Frequently Asked Questions:

WHAT IS AN ECHOCARDIOGRAM?
An echocardiogram, also called echo is a test that uses ultrasound to create images of the heart. It is a safe and painless test that helps doctors to diagnose many kinds of heart problems.

How does an Echo work?
During an echo test, a small microphone-like device called a transducer is held against the chest. The transducer sends ultrasound waves that bounce off the various parts of the heart. These reflected sound waves are sent to a computer, which turns the echoes into a moving image of the heart.

Why is an Echo done?
The echo test gives doctors useful information about the heart, such as:
• The size of the heart chambers and the thickness of the walls. This information can help identify certain types of heart conditions. For example, in patients with heart failure, the heart’s main pumping chamber tends to enlarge. In patients with long-standing hypertension, the chamber’s walls often thicken and stiffen.
• The heart’s pumping strength. In patients with cardiomyopathy (a type of heart muscle disease), the heart’s ability to pump is often decreased. In patients who have had a heart attack, damaged areas of the heart muscle do not pump as well as healthy areas.
• Valve function. The echo shows the shape and motion of the heart valves. It can help determine if a valve is normal, thickened, or torn. Doppler echo can show if the valve is narrowed or leaking and assess how severe the problem is.
• Other heart conditions. The echo may also be used to detect fluid around the heart, blood clots, or tumors inside the heart, and abnormal holes between chambers. In some cases, the echo is combined with an exercise test to see how well the heart pumps when made to work harder.

How safe is an Echo?
The echo test is very safe. There are no known risks from the ultrasound waves. The test is also painless.

HOW DOES HIGH BLOOD PRESSURE AFFECT YOUR HEART?
Blood pressure is the force of blood pushing against the artery walls as it moves through the body. When blood pressure is too high, the extra pressure on artery walls damages the delicate artery lining and increases your risk of developing cardiovascular disease. You can control high blood pressure by losing weight (if you need to) and eating less sodium (2000 – 2400 mg per day), exercising regularly and learning to manage stress. In addition to lifestyle changes, your doctor may prescribe medication to help lower your blood pressure. Taking medication is not a substitute for making lifestyle changes. Blood Pressure medications work best when combined with a low-sodium diet, exercise and weight loss. If medication has been prescribed for you, always take the exact amount prescribed every day.

WHAT IS CARDIOVASCULAR DISEASE?
Health arteries are smooth and elastic, allowing blood to flow easily through them to all parts of the body. Cardiovascular disease occurs when the normally smooth arteries are damaged and blood flow is restricted. Smoking, high blood pressure, high cholesterol and other factors can damage the delicate lining inside the arteries. It is easier for fats in the blood to stick to the rough, damaged artery walls. Fatty deposits called plaque narrow the arteries and make it harder for blood to get through. Buildup of plaque in the arteries is called atherosclerosis. Coronary arteries carry blood to the heart. Atherosclerosis in these arteries is called coronary artery disease.

WHAT ARE RISK FACTORS?
A risk factor is something that increases a person’s chance of developing cardiovascular disease. There are some risks that you can’t do much about. For example, if a family member developed cardiovascular disease at an early age (before the age of 60), your risk increases. Your age is also a factor. The risk of developing cardiovascular disease increases for men after the age of 45 and for women after the age of 55.
Risk factors you can control:
• Use of tobacco
• High blood pressure
• High blood cholesterol
• Lack of exercise
• Stress
• Diabetes


HOW DOES USING TOBACCO AFFECT YOUR HEART?
The chemicals in tobacco raise blood pressure and make the heart work harder. All forms of tobacco can damage the arteries. Fatty deposits are more likely to stick to the damaged artery walls. Smoking is the worst thing you can do to your heart. Find a way to quit. If you have trouble quitting, ask your doctor for help or join a “stop-smoking” program.

WHAT IS CARDIAC CATHETERIZATION?
 In this test, a thin tube called a catheter is inserted into a blood vessel and guided to the heart.  A special dye (which is visible by x-ray) is injected through the catheter.  The x-rays show where any problems may be.  Your doctor will then decide what, if any, treatment you may need.
 
Cardiac catheterization can show:
• how well the heart is pumping
• if any of the coronary arteries are blocked
• if the heart valves are working properly
• if you were born with a heart defect
• if the heart has been damaged by disease
 
The test is performed with you awake.  You will be given medication to help you relax.  After the test is completed, you will be asked to remain lying in bed for a few hours before you are discharged to home.  Many people can return to their usual activities in 1 or 2 days.  Talk to your doctor if you have any questions.

WHAT IS VALVULAR HEART DISEASE?
 
There are four valves in the ehart: pulmonary, tricuspid, aortic and mitral. The four valves act like one-way doors that keep blood moving forward.  When your heart beats, valves open to let blood through.  After each beat, valves close to keep blood from flowing backward.  Problems can occur if a heart valve doesn't open or shut all the way.  If a valve doesn't open or shut completely, blood can build up or flow backward.  The heart must then work harder to pump out the extra blood.  The sound of the blood flowing throug an abnormal valve is callled a heart "murmur."  It can be heard through a stethoscope.
 
Valvular heart disease can be diagnosed with an Echocardiogram or cardiac catheterization. If the valve is significantly damaged, surgery may be required to repair or replace it.

My doctor has prescribed Coumadin for me.  What should I know about this medication?
 
Anticoagulation therapy helps to prevent serious medical problems, such as stroke, heart attack, or problems in the legs or lungs. Your doctor wants to maintain the ideal thickness of your blood.  To do this, he or she will routinely test your blood to identify your prothrombin time(PT), reported as an International Normalized Ratio(INR).  This tells your doctor how quickly your blood clots, and how much Coumadin you should take.  There are certain factors which can affect your bleeding time.  The three most important factors to consider are Vitamin K, alcohol, and any other medications or supplements you take.
 
VITAMIN K
  Produced by your body as part of the clotting process, Vitamin K is also found in many fllods.  Your doctor will base your recommended Coumadin dose on your regular diet, so the key to maintaining an effective dosage level is to consistently follow your normal eating habits.
 
Common foods high in Vitamin K:
Collard greens, Mustard greens, Turnip greens, Broccoli, Chick peas, Brussels sprouts, Scallions, Cabbage, Lettuce, endive, kale, watercress
Salad oils, canola oil, soybean oil, olive oil, Soy protein, Mayonnaise, Spinach
 
ALCOHOL
 
Even if you drink in moderation and only occasionally, alcohol can increase your PT/INR.  Because of these risks, your docotr will likely recommend that you avoid drinking any alcohol while you are taking Coumadin.
 
DRUGS AND SUPPLEMENTS
 
Because Coumadin can interact with many drugs and supplements, tell your doctor if you regularly consume any supplemts or drugs, whether prescription or over the counter.