'transcatheter aortic valve replacement'

2D Echocardiography or 2D Echo of heart is a test in which ultrasound technique is used to take pictures of heart. It displays a cross sectional ‘slice’ of the beating heart, showing chambers, valves and the major blood vessels of heart. ‘Doppler’ is a special element of this ultrasound exam that assesses flow of blood in the heart. How is 2D Echo done? Patient is made to change in a front open robe and a colourless gel is applied to the chest area. Then he is asked to lay on his left side as the technician moves the transducer across the various parts of his chest to get specific/desired views of the heart. Instructions may also be given to the patient to breathe slowly or to hold it. This helps in getting superior quality pictures. What it detects? Echocardiography is a significant tool in providing the physician important information about heart on the following: • Size of the chambers, volume and the thickness of the walls • Pumping function, if it is normal or reduced to a mild/severe degree • Valve function – structure, thickness and movement of heart’s valves • Volume status as low blood pressure may occur as a result of poor heart function • Pericardial effusion (fluid in the pericardium – the sac that surrounds the heart), congenital heart disease, blood clots or tumours, abnormal elevation of pressure within the lungs etc. How safe is echocardiography? It is absolutely safe. There are no known risks of the ultrasound in this type of testing. Stress, modern lifestyle and many other factors have adverse effects on the heart. Hence, routine analysis of the heart health is important. 2D echocardiography is a screening test that produces live heart images. It allows your doctor to monitor the functioning of your heart and its valves.

Echocardiography is a test that uses sound waves to produce live images of your heart. The image is an echocardiogram. This test allows your doctor to monitor how your heart and its valves are functioning. The images can help them spot: • blood clots in the heart • fluid in the sac around the heart • problems with the aorta, which is the main artery connected to the heart During the procedure, a transducer (like a microphone) sends out sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or “echo” off of the heart structures. These sound waves are sent to a computer that can create moving images of the heart walls and valves. Why do people need an echo test? Your doctor may use an echo test to look at your heart’s structure and check how well your heart functions. The test helps your doctor find out: • The size and shape of your heart, and the size, thickness and movement of your heart’s walls. • How your heart moves. • The heart’s pumping strength. • If the heart valves are working correctly. • If blood is leaking backwards through your heart valves (regurgitation). • If the heart valves are too narrow (stenosis). • If there is a tumor or infectious growth around your heart valves. What are the types of echocardiography? There are several different types of echocardiograms. • Transthoracic echocardiography: This is the most common type of echocardiography. It’s painless and noninvasive. A device called a transducer will be placed on your chest over your heart. The transducer sends ultrasound waves through your chest toward your heart. A computer interprets the sound waves as they bounce back to the transducer. This produces the live images that are shown on a monitor. • Transesophageal echocardiography: If a transthoracic echocardiogram doesn’t produce definitive images, your doctor may recommend a transesophageal echocardiogram. In this procedure, the doctor guides a much smaller transducer down your throat through a thin, flexible tube in your mouth. They will numb your throat to make this procedure easier. This tube is guided through your esophagus, the tube that connects your throat to your stomach. • Stress echocardiogram: A stress echocardiogram uses traditional transthoracic echocardiography. However, the procedure is done after you’ve exercised or taken medication to make your heart beat faster. This allows your doctor to test how your heart performs under stress. • Three-dimensional echocardiography: A three-dimensional (3-D) echocardiogram uses either transesophageal or transthoracic echocardiography to create a 3-D image of your heart. This involves multiple images from different angles. It’s used prior to heart valve surgery. It’s also used to diagnose heart problems in children. • Fetal echocardiography: Fetal echocardiography is used on expectant mothers sometime during weeks 18 to 22 of pregnancy. The transducer is placed over the woman’s belly to check for heart problems in the fetus. The test is considered safe for an unborn child because it doesn’t use radiation, unlike an X-ray.

How do heart valves work? Blood passes through a valve before leaving each chamber of the heart. There are four valves within your heart. The heart valves make sure blood flows in only one direction through your heart. The mitral valve is located between the left upper and lower chambers of the heart. It has two leaflets that open and close similar to a double door. What is mitral stenosis? Stenosis means narrowing of an opening, such as a heart valve. Stenosis of the mitral valve limits the forward flow of blood from the left atrium to the left ventricle. This may cause a back-up of blood and fluid in the lungs. Mitral stenosis most commonly develops many years after a person has had rheumatic fever, although many patients diagnosed with mitral stenosis don’t recall ever having the illness. What are the symptoms? Many of the symptoms of mitral stenosis, such as shortness of breath and fatigue, result from a back-up of blood in the lungs. Other symptoms of mitral stenosis may include quick weight gain; weakness; dizziness; swelling in the ankles, feet and/or abdomen (edema); and/or heart palpitations (irregular heartbeat). What causes mitral stenosis? Mitral stenosis most commonly develops many years after a person has had rheumatic fever, although many patients diagnosed with mitral stenosis don’t recall ever having the illness. During rheumatic fever, the valve becomes inflamed. Over time, the leaflets of the inflamed valve stick together and become scarred, rigid and thickened, limiting its ability to open completely. How is mitral valve stenosis treated? Valve stenosis can sometimes be treated with medications if the symptoms are mild. When medications do not work to control symptoms, balloon valvotomy or surgical valve repair or replacement is performed. Balloon valvotomy successfully opens the narrowed valve and improves the overall function of the heart. If balloon valvotomy cannot be performed, surgical valve repair or replacement may be options. Valve repair may be performed to separate fused valve leaflets, sew torn leaflets or reshape parts of the valve.

A coronary angiogram is a diagnostic image, which uses dye and special X-rays to show the inside of your coronary (heart) arteries. These images are used to identify arterial narrowings that may be responsible for chest pain and future heart attacks. An angiography is the procedure, which uses special imaging techniques to produce coronary angiograms. To prepare for imagining, a very small tube (catheter) is inserted into a blood vessel in either the patient’s groin or arm. The tip of the tube is positioned at the beginning of the arteries supplying the heart, and a special fluid or dye is injected. This special fluid is visible by X-ray, which details the narrowing, occlusions, and other abnormalities of specific arteries. These images obtained are called angiograms. Why it's done? Your doctor may recommend that you have a coronary angiogram if you have: • Symptoms of coronary artery disease, such as chest pain (angina) • Pain in your chest, jaw, neck or arm that can’t be explained by other tests • New or increasing chest pain (unstable angina) • A heart defect you were born with (congenital heart disease) • Abnormal results on a noninvasive heart stress test • Other blood vessel problems or a chest injury • A heart valve problem that requires surgery What are risks? As with most procedures done on your heart and blood vessels, a coronary angiogram has some risks, such as radiation exposure from the X-rays used. Major complications are rare, though. Potential risks and complications include: • Heart attack • Stroke • Injury to the catheterized artery • Irregular heart rhythms (arrhythmias) • Allergic reactions to the dye or medications used during the procedure • Kidney damage