This is the most important way of imaging the structure and function of the heart safely and painlessly. Using modern digital ultrasound scanners we can see the heart chambers, blood vessels, valves and blood flowing in real time. These examinations may be at rest or after exercise on a treadmill. We can take images of the heart in single or multiple planes simultaneously, in 2D, 3D or in ‘4D’- when we combine 3D images with blood flow (Doppler) data.
The ultrasound information is analysed and stored digitally in our picture archive system (GE Image Vault PACS) so we can review it and compare measurements made of the heart over time.
This is a 3D view inside the heart’s left ventricle showing the valves opening & closing as the heart beats. It shows a small hole in the top left corner of the mitral valve, caused by a recent infection.
This test uses a static or moving ultrasound beam to create images of the heart in one and 2-dimensions. Changes in frequency of reflected sound from tissue or blood (Doppler effect) can be used to make very detailed assessment of the heart’s structure and function. Detailed measurements are made by a sonographer and the information obtained is interpreted by the cardiologist.
We can see whether the heart is normal or not, and if not, how severe the problem is. As the test is safe, we can use this test to measure changes over time.
Increasingly this test is used for screening those who are at risk of heart disease such as heart failure or may have inherited heart disease including bicuspid aortic valves, mitral valve prolapse, diseases of the aorta such as Marfan syndrome or heart muscle disease such as hypertrophic (HCM) or dilated cardiomyopathy (DCM).
Screening patients for conditions such as the effects of high blood pressure is critical to starting and monitoring preventative treatments such as lifestyle changes, drugs or devices.
This is a 2D and colour Doppler study of congenital atrial septal defect – a “hole in the heart”:
This ultrasound shows blood flow travelling from the left to the right atrium through the defect
The most recent development in medical ultrasound is 3D ultrasound which promises to transform the way ultrasound imaging is used in cardiology. It requires a substantial investment in new scanning equipment including multiplane imaging probes as well as advanced graphics hardware and software.
We now use this technique to do multi-plane imaging in stress echo. It enables multiple pictures to be taken simultaneously and quickly following exercise. It also allows us to measure the structure of the heart in 3D which allows more accurate images of valves, chambers and function of the heart than previously possible.
This 3D image of the heart (to the right) is constructed from the 4 larger images. The test measures the volume changes in the main pumping chamber – the left ventricle – as the heart beats.