Among diagnostic cardiac procedures that are informative, it is worth highlighting echocardiography or ultrasound examination of the heart. This is a hardware procedure performed using high-frequency sound waves. It is indispensable for accurately identifying problems that are directly related to the work of the myocardium and the entire cardiovascular system.
The effectiveness of echocardiography is directly related to the evaluation of its results. Competent interpretation of cardiac ultrasound is a direct path to a speedy diagnosis and drawing up an effective treatment plan. Entrust the solution to the problem to an experienced specialist, contact us for qualified medical support!
"The heart is on the left"
– The top of the organ and 2/3 of its parts are on the left, but 1/3 is behind the sternum in the middle.
Often people claim that they are stabbed in the heart and grab their left side. It is important to understand here: classic heart pain is pain, as a rule, precisely behind the sternum. Pain on the left side can also be cardiac. But they are burning, pressing. Therefore, if you have a stabbing sensation on the left side, the cause may not be cardiological at all. Answer: myth
Interpretation of EchoCG results in adults
The diagnostic conclusion is made only by the attending physician. The document in written (sometimes electronic) form is transferred to the patient in the diagnostic room, after which it is recorded in the hospital record. The individual indicators of the person undergoing the examination are entered into a special table, which already contains the normal figures for a specific age and gender.
Trying to decipher an ultrasound of the heart on your own is stupid and unsafe. The combination of several deviations may indicate different pathologies. You can’t do without experience and knowledge here.
| Cardiac parameter | Men's answers | Women's answers |
| LVMM—left ventricular myocardial mass | 135-180 g | 95-142 g |
| LVMI—left ventricular mass index | 71-92 g/m2 | 71-88 g/m2 |
| ESD – LV end-systolic size | 31-42 mm | 31-42 mm |
| ESD – LV end-systolic size | 31-42 mm | 31-42 mm |
| EDV - end diastolic size | 46-58 mm | 45-58 mm |
| Volume of fluid in the pericardial cavity | 10-30 ml | 10-30 ml |
| LV wall thickness in diastole | up to 11 mm | up to 10 mm |
| Blood ejection volume during LV systole | 60-100 ml | 60-100 ml |
| Wall thickness of the RV - right ventricle | 5 mm | 4.8-5 mm |
| LA size - left atrium | 18.5-33 mm | 17.5-33 mm |
| LA end-diastolic volume | 50-82 ml | 38-57 ml |
| End-diastolic volume of the RA – right atrium | 20-100 ml | 20-100 ml |
| Thickness of the IVS - interventricular septum in systole | 5-9.5 mm | 5-9.0 mm |
| IVS thickness in diastole | 7.5-11 mm | 7.5-11 mm |
| Aortic opening area | 20-35 mm2 | 20-35 mm2 |
| Thickness of the outer membrane of the pericardium | 1.2-1.7 mm | 1.2-1.7 mm |
Only a cardiologist can evaluate an ultrasound of the heart; the results are interpreted according to standard values, taking into account the general health of the patient, the medications he is taking and other factors. The size, weight, volume and location of the organ, the condition of the valves and tissues are studied. Parameters for contractions, blood vessels and blood flow, wall thickness and other important nuances are recorded. The speed of blood distribution through the chambers of the heart helps to determine Doppler measurements. It is often performed in conjunction with traditional ultrasound examination.
“Body weight has no effect on heart function”
- How it influences!
After all, this organ circulates blood throughout the body. And the more a person weighs, the more his heart muscle is exhausted. Although thin people can have problems, dystrophy is one of them. Body weight should be normal. There is a special formula that can be used to estimate the degree of correspondence between a person’s mass and his height. To do this, you need to divide your weight by your height squared. If the resulting figure ranges from 19 to 25, this is a good indicator. Answer: myth
Why is cardiac echocardiography needed?
There are a myriad of reasons why a doctor might recommend an echocardiogram. A harmless and inexpensive procedure is indispensable for:
- constant pain in the chest, rapid heartbeat, disturbing in a calm state, after minor physical exertion;
- hypertension (stable high blood pressure);
- swelling of the lower extremities, when kidney disease is not diagnosed;
- breathing difficulties that occur after physical activity;
- feeling of a foreign object in the chest.
The attending doctor can prescribe a procedure, and then conduct a full interpretation of the ultrasound of the heart, in case of constant dizziness, arrhythmia, atherosclerosis, pericarditis, heart muscle defects, coronary artery disease. Indications are often multiple pregnancy, hereditary predisposition, medical examination at the enterprise.
