2D Echocardiography in Hyderabad | Echo Test

What Does a 2D Echo Assess?

Left Ventricular Ejection Fraction (EF)

The percentage of blood pumped out of the left ventricle with each beat. Normal is 55 to 70%. EF below 40% indicates significant impairment and is the key measure in heart failure classification and treatment decisions.

Wall Motion

Each segment of the ventricular wall is assessed for normal contraction. Reduced or absent wall motion in a specific region indicates ischemia or infarction in the corresponding coronary territory.

Left Ventricular Size

Chamber dimensions and volumes are measured. Enlargement indicates volume or pressure overload. Combined with EF, this guides decisions on valve surgery timing.

Right Ventricular Function

Right heart size and function, particularly relevant in pulmonary hypertension, right heart failure, and congenital heart disease.

Valve Structure and Function

All four valves are imaged and assessed using color Doppler to detect regurgitation and continuous wave Doppler to measure gradients across stenosed valves. Critical for aortic stenosis grading and mitral valve assessment.

Pericardium

The sac surrounding the heart is visualized. Fluid in the pericardial space (pericardial effusion) is identified and quantified. Tamponade physiology, where the fluid compresses the heart and impairs filling, has characteristic echo features.

Aortic Root and Ascending Aorta

Dimensions of the aortic root are measured, important for surveillance in Marfan syndrome, bicuspid aortic valve, and ascending aortic aneurysm.

Diastolic Function

How well the left ventricle relaxes and fills with blood between beats. Diastolic dysfunction is the hallmark of heart failure with preserved ejection fraction (HFpEF) and is graded on echo.

Intracardiac Pressures

Doppler assessment of tricuspid regurgitation velocity estimates pulmonary artery pressure non-invasively. Elevated pulmonary pressure indicates pulmonary hypertension.

Intracardiac Masses

Thrombus (blood clots, particularly in the left atrial appendage in AFib or the left ventricle after heart attack), tumors, and vegetation from infective endocarditis are identified on echo.

Types of Echocardiogram

Transthoracic Echo (TTE)

The standard 2D echo. A probe is placed on the chest wall and images are obtained through the ribs. Covers all the assessments listed above. Non-invasive, safe, and produces no radiation.

Transoesophageal Echo (TOE)

An ultrasound probe is passed into the oesophagus (food pipe) under sedation. Provides higher-resolution images of structures behind the heart, including the mitral valve, left atrial appendage, and aorta. Used before valve procedures, to detect left atrial thrombus, and in infective endocarditis assessment.

Stress Echo

2D echo images are acquired at rest and immediately after exercise (treadmill) or pharmacological stress (dobutamine infusion). Wall motion abnormalities that appear only under stress reveal areas of myocardium with inadequate blood supply not visible at rest.

3D Echocardiography

Advanced imaging that reconstructs the heart in three dimensions. Particularly valuable for precise valve assessment before repair surgery and for guidance of structural heart interventions.

Contrast Echo

Agitated saline or ultrasound contrast agent is injected intravenously to improve endocardial border definition, detect intracardiac shunts (patent foramen ovale), or assess myocardial perfusion.

Conditions Diagnosed and Monitored with 2D Echo

Heart failure:

Measurement of ejection fraction and assessment of diastolic function classify heart failure type and guide treatment. Serial echos monitor response to therapy and cardiac remodeling.

Heart valve disease:

Echo is the primary investigation for all valve conditions. It grades severity, guides timing of intervention, and monitors disease progression with serial studies.

Cardiomyopathy:

Distinguishes dilated from hypertrophic from restrictive cardiomyopathy, measures hypertrophy in HCM, and detects outflow obstruction.

Coronary artery disease and heart attack:

Regional wall motion abnormalities identify the territory of ischemia or infarction. Post-heart attack echo quantifies residual function and guides further management.

Atrial fibrillation:

Measures atrial size, identifies valvular causes of AFib, and assesses left ventricular function before cardioversion or ablation.

Pericardial disease:

Detects pericardial effusion, quantifies its size, and identifies tamponade physiology requiring urgent drainage.

Congenital heart disease:

Identifies structural defects including ASD, VSD, and valve abnormalities. Essential for planning catheter closure procedures.

Pre-operative assessment:

Baseline cardiac function assessment before major surgery. Identifies unsuspected valve disease or reduced ejection fraction that may affect operative risk.

TAVI planning and follow-up:

Aortic valve area and gradient measurements determine severity of aortic stenosis and suitability for TAVI. Post-TAVI echo confirms valve function.

What to Expect During a 2D Echo at Germanten

Preparation:

No fasting or special preparation is needed for a standard transthoracic echo. Wear comfortable clothing that allows easy access to the chest.

Positioning:

You lie on your left side on an examination couch. This position tilts the heart slightly forward, improving the ultrasound window through the ribs.

Gel Application:

Ultrasound gel is applied to the chest to eliminate air between the probe and skin. Air blocks ultrasound transmission.

Probe Positions:

The sonographer moves the probe to several positions on the chest, left side of the sternum, the apex of the heart, and below the ribcage, to obtain views from different angles. The probe is held firmly but does not cause pain.

Doppler Assessment:

Color Doppler and spectral Doppler measurements are added to assess blood flow through valves and to measure velocities and gradients.

Duration:

A standard resting echo takes 20 to 30 minutes. Stress echo or complex assessments take longer.

Results:

At Germanten, all echos are reported by a senior cardiologist the same day. The report is issued with measurements, images, and a clinical summary. Findings are discussed with you directly.