need to look at the valves to ensure blood is flowing correctly through the heart. Leaky valves or valves that do not close properly could impede blood flow and put undue strain on the heart. A leaky valve may be indicated if blood is seen flowing backwards through the heart. This problem may need to be treated with medication or surgery, but the original diagnosis is typically made through echocardiogram results.

Determine the volume of blood that is circulating through the heart. This echocardiogram result could be directly affected by medications like diuretics. Low volume may indicate the heart is not pumping blood through the body as efficiently as it should. This problem could be caused by a number of conditions that affect the heart and cardiovascular system. How to interpret results of the echocardiogram
Some elements of ECHO results Left ventricular ejection fraction (LVEF)

Indicator of left ventricular systolic function 60% LVEF is taken as 'normal' 40-55% LVEF - though abnormal - may be clinically insignificant Thickened interventricular septum and posterior LV wall Occurs in hypertension and some cardiomyopathies(usually asymmetric hypertrophy) Some laboratories will report as mild, moderate or severe and/or quantify it using various mechanisms Usually given with normal ranges Hypokinesis indicates diminished contraction, eg ischaemic muscle Akinesis indicates absence of contraction, eg infarcted tissue Dyskinesis indicates the myocardial wall bulges outwards during systole - also seen in infarcted tissue

Concentric left ventricle (LV) hypertrophy

Valvular stenosis or regurgitation Chamber sizes Differences in myocardial contraction