TRANSTHORACIC ECHO TEST IS THE TRADITIONAL ECHO PERFORMED FROM THE CHEST WALL
This is the most basic but the most reliable and commonly used test to diagnose congenital heart disease. It is a non-invasive test. It may require sedation at times. ECHO IS AN OBSERVER DEPENDENT TEST. For this reason every cardiologist likes to do it himself.
The Echo Test consists of 3 components:
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2-D anatomical Diagnosis: The D refers to dimensional. So a 3 D heart is seen on a flat screen and images are integrated by the observer and details of the anatomy outlined based on the test.
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The Color Flow Mapping: In this color flow is seen similar to how blood is actually flowing in the heart. The flow is color coded blue or red but not on the basis of color of blood, but on basis of direction of flow.
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Doppler: In Doppler exam, the velocity of blood flow is measured to get an idea of pressures across the lesion or across a valve.
SEDATION
Since the child needs to be still during the test it is routine to sedate a child during the test. This is a short sedation of about 30 minutes. Usually Pedichloryl is given to the child. The effect of the medicine lasts for 30 min to 1 hour.
Sometimes the child may not sleep with the medicine. A second dose may be required.
TRANSESOPHAGEAL ECHO
This is a specialised test by which the heart is evaluated in greater detail from behind via an endoscope like device in the food pipe. This in a child cannot be performed while awake so patient is sedated and then done. The sedation is more deep and like but less than general anaesthesia. Usually the medicines are given intravenously. The image clarity is much superior and anatomy can be made out very clearly.
This can also be used during device closure of the Atrial or Venticular Septal defect. The test has to be done for a specific purpose not as a routine. Either it is done to answer a specific question or to assist in a complicated procedure.