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Cardiac Imaging: Echo, TEE, Nuclear and Cardiac CT
Heart imaging shows how the heart is built and how well it works. Dr. Smith performs and reads several kinds of heart imaging and uses them to diagnose disease and plan structural heart procedures.
What these tests are
Transthoracic echocardiogram (echo). An ultrasound of the heart taken through the chest wall. It shows pumping strength, valve function and pressures, with no radiation.
Transesophageal echocardiogram (TEE). A thin ultrasound probe is passed into the esophagus, just behind the heart, under sedation. It gives a much closer view of the valves and upper chambers, and is used to look for clots, assess valves before repair and guide procedures such as MitraClip, TriClip and Watchman.
Intracardiac echocardiography (ICE). A tiny ultrasound catheter placed inside the heart during some procedures, such as PFO closure.
Nuclear stress testing (SPECT and PET). A small amount of tracer shows blood flow to the heart muscle at rest and under stress, from exercise or a medicine, to look for blocked arteries.
Cardiac CT. A fast CT scan can measure calcium in the heart arteries (calcium score), show the arteries with contrast dye, and map the heart and blood vessels to plan TAVR, Watchman and other procedures.
Who they may help
These tests help people with chest pain, shortness of breath, a heart murmur, heart failure, atrial fibrillation, stroke or abnormal results on another test. Your cardiologist chooses the test that answers your question with the least burden and risk.
How they're done and recovery
An echo takes about 30 to 60 minutes and needs no preparation. For a TEE, you fast beforehand, receive sedation and a numbing throat spray, and need someone to drive you home. A nuclear stress test takes several hours, often with breaks; you may be asked to skip caffeine and certain medicines. A cardiac CT takes minutes on the scanner; some scans use contrast dye and a medicine to slow the heart rate.
Risks
Echo has no known risks. TEE carries small risks from sedation and, rarely, injury to the throat or esophagus. Nuclear and CT tests use radiation, and contrast dye can cause allergic reactions or kidney strain in some people. Your doctor weighs these against the value of the result.
Dr. Smith's experience
Dr. Smith is board certified in echocardiography (National Board of Echocardiography), nuclear cardiology (Certification Board of Nuclear Cardiology) and cardiac CT (Certification Board of Cardiovascular Computed Tomography), in addition to cardiovascular disease and interventional cardiology. He performs transesophageal, transthoracic and intracardiac echocardiography and reads nuclear perfusion imaging and cardiac CT. His published research on regadenoson nuclear stress imaging appeared in the Journal of Nuclear Cardiology.
Frequently asked questions
Do I need to fast before a TEE?
Yes. You will usually be asked not to eat or drink for several hours beforehand. Follow the instructions you receive from the office.
Can I drive after a TEE?
No. You receive sedation, so plan for someone to drive you home and avoid driving for the rest of the day.
What if I cannot walk on a treadmill for a stress test?
A medicine can stress the heart instead of exercise. This is common and works well for nuclear stress testing.
What is a coronary calcium score?
A quick, non-contrast CT scan that measures calcium in the heart arteries. A higher score suggests more plaque and can help guide prevention treatment.
How much radiation do nuclear and CT tests use?
Some, and the amount varies by test. Your doctor orders these tests when the expected benefit outweighs the small radiation risk.
Is an echocardiogram safe?
Yes. A standard echo uses ultrasound, not radiation, and has no known risks.
Ask about cardiac imaging at Cardiovascular Institute of the South
Dr. Smith sees patients at CIS Baton Rouge, 8401 Picardy Avenue · (225) 308-0247, and CIS Zachary, 6550 Main Street, Suite 1000 · (225) 654-1559. Your primary care doctor or cardiologist can also send a referral.