Contrast Echocardiogram (echo)

What is an echo?

This is an ultrasound scan of your heart (an examination using sound waves to make pictures of the inside of your body). This type of scan may be uncomfortable but should not hurt. This will be carried out by an echocardiographer (someone trained to perform ultrasound scans on the heart).

You will be asked to remove your clothing down to the waist and will be given a hospital gown with the opening to the front. You will be asked to lie on a couch on your left side.

Your heart will be monitored throughout the procedure by placing sticky pads on your chest. These are attached to leads linked to the echo ultrasound machine to record your heart rate and rhythm.

The echocardiographer (this can be a male or female) will put gel on your chest and will then roll the ultrasound probe over the area.  This will show a picture of your heart on the monitor of the ultrasound machine. This allows the cardiac team to assess (check) the condition of your heart.

Gel is needed for the scan as it lets the ultrasound probe move smoothly over your skin and helps give better pictures.  The gel may wet your clothes but will not stain them.  This will take about

30 minutes. 

If you wish you may bring a friend or relative as an impartial observer (a ‘chaperone’) to be present during your examination.  A chaperone does not have to be medically qualified but will ideally be:

• Sensitive, and respectful of your dignity and confidentiality.
• Prepared to reassure you if you show signs of distress or discomfort.

What is a contrast echo?

This is the same as a normal echo, but also needs an injection.  This will involve a cannula (a fine tube) being inserted into a vein in your arm or the back of your hand using a small fine needle. A consultant cardiologist (doctor who looks after your heart) will be present throughout the procedure.

There are 2 types of injection, you will be given either a:

• Contrast echo using ultrasound contrast medium (dye)

or

• Contrast bubble study using salt water.

Contrast echo using ultrasound contrast medium

This is carried out to help see your heart more clearly and assess the strength of the pumping function. This is used when normal echo images do not give enough information to show how strong your heart is pumping or to look for blood clots in your heart.  

It is often carried out in people who are taking Herceptin treatment. 

The contrast medium is injected into a vein and travels through the right side of the heart, through to the left side and leaves the body through the lungs. It does not stay in the body for more than a few minutes.

What are the risks and possible complications?

The risks and possible side effects can include:

• Reaction to the dye (contrast medium).  1 person in every 400 can suffer a mild reaction, for example, mild flushing or back pain.^1,2,3,4
• Anaphylactic reaction.  Less than 1 person in every 10,000 can suffer a serious reaction including death. ^1,2,3,4

You will be monitored during and after the procedure and staff are ready to deal with any reaction, if needed.

Please tell your doctor before the test if you have any allergies.

Contrast bubble study using salt water

This is carried out to help see if there is a tiny hole or problem at the back of your heart.

It is usually carried out in people who have suffered a stroke at a young age and the reason why the stroke happened was not found from other routine tests.

The salt water has been shaken between 2 syringes in order to create tiny bubbles and is injected into a vein. The scan will help to show the doctor if any bubbles cross from the right side of your heart to the left side. The tiny bubbles dissolve into your blood or leave the body through your lungs.

It is usually repeated 2 or 3 times and you may be asked to do the valsalva manoeuvre (hold your breath and blow the air into your cheeks) during one or more of these scan images.

What are the risks and possible complications?

The risks and possible side effects can include:

Reaction to the dye (contrast medium). 1 person in every 400 can suffer a mild reaction, for example, mild flushing or back pain.^1,2,3,4

Will I be in pain?

You may feel some discomfort while the needle is being inserted.

How long will the procedure take?

These scans take about 30 minutes to carry out. You can expect to be in the unit for about 1 hour. You will be able to go home after your scan and return to your normal activities.

Where will I need to go?

You will be given an appointment to attend the Cardiac Investigations Unit. This is normally carried out at the University Hospital of North Tees.

When will I be told the results of my scan?

Before you go home, your doctor will discuss what he or she found during the procedure and discuss any further treatment choices, if needed. A letter will be sent to you and your GP giving details of the results.

Contact numbers

If you have any worries or concerns please contact:

University Hospital of North Tees

Cardiac Investigation Unit
Telephone: 01642 624500
Monday – Friday, 9.00am – 5.00pm

Outside these hours you should contact your GP’s surgery for the Out of Hours Service number.

Further information is available from:

www.nhs.uk

NHS Echocardiogram patient information page Echocardiogram

NHS Choices

Telephone: 111 (when it is less urgent than 999)
Calls to this number are free from landlines and mobile phones
or via the website at www.nhs.uk

References

1. Goldberg YH, Ginelli P, Siegel R, Ostfeld RJ, Schaefer M, Spevack DM 2012 Administration of perflutren contrast agents during transthoracic echocardiography is not associated with a significant increase in acute mortality risk. Cardiology 122 119–125.
2. Wei K, Mulvagh SL, Carson L, Davidoff R, Gabriel R, Grimm RA, Wilson S, Fane L, Herzog CA, Zoghbi WA, et al.2008 The safety of deFinity and Optison for ultrasound image enhancement: a retrospective analysis of 78,383 administered contrast doses. Journal of the American Society of Echocardiography 21 1202–1206.
3. Platts DG, Luis SA, Roper D, Burstow D,Call T,Forshaw A, Pascoe R 2013 The safety profile of perflutren microsphere contrast echocardiography during rest and stress imaging: results from an Australian multicentre cohort. Heart, Lung and Circulation 22 996–1002.
4. Wever-Pinzon O, Suma V, Ahuja A, Romero J, Sareen N,Henry SA, De Benedetti Zunino M, Chaudhry FF, Suryadevara RS, Sherrid MV, et al. 2012 Safety of echocardiographic contrast in hospitalized patients with pulmonary hypertension: a multi-center study. European Heart Journal Cardiovascular Imaging 13 857–862.

Comments, concerns, compliments or complaints

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