Can a Cough Be Related to Heart Issues?
What To Expect During An Echocardiogram
An echocardiogram is a test that shows detailed pictures of your heart. There are many types, and they're performed in different ways. (Photo credit: E+/Getty Images)
An echocardiogram is a test that uses ultrasound to show how your heart muscle and valves are working. These sound waves make moving pictures of your heart so your doctor can get a good look at its size and shape. You might hear your doctor call this test "echo" for short.
A specialist called a cardiac sonographer (or echocardiographer) will perform your echocardiogram. These medical professionals are trained to use the equipment that produces the image of your heart.
Both EKGs and echoes are tests that involve putting sensors called electrodes on your chest. During an echo, a cardiac sonographer will move a wand across this area.
An EKG checks your heart's electrical activity. It looks for patterns to figure out if your heart is beating normally, too fast, too slow, or in an irregular way. It's a good first test to spot issues linked with heart disease and can also reveal problems with your heart's shape or size. But it's not very accurate in judging how well your heart pumps.
An echocardiogram, on the other hand, shows a detailed view of the heart's internal structure and how blood flows through it. The test:
Your doctor may order an echocardiogram to:
There are several types of these tests. Your doctor can tell you more about which is best for you.
Transthoracic echocardiogram
This is the standard echo test. It's like an X-ray but without the radiation. Specialists use the same technology to check a developing baby's health before birth.
How to prepare for transthoracic echocardiogram. On the day of the test, eat and drink as you usually would. Take all of your medications at the regular times.
What to expect. You'll undress from the waist up and put on a hospital gown. The cardiac sonographer will put three electrodes (small, flat, sticky patches) on your chest. The electrodes are attached to an electrocardiograph monitor (EKG or ECG) that tracks your heart's electrical activity.
You'll lie on your left side on an exam table. The sonographer will run a wand (called a sound-wave transducer) across several areas of your chest. There will be a small amount of gel on the end to help create clearer pictures. Changes in the sound waves, called Doppler signals, show the direction and speed of blood moving through your heart.
You may or may not hear these sounds during the test. The sonographer might ask you to move around so they can take pictures of different areas of your heart. They might also ask you to hold your breath sometimes.
You won't feel anything during the test except coolness from the gel and slight pressure from the transducer.
The test will take about 40 minutes. Afterward, you can get dressed and go back to your routine.
Transesophageal echocardiogram (TEE)
For this test, the transducer goes down your throat and into your esophagus (the tube that connects your mouth to your stomach). Because it's closer to your heart, it can create a clearer picture.
How to prepare for transesophageal echocardiogram (TEE). Tell your doctor beforehand if you have any problems with your esophagus, such as a hiatal hernia, swallowing problems, or cancer.
Don't eat or drink anything for 6 hours before the test. Take all of your medications at the usual times with a small sip of water if necessary. If you use medicine or insulin for diabetes, ask your doctor or the testing center about it.
What to expect. Before the transesophageal echocardiogram, a nurse will put an intravenous line (IV) into a vein in your arm or hand so they can give you medication. A technician will stick EKG electrodes on your chest. They'll also put a blood pressure monitor on your arm and a pulse oximeter clip on your finger to watch your vital signs.
You'll get a mild sedative to help you relax.
A member of your medical team will pass the ultrasound probe into your mouth, down your throat, and into your esophagus. It won't affect your breathing. They might ask you to swallow to help the probe along. This takes a few seconds and may be uncomfortable. Once the probe is in place, it will take pictures of your heart. You won't feel it.
The test takes about 10 to 30 minutes. Then, someone will take out the probe. Nurses will watch you for 20 to 30 minutes afterward.
Don't eat or drink until the sedative wears off, which takes an hour after the test. You might still be drowsy or dizzy, so someone else should drive you home.
Stress echocardiogram
You have this test while exercising on a treadmill or stationary bicycle. It shows the motion of your heart's walls and pumping action when it's working hard. It can also show a lack of blood flow that might not appear on other heart tests.
How to prepare for a stress echocardiogram. Don't eat or drink anything but water for 4 hours before the test. Don't drink or eat anything with caffeine (such as cola, chocolate, coffee, tea, or medications) for 24 hours before. Don't smoke the day of the test. Caffeine and nicotine might affect the results.
Your doctor may tell you to stop taking certain heart medications on the day of your test. Ask what you should do if you take one of these drugs:
Talk to them if you have questions.
