Echocardiography refers broadly to the use of diagnostic ultrasound as it pertains to the heart and cardiovascular system. The features of the imaging equipment used, as well as the principles underlying image generation, are analogous to other sonographic applications. It is primarily used to non-invasively diagnose and guide the treatment of cardiovascular disease.

Terminology

The performance of diagnostic, comprehensive echocardiography typically involves a dedicated sonographer capturing images with subsequent interpretation by a qualified reader, typically a cardiologist.

This differs in scope and indications from "focused" or "point of care" echocardiography which typically refers to an abbreviated protocol with a scope limited to focused, clinical questions.

Indications

General indications for a comprehensive echocardiographic study include:

• haemodynamic instability ⁵
• evaluation of suspected symptomatic structural heart disease
• palpitations or syncope with a concerning family history ³
• pulmonary embolism
  • assessment of right ventricular function ²
• suspected stenosis or regurgitation of a native cardiac valve
• suspected cardioembolic event or cardiac mass ¹
• assessment of a prosthetic heart valve
• clinical suspicion for infective endocarditis
• chest pain concerning for myocardial ischaemia
• pericardial disease
• assessment prior to surgery or cardioversion

Contraindications

Generally differ based upon the type of study in question, with notable examples including:

• transoesophageal echocardiography
  • structural oesophageal abnormalities
  • prior gastric surgery
  • lack of patient co-operation
• stress echocardiography ⁶
  • malignant dysrhythmias
  • active myocardial ischaemia
  • severe, uncontrolled hypertension
  • hemodynamically significant left ventricular outflow tract obstruction

Techniques

• two-dimensional (transthoracic) echocardiography
• M mode echocardiography
• Doppler echocardiography
• stress echocardiography
• contrast-enhanced echocardiography
• three-dimensional echocardiography
• transoesophageal echocardiography
• intracardiac ultrasonography
• intravascular ultrasonography