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Other types of echocardiograms
Other types of echocardiograms that may be used to evaluate congenital heart disease include the fetal echocardiogram, the transesophageal echocardiogram, and the stress echocardiogram.
Fetal echocardiogram. The structures of the heart in a developing fetus are evaluated using a fetal echocardiogram. This procedure is usually performed during the fifth month of pregnancy and poses no known risk to the fetus or mother. Doctors typically order a fetal echocardiogram if an embryo is believed to be at increased risk for developing a congenital heart defect or a prenatal exam has detected abnormal heart sounds in the developing fetus.
Transesophageal echocardiogram (TEE). For more detailed information about the heart valves and possible blood clots in the heart, a transesophageal echocardiogram or TEE may be necessary. In this procedure, the transducer is mounted on the tip of a 1/2 inch-diameter, flexible tube that is inserted through the patient's mouth down into the esophagus, the passageway that runs from the throat to the stomach. The advantage of the transesophageal echocardiogram is that it provides a more detailed image of the heart valves and blood flow because the esophagus is close to the heart.
Patients are asked to fast for at least eight hours before the test; ask your physician about taking medications. This procedure does not interfere with breathing, and patients are given a numbing medication and a mild sedative to make them more comfortable. Most patients rest comfortably during the procedure, which usually lasts between 15 and 20 minutes. Some individuals experience a minor sore throat following this procedure.
Stress Echocardiogram. A stress echocardiogram is done under conditions that increase the work of the heart, so pumping capacity and efficiency of the heart as well as any blockages of the coronary arteries can be evaluated. Patients undergoing a stress echo are asked to fast for three hours before the exam, wear comfortable clothing, and take medications as usual unless otherwise instructed.
The stress echo starts by obtaining images of the heart at rest. Then the technician will take additional images after the workload of the heart has been increased. For an exercise stress test, patients usually use a treadmill or a stationary bicycle to reach their peak exercise level. For patients who are unable to exercise, a medication is injected to simulate the effects of exercise on the heart, usually dobutamine. Dobutamine causes the heart rate to gradually increase. After receiving the drug, some people experience a slight flushing in the cheeks, a tingling scalp, and the uncomfortable feeling that their heart is beating faster and harder. Atropine is another medication that may be used but it has potentially serious side effects for people with glaucoma.
Although echocardiography uses ultrasound, which poses no known risk to the body, a stress test is not completely risk free. On rare occasions, a heart problem can occur during a stress test. To detect any problems that may arise, blood pressure and the heart's electrical activity are monitored continuously throughout the test. The technicians who administer the test are trained to treat potential complications that may arise.
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