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Neurology
Stroke: The Warning Signs and Why Every Minute Counts
Face drooping, arm weakness, speech trouble — any one of them, appearing suddenly, is a stroke until proven otherwise. Call 1122 and note the time.
28 Aug 202611 min read
Echocardiogram
Pronounced ek-oh-KAR-dee-oh-gram
Also known as Echo, Cardiac ultrasound, 2D echo
An echocardiogram is an ultrasound scan of the heart that shows the chambers and valves moving in real time and measures how strongly the heart pumps. It uses sound waves only, with no radiation and no injection in the standard test.
In Cardiology
Where an records electricity, an echo shows structure and movement. A probe pressed against the chest sends sound into the body and listens for the echoes, building a live picture of the valves opening and closing, the muscle contracting, and the sac around the heart. Doppler settings add the direction and speed of blood flow, colouring leaks and narrowings so they can be measured.
How the test is done
You undress to the waist, lie on your left side, and gel is applied to the chest. The sonographer presses the probe firmly between the ribs and under the breastbone from several positions, and will ask you to hold your breath or roll further onto your side to open the gaps between the ribs. It takes twenty to forty-five minutes, needs no preparation and no fasting, and the only discomfort is the pressure of the probe and the coolness of the gel. A transoesophageal echo, in which a probe is swallowed under sedation, is a different and less common test used when the standard view is not enough.
The single number most often quoted from the report is the ejection fraction — the percentage of blood the left ventricle expels with each beat. Around 55 to 70 per cent is normal; below 40 per cent indicates significantly reduced pumping, and the range between is borderline. It is an estimate with real measurement variation, so a difference of a few points between two scans is usually the method rather than the heart. The echo also grades valve leaks and narrowings, measures wall thickness in long-standing , and looks for fluid around the heart or a clot inside it.
Where this comes up
Cardiology
Chest Pain: When to Worry and When to Call for Help
Chest pain lasting more than a few minutes with sweating, breathlessness or pain spreading to the arm or jaw is an emergency. Call Rescue 1122 now.
25 Aug 202611 min read
Related terms
- UltrasoundSonography, Ultrasound scanAn ultrasound scan builds images from high-frequency sound waves reflected back off the body's tissues. It uses no radiation, which is why it is the scan used in pregnancy.
- ECGEKG, ElectrocardiogramAn ECG records the heart's electrical activity through stickers placed on the chest and limbs, printing it as a tracing. It takes a few minutes, is painless and involves no radiation, and it is the first test in chest pain, palpitations and blackouts.
- ArrhythmiaDysrhythmia, Irregular heartbeatAn arrhythmia is a heartbeat that is too fast, too slow or irregular because the heart's electrical signalling has gone wrong. Some are harmless and lifelong, others raise the risk of stroke or are immediately dangerous.
- OedemaEdema, Fluid retentionOedema is swelling caused by fluid collecting in the tissues, most often seen in the ankles and legs. It is a sign rather than a diagnosis, and what matters is the reason behind it.