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To continue the discussion of a weak heart, congestive heart failure, it’s necessary to describe the main imaging tool used to establish the diagnosis.

The echocardiogram is an elegant procedure that uses high frequency sound waves, called ultrasound to transmit and then receive the “echoed” sound waves.

The reflection of this ultrasound, or echo, is picked up by electrodes attached to the chest.

This information characterizes the tissue that reflects the echo based on penetration and the time it takes to reflect back to the probe.

This information is processed into an image of the heart. As the technology has evolved the definition and quality has reached a very high level.

Another cool aspect to “echo” is the ability to reflect these sound waves off of blood cells as they are moving through the heart.

By using the Doppler effect principle that is simply the change in frequency of the sound wave coming from a moving source other very important information can be obtained.

Think of the sound of a train whistle as the train is moving and how it changes as the train moves toward you and then away.

This Doppler aspect to “echo” enables the acquiring of the direction of blood flow through the heart, the speed of that flow and the actual calculation of blood pressures in different areas of the heart.

This information can then be quickly utilized to assess how the heart is functioning, in other words if it is strong or weak. Is it pumping the normal amount of blood per beat or is it weak, which produces the symptoms I mentioned.

All four chambers of the heart can be quickly assessed as well as the four valves that regulate blood flow in its journey through the heart.

Like all high-tech devices, the echo equipment has been refined and miniaturized and has gone from being the size of a small refrigerator to a laptop computer.

I carry one with me as I do outreach cardiology clinics and have used it in patients’ homes when I do a home visit.

This information is invaluable in making a diagnosis and monitoring the heart’s response to different therapies.

I’ll discuss abnormal findings and therapy next time.

Dr. Kipp Webb is a cardiologist at Big Sky Heart. He is a fellow of the American College of Cardiology and is board-certified in cardiovascular diseases and interventional cardiology. He can be reached at 237-5888.

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