What to expect. For the procedure, a cardiac sonographer will stick EKG electrodes to your chest. They'll chart your heart activity and take your pulse and blood pressure.
The sonographer will first do a transthoracic echocardiogram. Then, you'll get on a treadmill or a stationary bicycle and start exercising. The medical team will slowly raise the intensity of the exercise machine. In the meantime, they'll watch the EKG monitor for changes and ask about any symptoms.
You'll exercise until you can't do it anymore. The sonographer will quickly do another echocardiogram.
After the tests, you'll exercise slowly to cool down. The team will watch your vital signs until they're back to normal.
The appointment takes about an hour, but the test itself usually takes less than 15 minutes.
Dobutamine stress echocardiogram
This is another form of stress echocardiogram. But instead of exercising, you get a drug called dobutamine that makes your heart feel like it's working hard.
This test checks your heart and valves when you can't exercise on a treadmill or stationary bike. It can tell your doctor how well your heart handles activity. It also helps them figure out your risk of coronary artery disease and how well any cardiac treatments are working.
How to prepare for a dobutamine stress echocardiogram. Four hours before your test, stop eating and drinking everything except for water. But before this, most foods and drinks are OK.
You'll also need to stop smoking the day you're scheduled to have the test since nicotine can skew the results.
Food and drinks with caffeine, such as soda, energy drinks, chocolate, coffee, and tea are off-limits 24 hours before the test. You should even avoid products that are decaffeinated or caffeine-free since they can still affect your test results.
Talk to your doctor about which medications are safe to take before a dobutamine stress test. You may need to stop taking some heart drugs a day ahead of the test.
What to expect. A technician will attach EKG electrodes to your chest. A nurse will put an intravenous line (IV) into a vein in your arm in order to give you the dobutamine.
The team will do a transthoracic echocardiogram, measure your resting heart rate, and take your blood pressure. Then, you'll get the dobutamine. Your heart will begin beating faster and stronger. You might have a warm, flushed feeling and a mild headache.
Lab personnel will ask how you're feeling. They'll watch for changes on the EKG monitor and take out the IV once you've gotten all the dobutamine.
The appointment will take about an hour, but the IV usually lasts about 15 minutes. Plan to stay in the waiting room until any symptoms have gone away.
Intravascular ultrasound
During this test, your doctor threads the transducer into your heart's blood vessels through a catheter in your groin. It gives more detailed information about atherosclerosis (a buildup of plaque) inside your blood vessels.
How to prepare for an intravascular ultrasound. Your doctor will tell you what medications to take and what to eat or drink before the test. You'll likely need to avoid food and drinks after midnight on the day of your test. Your doctor may tell you to wear loose clothes and leave your jewelry at home.
What to expect. You'll put on a hospital gown and lie on a special table. A nurse will attach EKG electrodes to your chest. They'll put an IV line into your arm and give you a mild sedative so you can relax.
Your doctor will use a medication to numb your groin. They'll make a small cut there, put a short tube called a plastic inducer sheath through it, and run a catheter (a long, narrow tube) through the cut and into the arteries of your heart. The catheter has a wire with an ultrasound tip inside. It will make pictures of your artery.
The test takes about an hour. After your doctor removes the catheter and sheath, a nurse will put a tight bandage on your groin to prevent bleeding. You probably won't need stitches to close the cut in your groin. You'll lie flat with your leg straight for 3 to 6 hours. You might have to stay in the hospital overnight.
Fetal echocardiography
This test takes detailed pictures of your baby's heart before they're born. Doctors use it to diagnose heart problems present at birth (called congenital heart defects).
How to prepare for a fetal echocardiogram. Some ultrasounds carried out during pregnancy require a full bladder, but that's not the case for a fetal echocardiogram. You won't need to do anything special to get ready for the test. Expect it to take between 30 minutes and 2 hours.
What to expect. Your health care team can do a fetal echocardiogram in one of two ways:
A few components make up an echocardiogram. They include:
The guidelines for an echocardiogram are a bit different if you have diabetes:
If you take insulin to control your blood sugar, ask your doctor how much of your medication you should take the day of the test. Often, your doctor will tell you to take only half of your usual morning dose and to eat a light meal 4 hours before the test.
If you take pills to control your blood sugar, don't take your medication until after the test is complete unless otherwise directed by your doctor.