Ultrasound cardiography is performed for both adults and children. When a baby is suspected of having abnormalities in myocardial development, shortness of breath appears without symptoms of an acute respiratory infection, loss of consciousness is observed, it is imperative to check the functioning of the main organ. The pediatrician can refer for diagnostics when, during the use of a phonendoscope, extraneous sounds were noticed against the background of normal contractile activity.
The above-mentioned cardiac examination also plays an important role for a teenager. The test is aimed at assessing the normal development of the organ during puberty, because it is at this time that a sharp increase in body size is often observed.
“Heart disease occurs only in older people”
– Of course, older people are more susceptible to such diseases: the body ages, loses its former shape and “engine”.
But, unfortunately, young guys and small children often turn to cardiologists with problems. Complaints arise for various reasons. This could be physical or emotional stress, or a previous infection that caused complications. The cause of the disease can also be heredity. It happens that a person leads a healthy lifestyle: eats right, plays sports, does not have bad habits, but from his parents he inherited, for example, incorrect cholesterol metabolism. In this case, problems cannot be avoided. Answer: myth
Deviations from the norm
There are a huge number of indicators indicating deviations from the norm. Eg:
- Stenosis is said to occur when the valve opening is reduced in diameter, making it difficult to pump blood.
- If the valve leaflets interfere with the reverse blood flow, perform their natural function inadequately, insufficiency is suspected.
- Pericarditis is detected when, with a normal fluid level of 20-30 ml, all 500 ml are traced.
The list of deviations from the norm and possible diagnoses associated with this can be endless. But you shouldn’t take deciphering an ultrasound of the heart so lightly. Here it is inappropriate to guess and assume without the help of a doctor. Mistakes lead to irreparable consequences. Therefore, experiments should be abandoned.
“During physical and emotional stress, the heart pumps more blood than at rest”
– At rest, the heart pumps about 4.5–5 liters of blood per minute.
But with physical stress, the figure can increase two to three times, sometimes reaching one hundred liters. Let's say an athlete is running a cross-country race. In order for a person to cope with a difficult task, his heart needs to provide the muscles with energy, fill the body with glucose and oxygen. With emotional stress, the situation is even more serious, because our emotions are adrenaline, that is, acceleration. Acute stress, such as the loss of a loved one, increases the risk of heart disease by 21 times, and chronic stress increases the risk by 50 times. Answer: true
Diagnosis and treatment
If you or your loved ones are experiencing the symptoms described above, we recommend getting tested. During diagnosis, the doctor monitors heart parameters at rest and during exercise.
The patient is prescribed:
- daily ECG monitoring,
- echocardiography (ECHO-CG),
- chest x-ray,
- CT and MRI using special equipment that allows you to examine the heart virtually between beats.
Such diagnostics are carried out not only during the initial examination of patients with suspected disease, but also in dispensary groups of patients with an already confirmed diagnosis.
Depending on the diagnostic results, the doctor prescribes the necessary treatment: therapy or surgery.
- Therapy is aimed at preventing, preventing and alleviating relapses of the disease that became the root cause of the defect, as well as treating heart failure.
- Surgical intervention is an extreme necessity, which due to age or complications may not be prescribed for all patients.
Typically, heart valve disease is a mechanical problem that can only be solved with surgery performed by a surgeon. For stenosis, an operation is indicated to separate the fused valve leaflets and widen the atrioventricular opening - commissurotomy. If there is insufficiency, prosthetics are performed: replacement with a biological or mechanical analogue.
“In children and adults, the heart beats at different frequencies”
– In children under five years of age, the heart makes about 120 beats per minute, while in adults the optimal frequency is from 55 to 70 beats.
Your heart rate may increase. It also depends on the state of the autonomic nervous system, temperature, and physical fitness. A trained person’s “engine” will run slower than someone who does not exercise. Answer: true
Interpretation of ultrasound of the heart
In order for the interpretation of cardiac echocardiography to be carried out without errors and completely, the patient’s age, general state of health, and the presence of chronic diseases (pancreatitis, tonsillitis, asthma, vasculitis, etc.) are taken into account. It is impossible to determine the pathology on your own (without knowledge and experience). Only a doctor can correctly assess the answer. There is no place for experiments and guesswork. It is inappropriate to look for answers on the Internet on the websites of companies with a dubious reputation. Trust your health to professionals who provide guarantees and value each patient.
