The cross with the cross
Echocardiography plays an important role in the diagnosis of heart problems.
At NUHR Medical Center, we basically use two different types of echocardiography: the more commonly used transthoracic and transesophageal echocardiography.
But how exactly do these procedures take place at NUHR Medical Center, and what should you bear in mind when preparing for them?
How does an echocardiogram work?
Echocardiography, often referred to as cardiac echo or swallow echo, is one of the most important routine examinations of the heart.
It provides information about various heart diseases.
There are several variants of this examination, some of which can be combined with each other.
During echocardiography, an ultrasound probe is held against the chest from the outside.
Alternatively, an ultrasound probe at the tip of an endoscope can be inserted through the esophagus up to the level of the heart.
The devices emit sound waves that are reflected to varying degrees by the different tissues of the heart and the blood-filled heart chambers.
The echo of these sound waves is displayed on a monitor as a moving black and white image.
The ultrasound image generated shows the structure of the heart and thus enables the size of the heart chambers, the function of the heart valves and the thickness of the heart muscle to be assessed.
In addition, the heart can be observed at work in real time, allowing the direction of blood flow and the heart’s pumping capacity to be determined.
What is the difference between ECG and echocardiography?
Echocardiography and the electrocardiogram (ECG) are both important diagnostic procedures in cardiology, but differ in their methodology and the information they provide.
Echocardiography uses ultrasound waves to examine the heart.
ECG, on the other hand, records the electrical activity of the heart.
Electrodes are attached to the skin, allowing the electrical signals of the heart muscle to be measured and recorded on an electrocardiograph.
The ECG shows the electrical excitation and heart rhythm and can detect cardiac arrhythmias, ischemia and infarctions.
Echocardiography visualizes the heart structure and function using ultrasound, while the ECG measures the electrical activity of the heart.
Both procedures complement each other and are important for assessing heart health.
What types of echocardiography are there?
Transthoracic echocardiography (TTE)
Transthoracic echocardiography (TTE) is the most common form of echocardiography.
In this procedure, the ultrasound probe is placed on the anterior chest wall from the outside.
TTE is simple, quick and inexpensive and provides a lot of information about the cavities of the heart, the heart valves, the heart muscle and the performance of the heart.
Additional examination options for TTE:
3D image of the heart
A special ultrasound probe can be used to create a three-dimensional image of the heart.
This is particularly useful for assessing heart valves and heart failure.
Doppler and color Doppler echocardiography
These are methods that make the blood flow visible.
The color Doppler shows the direction of the blood flow in different colors and measures the flow velocity of the blood.
This helps to detect small valve defects or holes in the cardiac septum.
Exercise echocardiography
In this examination, cardiac output is increased under physical stress on a bicycle ergometer or with special medication.
This method can reveal signs of impaired blood flow in the coronary arteries by observing movement disorders in the heart wall under stress.
Sometimes a contrast agent is injected to make the blood flow in the heart more visible.
Transesophageal echocardiography (TEE)
Transoesophageal echocardiography (TEE) offers a more precise image of the heart compared to transthoracic echocardiography (TTE).
The ultrasound probe is located at the tip of a flexible tube that is inserted into the esophagus through the mouth.
This proximity to the oesophagus enables detailed images, particularly of the atria and heart valves.
TEE is used in various clinical scenarios:
- In atrial fibrillation, TEE is used to identify blood clots in the atria and assess the risk of stroke.
- If endocarditis is suspected, TEE is used for the precise diagnosis of bacterial infections of the heart valves.
- Aortic aneurysms can be investigated with TEE to assess potential risks.
- TEE enables a detailed examination of congenital heart defects, which is particularly important for prenatal diagnostics.
How does the examination work?
The upper body must be free for transthoracic echocardiography (TTE).
You will normally lie in a slight lateral position, sometimes with your upper body slightly elevated.
Older and frail people in particular, or those with shortness of breath, often find it difficult to maintain the lateral position and are then examined in the supine position, although this can reduce the image quality somewhat.
A contact gel is applied to the skin and the probe is inserted over the chest with light pressure.
The resulting images are immediately displayed on the monitor and can be saved and analyzed.
In transoesophageal echocardiography (TEE), a long, flexible tube is carefully inserted into the oesophagus via the mouth.
It helps to actively swallow, which is why this examination is also known as swallowing echo.
To minimize the gag reflex, we spray a local anaesthetic into the throat.
Sometimes we also give our patients a mild sedative.
In this case, however, you should note that you are not allowed to drive a car, motorcycle or bicycle on this day.
What can be determined during a cardiac echo?
Echocardiography provides a detailed image of the heart, including its structure, exact structure, heart movement and blood flow.
This examination provides reliable and precise diagnoses.
As the results are usually available immediately, cardiac cardiography offers a rapid diagnostic option.
What diseases can be detected by cardiac ultrasound?
The ultrasound image of the heart provides information about various diseases:
- Changes to the heart valves
- Congenital heart defects such as a hole in the cardiac septum
- Heart muscle diseases, characterized by thickened heart walls and/or enlarged heart chambers
- Diseases of the pericardium (heart sac)
- Circulatory or pumping disorders in the heart
- Changes that may indicate a pulmonary embolism, a tumor or an aneurysm in the aorta
In people with coronary heart disease (CHD) or after a heart attack, echocardiography can also help to identify damaged areas of the heart more precisely.
