Name of the Procedure:

Transthoracic Echocardiography with Contrast, or Without Contrast Followed by with Contrast, Real-Time with Image Documentation (2D), Includes M-Mode Recording, When Performed, Follow-Up or Limited Study (C8924)

Common name(s): Echocardiogram with Contrast, Contrast Echocardiography

Summary

A transthoracic echocardiography (TTE) is a non-invasive diagnostic test that uses ultrasound waves to create detailed images of the heart. It can be performed with or without an injectable contrast agent to enhance image clarity. This procedure helps in assessing heart structures and functions in real time, including the heart chambers, valves, and blood flow.

Purpose

• Medical Conditions: Heart valve diseases, cardiomyopathy, congenital heart defects, pericardial disease, and heart function evaluation post-myocardial infarction.
• Goals/Outcomes: To provide comprehensive images of the heart to diagnose abnormalities, assess the effects of diseases, guide treatment decisions, and monitor the progress of cardiac conditions.

Indications

• Symptoms of heart disease (chest pain, shortness of breath, fatigue)
• Abnormal findings on other cardiac tests (EKG, chest X-ray)
• Follow-up study for patients with known heart conditions
• Pre-operative assessment before cardiac surgeries

Preparation

• Instructions: Usually, no special preparation is needed. Fasting may be required if sedation is planned.
• Diagnostic Tests/Assessments: Review of patient’s medical history, physical examination, possibly an initial non-contrast echocardiogram.

Procedure Description

1. Initial Setup: The patient lies on an examination table, and electrodes are placed on the chest to monitor heart activity.
2. Ultrasound: A special gel is applied, and a transducer is moved over the chest to capture heart images.
3. With/Without Contrast: The procedure starts without contrast. If better image clarity is needed, a contrast agent is injected into a vein.
4. Imaging: Real-time 2D images are displayed, and M-mode recording may be done for detailed motion analysis.
5. Completion: The transducer is removed, and the gel is wiped off. The results are analyzed by a cardiologist.

• Tools/Equipment: Ultrasound machine, transducer, contrast agent (if used).
• Anesthesia: Generally not required; mild sedation may be used if necessary.

Duration

Typically 30-60 minutes.

Setting

Performed in a hospital, outpatient clinic, or specialized cardiac diagnostic center.

Personnel

• Cardiologist or trained sonographer (conducts the test)
• Nurse (administers the contrast agent)
• Cardiologist (reviews and interprets images)

Risks and Complications

• Common: Minimal; slight discomfort from IV contrast injection.
• Rare: Allergic reaction to contrast agent, arrhythmias, slight risk of infection at the injection site.

Benefits

• Expected Benefits: Accurate diagnosis and monitoring of heart conditions, aiding in the planning of treatment plans.
• Realization Time: Immediate image acquisition, with results typically discussed shortly after.

Recovery

• Post-procedure Care: Generally none; patients can usually resume normal activities immediately.
• Recovery Time: Typically immediate.
• Follow-up: As directed by the healthcare provider, based on the findings.

Alternatives

• Other Options: Stress echocardiography, cardiac MRI, cardiac CT scan.
• Pros/Cons: Other imaging tests may provide additional details but are often more invasive or costly.

Patient Experience

• During: Mild discomfort from gel application and transducer pressure; slight stinging if contrast is injected.
• After: Generally no discomfort; normal activities can usually be resumed right away.
• Pain Management: Not typically needed. If sedation was used, some drowsiness might occur.