Study parameters
Thanks to ultrasonic waves, you can accurately determine:
- myocardial parameters (sizes of all its parts);
- tissue structure, wall density;
- rhythms, abbreviations, etc.
Imaging will help detect scarring, thrombosis, benign and malignant tumors. The test informs about the condition of the mitral valve, blood volumes and the level of vascular blockage.
By interpreting cardiac echocardiography, the presence/absence of the following diseases can be determined:
- ischemia, when there is a persistent disturbance of blood supply against the background of vascular blockages;
- necrosis, during which tissue death occurs (infarction);
- blood pressure above or below normal (hypo-, hypertension);
- defect, that is, a structural defect of an acquired/congenital type;
- decompensation, when a whole syndrome of failures is noticeable;
- valvular dysfunction;
- rhythmic disruptions;
- rheumatism, when inflammation is observed;
- pericarditis, in which there is inflammation of the membrane;
- stenosis, which indicates a narrowing of the aortic lumen;
- vegetative-vascular dystonia.
Competent image decoding is the basis for success. After all, it is thanks to him that one can establish the fact whether there is a disease or not.
Among the research parameters, several main areas are distinguished. When interpreting cardiac ultrasound in children and persons over 13 years of age, the diameter of the left ventricle and left ventricle, the thickness of the posterior wall of the left ventricle, and more are determined. Each number has a meaning individually. Also, all indicators are taken into account together, because many of them are related to each other and often form a single clinical picture.
How it happens
A painless examination is carried out in a hospital setting or at home, if the situation requires it. The manipulation takes from 20 to 45 minutes. This is a safe way to assess the functioning of the heart muscle and blood vessels, which has no contraindications and is not harmful to health. Step by step it usually looks like this:
- The visitor bares his torso, undresses to the waist and takes a horizontal position, lying on his back with his head towards the diagnostician.
- A special gel is applied to the chest area to help conduct ultrasound waves better.
- A special sensor is used, thanks to which the diagnostician carries out an inspection. The detector is moved slowly across the area being examined to ensure that nothing is missed. The attentiveness of the diagnostician will help with echocardiography decoding.
- The specialist can correct the patient’s position and condition, for example, asking him to hold his breath, roll over, raise his arm, bend his knees, and more.
The response is assessed by a competent specialist, a doctor. It is important that all indicators are taken into account, as well as the individual parameters of the patient’s body. The time of the diagnostic procedure and the state of health, that is, the well-being of the person being diagnosed, are taken into account. Standards and actual figures are reviewed. A comparison is being made. Only after a thorough study can a diagnosis be made and a course of therapy formed. A person who has nothing to do with modern cardiology will not be able to understand the indicators, even if he uses a plate with standard figures for this. Only a properly qualified doctor should be involved in forming a conclusion!
Differences in men, women and children
Normally, data by age and gender is different. EchoCG interpretation helps to analyze the full cycle of myocardial activity (1 systole + 1 diastole). With a heartbeat of 70 beats in 60 seconds, 1 cycle is normally 0.85 seconds.
Adult women and men, as well as children, have different normal values. For example, the heart mass of a representative of the stronger sex aged 25-30 years is about 135 g. In a woman - up to 100 g. The EDV of the left ventricle in men normally reaches 193 ml, in women it does not exceed 136 ml.
The LV wall mass index is an indicator of the ratio of the weight of the organ to the surface area of the human body. The strong half of humanity is characterized by indicators from 71 to 95 g/m2, the fair sex is characterized by a range from 71 to 90 g/m2.
Introductory part
Before heart surgery, a person has many questions. Some of them we ask the doctor, and some we cannot even formulate. When we understand what is happening to our body and what we can do to restore health, it is easier for us to endure all procedures.
Acquired heart valve defects
- these are diseases that are based on morphological and/or functional disorders of the valve apparatus (valve leaflets, annulus fibrosus, chordae, papillary muscles), developed as a result of acute or chronic diseases and injuries, disrupting the function of the valves and causing changes in intracardiac hemodynamics.
Valve defects can be congenital or acquired.
Congenital defects occur when the structures of the heart are formed incorrectly during intrauterine development; sometimes they do not make themselves felt until adulthood. Acquired defects arise due to rheumatism, infection, metabolic disorders (when calcium is deposited in the valves), trauma and other reasons.
