Ecocardiograma questions.

[Rods]

Sorry by my naive questions but, here I go.. =D;

1. Sometimes things "get better", sometimes things "get worse". Even mantaining the same doctor, the same eco machine. Is this common?
2. When there is calcium in excess in valve, is it possible to see it in the Eco exam?
3. The maximum gradient (peak)... sometimes is 16 mmHG, sometimes 20 mmHG, 28 mmHG... but the mean gradient varies less than it. 10 to 14... =/

 

[joanpieroni]

I think the numbers in the echo have to do with how much blood is flowing thru the valve??

 

[epstns]

Well, Rods, you've tripped over the main reason why echo's are only used for diagnostic and monitoring before surgery. They are notoriously inconsistent. One can have the same machine, the same technician and the same "body" and still have a good bit of variability of the echo readings. That's just the way they are. Sometimes just the precise positioning of your body when the echo is done can either add or remove shadows or can affect the blood flow through your heart and arteries. Most of the echo "measurements" are derived from calculations based upon blood flow sensed via Doppler sonography - sound waves. There is no real "vision" via echo.

This is why the docs generally require a cath prior to surgery, as the angiogram gives them actual measurements and allows them to better visualize the patient's heart and circulatory system.

 

[Paleowoman]

2. When there is calcium in excess in valve, is it possible to see it in the Eco exam?

Yes - calcification can be seen on echo. It can also be seen on CT angiogram, but they see the full extent of it when the valve is changed.

3. The maximum gradient (peak)... sometimes is 16 mmHG, sometimes 20 mmHG, 28 mmHG... but the mean gradient varies less than it. 10 to 14... =/

The maximum varies a lot, with position and breaths, that's why they take it several times. The mean doesn't vary so much, but it's not the mean of the maximum, it's like the 'middle' between max and minmum, at least that's my understanding of it. You could ask the technician to explain it to you next time you have an echo.