Background & Scope
Echocardiography is a noninvasive medical imaging technique used to assess the structure and function of the heart. Echocardiography is both an imaging technique and a subspecialty of cardiology. Echocardiography is typically performed by a cardiologist, cardiac anesthesiologist, or radiologist.
Echocardiography uses ultrasound waves to produce images of the heart and its surrounding structures. During the procedure, an ultrasound transducer is placed on the patient's chest and images are taken of the heart from various angles. The images are then analyzed to assess the structure and function of the heart. Echocardiography is most commonly used to diagnose and monitor cardiac diseases such as valve disorders, congenital heart defects, and coronary artery disease.
Echocardiography is used to visualize the heart chambers, valves, wall thickness, and blood flow within the heart. It can also measure heart function such as ejection fraction, cardiac output, and valve area. Additionally, echocardiography can be useful in detecting certain types of congenital heart defects and valvular damage due to infection (vegetation). Additionally, it may be used to evaluate the effects of certain medications or treatments on the structure and function of the heart.
Qualifications, Training, and Certifications
Although cardiologists, cardiac anesthesiologists, and radiologists are the most common specialists to perform echocardiography, echocardiography is a subfield within cardiology (cardiovascular disease). As of 2023, there is no subcertification offered in echocardiography by the American Board of Medical Specialties, though certification in echocardiography is offered through various organizations such as the American Society of Echocardiography (ASE).
Conditions, Diseases, Treatments, and Procedures
Echocardiography is most commonly used to diagnose and monitor cardiac diseases such as valve disorders, congenital heart defects, and coronary artery disease. Additionally, echocardiography can be useful in detecting certain types of congenital heart defects. Echocardiography is also used to diagnose and monitor other cardiac conditions such as cardiomyopathy, myocarditis, pericardial effusions, valvular vegetations, and aortic dissection. Additionally, it may be used to evaluate the effects of certain treatments on the heart such as chemotherapy or radiation therapy.
Echocardiography can also be used to diagnose and monitor certain types of heart injuries such as myocardial contusion, myocardial infarction, pericardial tamponade, and aortic dissection. Additionally, it may be used to diagnose certain types of cardiac arrhythmias such as atrial fibrillation, ventricular tachycardia, and atrioventricular block.
Echocardiography procedures include transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), stress echocardiography, three-dimensional echocardiography (3DE), and contrast echocardiography. Transthoracic echocardiography is the most common type of echocardiogram and is used to assess the overall structure and function of the heart. Transesophageal echocardiography is more invasive than TTE but provides more detailed images of the heart. Stress echocardiography is used to assess how well the heart functions under stress such as exercise or medications. Three-dimensional echocardiography provides three-dimensional images of the heart that can be used for diagnosis and treatment planning. Contrast echocardiography uses an intravenous contrast agent to produce clearer images of the heart structures.
Related Medical Specialties
Echocardiography is an important tool for diagnosing and monitoring cardiac diseases and can help guide treatment decisions. It is closely related to several other medical specialties.
Cardiology is the primary medical specialty related to echocardiography. Cardiologists are physicians who specialize in diagnosing and treating cardiovascular diseases and conditions. They use echocardiography to diagnose and monitor various types of heart diseases such as valve disorders, congenital heart defects, and coronary artery disease. Additionally, cardiologists may also use echocardiography to evaluate the effects of certain treatments on the heart such as chemotherapy or radiation therapy.
Radiology is another medical specialty closely related to echocardiography. Radiologists are physicians who specialize in interpreting images produced by various imaging techniques such as x-rays, CT scans, and ultrasounds. Echocardiography produces ultrasound images that can be used to assess the structure and function of the heart. Radiologists can interpret these images to diagnose and monitor cardiac conditions.
Cardiac anesthesiology is the subfield within anesthesia that specializes in anesthesia for patients undergoing cardiac procedures and includes the pre- and postoperative care of those patients. Cardiac anesthesiologists will typically perform echocardiography intraoperatively.
Additionally, echocardiography is closely related to other medical specialties such as vascular surgery, pediatric cardiology, and interventional cardiology. Vascular surgeons specialize in diagnosing and treating diseases of the vascular system. Pediatric cardiologists specialize in diagnosing and treating cardiovascular conditions in children. Interventional cardiologists specialize in performing minimally invasive procedures to diagnose and treat cardiac conditions. All of these medical specialties use echocardiography to diagnose and monitor cardiac diseases or conditions.
Medical-Legal Cases Involving Echocardiography
Echocardiography can be used as evidence in medical-legal cases involving cardiac conditions.
One example of a medical-legal case involving echocardiography is a case involving a misdiagnosis of a valve disorder. In this case, the patient was admitted to the hospital with chest pain and was subsequently diagnosed with aortic regurgitation. However, echocardiography suggested that the patient had mitral valve stenosis instead. The patient underwent surgery to repair the mitral valve and subsequently filed suit against the hospital for misdiagnosis of their condition. The plaintiff argued that the hospital should have used echocardiography to more accurately diagnose the condition prior to surgery.
Another example is a case involving delayed diagnosis of coronary artery disease. In this case, the patient had symptoms suggestive of coronary artery disease, but his echocardiogram did not show any abnormalities. However, subsequent tests revealed that the patient did indeed have coronary artery disease. The patient subsequently sued the hospital for delayed diagnosis arguing that the hospital should have used echocardiography to make the diagnose.
Medical-legal cases involving echocardiography typically require expert interpretation of echocardiographic images.