The main types of heart valve defects:
- mitral stenosis
- mitral valve insufficiency
- mitral valve prolapse
- aortic stenosis
- aortic valve insufficiency
- tricuspid stenosis
- tricupidal insufficiency
The normal functioning of the heart largely depends on the functioning of its valve apparatus.
Obstacles to the passage of blood cause overload, hypertrophy and expansion of the structures above the valve. Obstructed heart function disrupts the nutrition of the hypertrophied myocardium and leads to heart failure.
Etiology and pathogenesis
Etiology of stenosis
and combined rheumatic disease,
insufficiency
- usually rheumatic, rarely septic, atherosclerotic, traumatic, syphilitic.
Stenosis is formed as a result of cicatricial fusion or cicatricial rigidity of the valve leaflets and subvalvular structures; valve insufficiency - due to their destruction, damage or scar deformation.
Failure
valve damage occurs due to destruction or damage to its valve flaps. Valve insufficiency is characterized by incomplete closure of the leaflets and occurs as a result of their wrinkling, shortening, perforation or expansion of the fibrous valve ring, deformation or separation of the chordae and papillary muscles. In some cases, valve insufficiency develops as a result of dysfunction of the valve apparatus, in particular the papillary muscles.
Often stenosis and insufficiency develop on one valve (the so-called combined defect
).
In addition, there are cases when the defects affect two or more valves - this is called combined
heart disease.
Affected valves form an obstacle to the passage of blood - anatomical in case of stenosis, dynamic in case of insufficiency. The latter is that although some of the blood passes through the hole, it returns back in the next phase of the cardiac cycle.
A “parasitic” volume is added to the effective volume, performing a pendulum-like movement on both sides of the affected valve. Significant valvular insufficiency is complicated by relative stenosis (due to increased blood volume). Obstruction to the passage of blood leads to overload, hypertrophy and expansion of the overlying chambers of the heart.
The expansion is more significant with valve insufficiency, when the overlying chamber is stretched by additional blood. With stenosis of the atrioventricular orifice, the filling of the underlying chamber is reduced (left ventricle with mitral stenosis, right ventricle with tricuspid stenosis); There is no hypertrophy or expansion of the ventricle.
With valve insufficiency, the filling of the corresponding ventricle is increased, the ventricle is dilated and hypertrophied. Difficulty in the functioning of the heart due to improper functioning of the valve and degeneration of the hypertrophied myocardium leads to the development of heart failure.
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Heart valve surgery
Often heart defects do not manifest themselves for a long time, because the heart adapts to working under overload. In the case where the heart defect is “moderate” and does not lead to serious overload of the heart, in some cases they are limited to observation or drug therapy. But when the defect is severe, it must be treated surgically.
The following operations are performed on heart valves: reconstruction or complete replacement of a damaged valve.
Heart valve reconstruction
Sometimes during surgery it is possible to preserve the valve flaps and only correct their shape. This procedure is called valve repair.
.
Sometimes the shape of the valve can be restored by strengthening its base with threads, or by sewing a special ring to the base, while the valve’s own flaps are preserved. This procedure is called annuloplasty.
, it is possible only for the mitral and tricuspid valves.
Valve reconstruction can largely restore its function. For severe heart valve damage, valve replacement surgery may be the only treatment option. The results of these operations exceed the effect of drug therapy. Today, heart valve surgery can be performed on patients of any age group.
Access for operations on the aortic valve or on several valves simultaneously is made through an incision in the center of the sternum. When performing operations on the mitral valve, it is possible to use the “keyhole technique,” when surgical access is made through a small incision in the projection of the mitral valve: on the side and below the chest.
When it is impossible to save the leaflets of the native valve, or if they are preserved, there is a high probability of the defect returning and repeated surgery, the native valve is excised and implanted in its place
artificial
valve prosthesis
.
The most commonly performed surgeries are mitral valve reconstruction. In this case, the own valve is preserved - this is very important.
, Ross surgery is performed to treat aortic disease.
. The damaged aortic valve is replaced with the patient's own pulmonary valve, which is similar in structure, and an artificial prosthesis is implanted instead of the excised pulmonary valve.
When the aortic valve and aortic wall are damaged, it may be necessary to replace the ascending aorta with a valve-containing aortic graft
(sometimes called a conduit). In this case, not only the aortic valve is replaced, but also the adjacent ascending aorta.
Your attending physician will inform you about the possibility of reconstructive surgery on the heart valve in your case. In some cases, the question of the possibility of valve reconstruction is decided during the operation: if reconstruction is not possible, then an operation is performed to replace the damaged valve.