Don't take your diabetes medication and skip a meal before the test.
If you have a glucose monitor, bring it with you to check your blood sugar levels before and after your test. If you think your blood sugar is low, tell the lab personnel immediately.
Plan to eat and take your blood sugar medication following your test.
It depends on the type of echo you're having. The test itself can take anywhere from 10 minutes to 2 hours. After the test, your doctor will want to keep an eye on you for at least half an hour.
For some types, such as anintravascular ultrasound, your recovery time may be considerably longer.
The sound waves used during an echocardiogram aren't harmful. But there are some possible risks of the test:
After a transesophageal echocardiogram, you may have:
The drug you get during a stress echo could also cause side effects such as:
An echocardiogram can help your doctor diagnose several kinds of heart problems, including:
An echocardiogram is a test that uses sound waves to create pictures of your heart. You might need one if your doctor suspects you or your baby has problems like an enlarged heart, weak heart muscles, issues with heart valves, and even birth defects in the heart. There are different types of echocardiograms, depending on what your doctor needs to see. It's a safe way to diagnose and keep an eye on heart conditions.
What 5 abnormalities can be found on an echocardiogram?
An echocardiogram can reveal:
Do you have to take your bra off for an echocardiogram?
For some echocardiograms, you'll need to take off all your clothes from the waist up and put on a hospital gown.
What should you not do before an echocardiogram?
Before an echocardiogram, you shouldn't eat or drink anything for a certain period of time, depending on the type of test. You may also need to avoid caffeine, smoking, and certain medications on the day of the test. Your health care team will tell you how to prepare.
Top 5 Most-Read PAH Content Of 2023
This year's top 5 most-read articles on pulmonary arterial hypertension (PAH) explored expert opinions on treatment approaches, data on newly emerging therapies, the impacts of alcohol, and more.
The top 5 most-read pulmonary arterial hypertension (PAH) pieces on AJMC.Com this year included insights into health care professionals' opinions on right heart (RH) imaging, the approval of new treatments, treatment outcomes in subpopulations, as well as the influence of alcohol consumption on blood pressure.
These are the top 5 most-read PAH articles of 2023.
5. GERD Treatment May Yield More Favorable PH Outcomes for Patients With Codiagnoses
Current treatments for gastroesophageal reflux disease (GERD) involve medications such as proton pump inhibitors that can reduce the acidity of aspirations in these patients. After observing that patients with pulmonary hypertension also indicated with GERD experience better outcomes, researchers hypothesized that these treatments could have a protective effect for patients enduring lung disease.
Read the full article.
4. More Evidence Needed to Clarify the Role of Right Heart Imaging in PAH
A total of 17 experts from the field of pulmonology and cardiology completed 3 assessments on how right heart imaging (RH) influences treatment decisions in PAH. As many agreed on the long-term benefits RH imaging can provide for disease monitoring, survey results expressed a wide degree of variability in RH imaging implementation, stressing the need for improved risk-assessment algorithms and parameters in this area.
Read the full article.
3. ICER to Review Sotatercept for Pulmonary Arterial Hypertension
In the late spring of 2023, the Institute for Clinical and Economic Review said it would assess the comparative clinical effectiveness and value of sotatercept as a therapy for PAH. Sotatercept counteracts the underlying mechanism of PAH that consequently constricts pulmonary vessels, making it the first treatment to directly act on the cause of disease. Upon acceptance by the FDA, sotatercept could be available in the US market in 2024.
Read the full article.
2. Data for Therapies to Treat Cholesterol, PAH Highlight ACC Scientific Sessions
This year's American College of Cardiology (ACC) Scientific Session accepted over 4000 abstracts across 84 countries and took place in New Orleans, Louisiana. Among the highlighted presentations ahead of the event were those covering value-based care, the development of new treatments for PAH and cholesterol, special topics in cardiology, and more.
Read the full article.
Check out all the coverage from ACC 2023.
1. Elevated Systolic Blood Pressure Linked to Alcohol Consumption
Meta-analyses on the relationship between alcohol consumption and blood pressure increases are lacking, especially regarding more minimal alcohol consumption. To investigate and elucidate this relationship further, investigators conducted systemic search of studies reporting on these associations. Researchers' findings suggest that elevated systolic blood pressure and alcohol consumption have a direct and linear relationship and, alarming, no threshold seems to exist here.
