EKO (Echocardiography / Heart Ultrasound)
ECHO is an imaging method that captures a motion picture of the heart. It works with sound waves that cannot be heard by the human ear, namely ultrasound waves, produced by a device (probe) placed on the chest. These ultrasound waves pass through the chest wall and strike the layers of the heart, reflecting back like radar, where they are detected by the device’s sensors and processed by the main machine to be converted into an image. Therefore, its other name is heart ultrasound. ECHO is a fundamental test for understanding the anatomy of the heart. Additionally, by detecting the speed and direction of blood flow, it provides information about the heart’s physiology—that is, its functional state. ECHO is highly beneficial in detecting the following issues:
- Decrease in the heart’s pumping power or stiffening of the heart walls (heart failure)
- Heart valve diseases (valve stenosis and regurgitation)
- Fluid accumulation in the heart sac (pericardial effusion) or stiffening (constrictive pericarditis)
- Areas of the heart wall that do not move (myocarditis, heart attack, vascular occlusion, etc.)
- High blood pressure in the vessel leading from the heart to the lungs (pulmonary hypertension)
- Heart muscle diseases (HCM, ARVC, etc.)
- Heart holes and other congenital heart diseases (ASD, PFO, PDA, VSD, etc.)
- Ballooning in the initial part of the aorta (aortic aneurysm)
- Other rare diseases (PVL, amyloidosis, tumor, cyst, etc.)
ECHO is usually performed during rest while the patient is lying down (Transthoracic ECHO; TTE). This is what is meant when the word ECHO is used alone. However, some patients feel fine at rest but complain of symptoms during activities requiring exertion. Therefore, the patient’s heart rate is sometimes increased using medication or exercise (treadmill or stationary bike); in other words, the heart is intentionally placed under stress and an ECHO is performed immediately. This is called a stress ECHO. Stress ECHO is used to indirectly understand whether heart vessels are blocked or to determine the viability of certain heart regions after a heart attack. Sometimes, images obtained from a TTE are not clear (due to obesity, COPD, etc.) or some anatomical structures (for example, the left atrial appendage) cannot be seen with TTE. In this case, an ECHO is performed through the esophagus. Since the esophagus is very close to the heart, it provides highly clear images. This is called transesophageal echocardiography (TEE).
References
- Otto CM. Textbook of clinical echocardiography, 7th ed. Philadelphia PA: Elsevier; 2023.
- Armstrong WF, Ryan T, eds. Feigenbaum’s echocardiography, 8th ed. Philadelphia PA: Wolters Kluwer; 2019.