Echocardiography can at many times be subjective, meaning that the person performing the echo may have personal input that affects the interpretation of the findings. This leads to so-called "inter-observer variability", where different echocardiographers might produce different reports when examining the same images.
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This necessitated the development of accreditation programs all around the world. The aim of such programs is to standardize the practice of echocardiography and to ensure that practitioners have the proper training prior to practicing echocardiography which will eventually limit inter-observer variability.
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Accredited radiographers, sonographers, or other professionals are required to pass a mandatory exam. Cardiologists and sonographers who wish to have their laboratory accredited by IAC must comply with these standards. The purpose of accreditation is to maintain quality and consistency across echocardiography labs in the United States.
Accreditation is offered in adult and pediatric transthoracic and transesophageal echocardiography, as well as adult stress and fetal echo. Accreditation is a two part process; first each facility will conduct a detailed self-evaluation, paying close attention to the IAC standards and Guidelines. The facility will then complete the application and submit actual case studies to the board of directors for review. Once all requirements have been met, the lab will receive IAC certification.
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IAC certification is a continual process and must be maintained by the facility, this may include audits or site visits by the IAC. Under both credentialing bodies sonographers must first document completion of prerequisite requirements, which contain both didactic and hands-on experience in the field of ultrasound. Applicants must then take a comprehensive exam demonstrating knowledge in both the physics of ultrasound and the clinical competency related to their specialty.
Credentialed sonographers are then required to maintain competency in their field by obtaining a certain number of Continuing Medical Education credits, or CME's. In , New Mexico and Oregon became the first two states to require licensure of sonographers.
The American Society of Echocardiography ASE is a professional organization made up of physicians, sonographers, nurses, and scientists involved in the field of echocardiography. One of the most important rolls that the ASE plays is providing their recommendations through the ASE Guidelines and Standards, providing a resource and educational opportunities for sonographers and physicians in the field. There have been various institutes who are working on use of Artificial intelligence in Echo but they are at a very early stage and still needs full development.
From Wikipedia, the free encyclopedia. Not to be confused with electrocardiography or other types of electrography. This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources.
Unsourced material may be challenged and removed. An abnormal echocardiogram: Image shows a midmuscular ventricular septal defect. The trace in the lower left shows the cardiac cycle and the red mark the time in the cardiac cycle when the image was captured. Colors are used to represent the velocity and direction of blood flow.
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Main article: Transthoracic echocardiogram. Main article: Transesophageal echocardiogram. Main article: Cardiac stress test. Main article: Strain rate imaging. European Journal of Echocardiography. Echo Research and Practice. In Thompson, Gilbert ed. Pioneers of Medicine Without a Nobel Prize. World Scientific.
Retrieved 23 September Tex Heart Inst J. Journal of the American College of Cardiology. October An echocardiogram echo is a graphic outline of the heart's movement. During an echo test, ultrasound high-frequency sound waves from a hand-held wand placed on your chest provides pictures of the heart's valves and chambers and helps the sonographer evaluate the pumping action of the heart.
Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves. However, ICE is generally more expensive. Two-dimensional echocardiography is most commonly used; contrast, Doppler and other echocardiography modalities provide additional information. Three-dimensional echocardiography is particularly useful in evaluating the mitral valve apparatus for surgical correction. Contrast echocardiography is a 2-dimensional echocardiogram done while agitated saline or another ultrasonographic contrast agent is rapidly injected into the cardiac circulation.
Agitated saline develops microbubbles, which produce a cloud of echoes in the right cardiac chambers and which, if a septal defect is present, appear on the left side of the heart. Usually, the microbubbles do not traverse the pulmonary capillary bed; however, one agent, sonicated albumin microbubbles, can do so and can enter left heart structures after IV injection and can therefore be used to delineate the heart chambers, especially the left ventricle.
Spectral Doppler echocardiography can record velocity, direction, and type of blood flow. This technique is useful for detecting abnormal blood flow eg, due to regurgitant lesions or velocity eg, due to stenotic lesions. Spectral Doppler echocardiography does not provide spatial information about the size or shape of the heart or its structures. Color Doppler echocardiography combines 2-dimensional and spectral Doppler echocardiography to provide information about the size and shape of the heart and its structures as well as the velocity of and direction of blood flow around the valves and outflow tracts.
Color is used to code blood flow information; by convention, red is toward and blue away from the transducer. Tissue Doppler imaging uses Doppler techniques to measure the velocity of myocardial tissue contraction rather than of blood flow. Myocardial tissue movement can also be evaluated with speckle-tracking echocardiography , which uses algorithms to track myocardial echo speckles characteristic reverberations from the myocardium during an ultrasound from frame to frame.
Strain imaging uses these data to calculate myocardial strain percentage change in length between contraction and relaxation and myocardial strain rate rate of change in length. Strain and strain rate measurements can help assess systolic and diastolic function and identify ischemia during stress testing. This technique continues to evolve; its widespread acceptance and use in the US have been hampered by lack of 3rd-party reimbursement.
TTE is an alternative to radionuclide imaging to identify myocardial ischemia during and after exercise or pharmacologic stress testing. Stress echocardiography shows regional wall motion abnormalities that result from an imbalance in blood flow in epicardial coronary vessels during stress.