Echocardiogram

Okay, so doing a post about echocardiograms is a bit off piste for a student nursing blog, but its definitely not a bad thing having an appreciation for how they work, especially if you’re placement is cardiology based.

What are they?

Echo’s use ultrasound waves to visualise internal organs, with the waves reflecting back off the structures of the heart. This allow practitioners to see the chambers, valves and blood vessels, as well as any fluid around the heart.

What are they used for?

Ejection fractions – a measurement of how much blood is pumped out of the left ventricle with each contraction, used to measure heart failure.

Anatomy – the size of ventricles, atria and heart walls can be measured, looking for any changes in size or wall thickening.

Valve defects – valve movement can be easily seen on an echo, but when used with a doppler can identify if there is any valve regurgitation.

Volume status – identify normal vs abnormal heart volumes.

Fluid – any fluid in and around the heart shows very clearly as dark space, allowing identification of abnormal fluid deposits.

Congenital diseases – visual abnormalities and septal defects.

How are they done?

There are two different types of echo:

Transthoracic this is a non-invasive scan that uses a probe on the outside of the chest and is is typically done at a patients bedside.

Transoesophageal –  this version is more invasive and involves passing a probe through the mouth into the oesophagus to view the heart.

Stress echo – a transthoracic echo that is done while the patient either undergoes exercise on a treadmill or bike or when they’ve been given a medication to make the heart work harder (eg. dobutamine or dipyridamole).

Contrast echo –  a contrast agent that shows up on the scan is injected into the bloodstream to enhance the image.

So what?

At the moment, while nurses don’t do the echos themselves (although one Heart Failure specialist is currently undergoing the training), it’s still important to have an appreciation for it. Cardiology and all its baggage can pop up in any area, whether that’s an ejection fraction at handover or having a patient waiting for an echo as part of their treatment. Being able to explain the general procedure and what to expect can help alleviate any anxiety.

Student nurses, if you get the chance, spend some time with the cardiac physiologist/doctor doing an echo – get them to explain all of the different angles and the information they can get from them.

More Information

British Society of Echocardiograms – https://www.bsecho.org/

Echo Research and Practice journal – https://erp.bioscientifica.com/ 

Journal article that goes into loads more detail if you’re interested – https://www.magonlinelibrary.com/doi/full/10.12968/bjca.2018.13.7.324

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