Read the full article.
Amazon's New Echo Frames Can't Touch The Ray-Ban Meta
This April marked the 10th anniversary since Google released the first generation of Glass. It may be difficult to believe with a decade of hindsight, but the limited release "Explorer's Edition" were coveted objects. For a little while, at least, they felt like the future.
The last 10 years of smartglasses has, however, been an extremely mixed bag. There have been more misses than hits, and it feels like we're still years out from reaching any sort of consensus on form and functionality.
Google Glass never reached the kind of critical mass required to launch a commercial product, though the company seems content to give things another shot every couple of years.
The success of AR, meanwhile, has largely been confined to smartphone screens — though not for lack of trying. Magic Leap, Microsoft and Meta have all launched AR products with varying degrees of success, and next year's Apple Vision Pro release is sure to move the needle on…something. But technical limitations have confined these solutions to significantly larger form factors.
Shrinking that sort of technology down to regular glasses size is a nice goal, but one that is a ways off. It's telling that Meta's recent hardware event saw the release of two head-worn devices. The first was the Quest 3, a VR headset that offers an AR experience courtesy of passthrough technology. The other, the Ray-Ban Meta, has no pretense of offering augmented reality, but it does manage to fit things into the standard glasses form factor.
Image Credits: Brian Heater
Like the Snapchat Spectacles before them, the Ray-Ban Meta are all about content capture. A camera built into the frame lets the wearer shoot quick videos and livestream for social media. As far as content consumption goes, speakers are built into the temples, directing music or podcast audio toward the wearer's ear.
Unlike the Ray-Bans, however, Amazon's Echo Frames 3 don't do video capture (you can practically hear the collective sigh of relief from privacy advocates across the globe). They do, however, offer a similar audio set up. The speakers are located in the temples, just ahead of the temple tips. The company has opted against bone conduction here, which is probably for the best (while neat, the technology is generally passable, at best).
Unlike most headphones and earbuds, they don't cover the entrance to the ear canal. That's great for situational awareness and less than great for immersive sound. If you want to stay focused on the world around you while you walk down the street or ride a bike listening to music, it's not a bad option.
Image Credits: Brian Heater
Given their proximity to the ear, they get plenty loud, and due to their directional nature, they're hard to hear if you're not wearing them (though not totally silent to others). The actual audio quality, on the other hand, leaves much to be desired. They do in a pinch for music, but I'd rather not rely on them as a daily driver of any sort.
As their name implies, however, the real centerpiece here is Echo functionality. The Frames are yet another form factor for summoning Alexa. This makes enough sense on the face of it, a hands-free voice assistant you can take anywhere your phone gets a decent connection. You can play/pause, make calls and set reminders, for starters — all things you can do on a pair of earbuds with a connected voice assistant.
Image Credits: Brian Heater
There are five different styles: black square, black rectangle, blue round, brown cat eye and grey rectangle. Amazon sent the first, which look like your average pair of Buddy Holly/Elvis Costello glasses, albeit with a plasticky design and larger temples, owing to the electronics contained inside. They fit me well enough, and while they're not exactly what I would have picked out at, say, Warby Parker, I don't feel embarrassed wearing them publicly.
You can further customize the Frames with prescription lenses, blue light filtering or go in for sunglasses. All nice options to have, certainly.
The battery life is stated at 14 hours of "moderate" usage. With a standard amount of music listening, you should be able to get through a day on a single charge. That's especially nice given that the charging dock is big and awkward relative to the glasses themselves. Included in the packaging are charging instructions (along with some short braille instructions — a nice touch on the accessibility front), which are necessary as the design isn't intuitive.
Image Credits: Brian Heater
You fold the glasses and face the lenses up, so the charging points on the temples contact the charger. It's a far cry from the Ray-Ban Meta's extremely convenient and well-designed charging case. Amazon's case, on the other hand, is collapsible. It's not nice, but there's definitely an added convenience in being able to fold it flat while wearing the glasses.
My feelings about the latest Echo Frames may well have been different had I not recently tested the Ray-Ban Meta. At $270, they're $30 cheaper than the Meta glasses. If you're attempting to decide between the two, I would say bite the bullet and spend the extra $30. Of course, it's also worth factoring in that — as I write this — Amazon is currently offering the new Echo Frames for a deeply discounted $200.
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