Specialised cardiac imaging

A transthoracic echo is an easy and safe test which provides information on heart muscle function and valve function. It is particularly useful before and after cardiac surgery and for patients following a heart attack.

The physiologist moves a small, hand-held probe across the patient's chest to obtain a variety of ultrasound images.

The test takes approximately 30 minutes and can be performed as an inpatient, outpatient or part of a clinic appointment.

We perform a number of advance transthoracic studies. These can be for:

• Heart failure
• Contrast studies to assess for heart function, thrombus and small holes in the heart.
• 3D, strain and speckle studies
• Congenital heart disease
• Dys-synchrony studies for patients with suspected uncoordinated heart function that may need highly specialised pacemakers (CRT devices)

A TOE is a procedure to take detailed ultrasound images of your heart from the gullet (also known as the oesophagus or food pipe) which lies directly behind your heart.

To do this, a long flexible probe will be passed into your mouth and down the gullet. This provides an excellent view of your heart chambers and valves, and allows us to examine how efficiently they are working. This procedure provides the most accurate information in diagnosing problems with the heart valves such as:

• Infection of the heart valves (endocarditis).
• The need to repair or replace the valve, or whether the valve needs stretching (valvuloplasty).
• A blood clot (thrombus) in the heart chambers.

The procedure is performed as a day case, under sedation. You will be able to go home two to three hours after the procedure.

The Dobutamine Stress Echo (DSE) aims to make the patient's heart beat faster and harder using the drug Dobutamine and occasionally atropine. Abnormalities not seen at rest can then be detected (ischemia) and areas of muscle which are thought not to be working can be assessed to see if they have the ability to recover (viability).

The test is performed by a team including a consultant, a physiologist and a nurse. Patients are admitted to Thames Ward as a day patient, and the procedure and is usually performed under a light sedation.

Patients are asked to cycle on the specially designed exercise bike which can tip the patient into a position allowing the physiologist to take images of their hearts while still cycling. This enables the consultant to see and measure dynamic changes to the patient's heart while they are exercising without having to use medication of any type.

Unexplained shortness of breath, valve disease and heart muscle diseases can all be diagnosed using this procedure.