This examination can also be useful if an electrocardiogram (ECG) has shown abnormalities.
Although echocardiography cannot image the coronary arteries directly, it can provide indirect indications of their blood flow.
For example, certain areas of the heart may appear less mobile than normal on ultrasound, which may indicate poor blood flow to the coronary arteries.
However, direct imaging of the coronary arteries would require a cardiac catheterization or a computer tomography (CT) scan of the heart.
What are the risks of an echocardiogram?
No risks are to be expected with external echocardiography, as this examination is not associated with radiation exposure.
Swallowing echo (TEE) may cause gag reflexes and increased salivation, but injury to the oesophagus is extremely rare.
If local anaesthetics, sedatives or contrast agents are used during echocardiography, there is a risk of side effects such as allergic reactions or breathing problems.
Contrast agents can cause temporary headaches, nausea, anxiety or visual and hearing problems.
The risks of an exercise echocardiography are similar to those of an exercise ECG.
Possible complications include cardiac arrhythmia, a sharp rise or fall in blood pressure or insufficient oxygen supply to the heart muscle.
For this reason, it is important that we clarify whether there is an increased risk of such problems before the examination.
In addition, the examination at NUHR takes place in a specially equipped room, which allows us to react immediately in the event of any complications.
Do I need to prepare for an echocardiogram?
As a rule, you do not need to prepare for standard echocardiography from the outside.
However, if the transducer is inserted through the oesophagus (TEE), you should refrain from eating and drinking for at least four hours before the examination.
After the examination, you can normally eat and drink again after one to two hours.
What are the advantages of a cardiac ultrasound?
In contrast to other imaging procedures such as computer tomography or magnetic resonance imaging, it is radiation-free.
This means that the patient is not exposed to any radiation.
Side effects during cardiac echo are also extremely rare, which makes the examination a safe option.
In addition, ultrasound cardiography is also safe for pregnant women and patients with an allergy to contrast agents, as no ionizing radiation or contrast agents are used.
Another advantage is that you can move around during the ultrasound examination.
In contrast, other imaging procedures often require the patient to lie still during the examination.
Echocardiography can easily be repeated as often as required if further examinations are necessary or to monitor the progression of heart disease.
No special preparation is required for transthoracic echocardiography, which is performed externally.
For transesophageal echocardiography, however, it is recommended that you stop eating a few hours before the examination to ensure a clear view of the heart.
What does an echocardiogram cost?
An echocardiography at NUHR costs from €250.
We attach great importance to comprehensive care and customized treatment plans that are individually tailored to your needs.
At the beginning of our treatments, we carry out detailed discussions and medical examinations in order to draw up a suitable treatment plan together with you.
You will then receive a specific offer based on this.
Is echocardiography covered by health insurance?
Whether the costs of an echocardiography are covered by your health insurance depends on your insurance provider.
As a rule, most ultrasound examinations are covered by health insurance companies.
For those insured by BVAEB, SVS-LW and SVS-GW, there is the possibility of partial direct billing for our prescribed therapies.
However, other health insurance companies also generally grant a corresponding reimbursement.
Conclusion
Echocardiography is an extremely useful and versatile examination method that allows doctors to assess the heart in detail.
At the NUHR Medical Center, we offer echocardiography as part of our comprehensive NUHR Medical Check.
But we’re not just about medical examinations.
At NUHR, we attach great importance to ensuring that you want for nothing.
We take care of your overall well-being.
Treatment & Therapy
In most cases, back pain is caused by wear and tear, as well as non-specific pain, the cause of which cannot be immediately identified by X-ray diagnostics or magnetic resonance imaging, but which requires a thorough clinical or physical examination. Exercise therapy is often the best remedy, as very often the complaints are due to a lack of exercise and incorrect strain.
Avoiding stress and getting away from the everyday environment and its movements can also be beneficial.
Avoiding stress and getting away from the everyday environment and its movements can also be beneficial.
The team of doctors at the NUHR Medical Center works in a multimodal and multiprofessional way and specializes in pain of all kinds, including back pain.
We not only treat the symptoms, but also get to the bottom of the cause.
Medication is only used where it is appropriate and necessary.
However, our focus is clearly on special forms of therapy that are individually tailored to each person.
We call this the NUHR Med Concept.
It is based on the three pillars of individuality, intensity and regularity of therapies.
This can be, for example, Dorn and Breuss spinal therapy or Tilscher back training.
We are also specialists in the field of arsonvalization, which involves working with electrical currents.
Kinesio taping can also stimulate the skin receptors and stabilize muscle tension.
We offer individual programs for expectant mothers.
We not only treat the symptoms, but also get to the bottom of the cause.
Medication is only used where it is appropriate and necessary.
However, our focus is clearly on special forms of therapy that are individually tailored to each person.
We call this the NUHR Med Concept.
It is based on the three pillars of individuality, intensity and regularity of therapies.
This can be, for example, Dorn and Breuss spinal therapy or Tilscher back training.
We are also specialists in the field of arsonvalization, which involves working with electrical currents.
Kinesio taping can also stimulate the skin receptors and stabilize muscle tension.
We offer individual programs for expectant mothers.
