Imaging

Cardiac imaging is a medical examination method used to evaluate the structure and functions of the heart using various medical techniques. Echocardiography evaluates the movement of heart muscles and blood flow using sound waves. Magnetic resonance imaging (MRI) creates detailed images of the heart using strong magnetic fields and radio waves. Computerized tomography (CT) evaluates the coronary arteries and heart chambers by obtaining cross-sectional images with x-rays. These methods play an important role in diagnosing heart diseases, creating treatment plans and monitoring the course of the disease.

Liv Hospital Heart Imaging Department

Liv Hospital Heart Imaging Department provides services with the latest technological equipment and expert staff in the field of heart imaging.

• ECG/Exertion Test
• Echocardiography (2D)
• Transesophageal Echocardiography (Through the Esophagus)
• 4D Echocardiography
• Stress Echocardiography (Medicated and Stressed)
• Carotid Doppler Examination
• Early Diagnosis of Heart Contraction Disorders Not Reflected in the Clinic (Strain Imaging)
• Thallium Scintigraphy
• Coronary CT Angiography and Calcium Scoring

What is Echocardiography?

Echocardiography is the examination of the structure and functions of the heart’s cavities, valves and large vessels exiting the heart using sound waves. The echocardiography devices used in this method, which is basically based on the principle of ultrasound, are technologically highly advanced devices compared to ultrasound devices, since the heart is a mobile organ. Imaging is performed from various areas of the chest wall using a device called a transducer, which allows the transmission of sound waves. Thus, the heart is examined from different angles and its structure and functions are examined. Since it is an ultrasonographic method, it has no risks for the patient, does not involve radiation and is a painless procedure. Application time varies between 15 minutes and 30 minutes depending on the disease.

Why is Echocardiography Performed?

Echocardiography is often used to evaluate heart murmurs detected by listening during a cardiology examination, and to evaluate the structure and functions of the heart in patients presenting with complaints such as chest pain, shortness of breath, palpitations, and fainting. Thus, it is possible to evaluate the size of the heart chambers, the structure and functions of the heart valves, and the contraction of the heart. Evaluation of valve functions in patients with prosthetic valves is very important in examining heart functions and heart wall movements in patients with balloons or stents applied to their coronary arteries and in those who have undergone coronary bypass surgery. In patients with arrhythmia, echocardiography is performed to investigate the presence of clots in the heart, to diagnose congenital heart defects, and to diagnose heart tumors. It is also used to determine the amount and importance of fluids collected around the heart and to examine the diseases of the large vessels coming out of the heart.

What is Transesophageal Echocardiography?

In some cases where transthoracic echocardiography performed through the chest wall is insufficient, echocardiographic examination is performed through the esophagus to examine the heart more closely and in detail. This examination is similar to gastric endoscopy. In our center, this procedure is performed while the patient is lightly anesthetized for the sake of patient comfort, safety and a better examination. Thus, the patient does not feel any discomfort related to the procedure during the procedure.

Why is Transesophageal Echocardiography Performed?

If findings suggestive of clot, mass or infection within the heart are detected on chest wall imaging, TEE should be performed for detailed examination of these. Detailed examination of prosthetic valves should be used when diagnosing congenital heart holes and other heart defects and when dilation or rupture of the aorta, the main artery, is suspected. If the patient cannot be adequately imaged with transthoracic echocardiography due to obesity, lung disease or defects in the chest structure, this method should also be chosen. This procedure is also used to guide the practitioner and increase the success of the procedure during valve repair and/or replacement in cardiac surgery and valve replacement procedures performed via catheter.

What is 4D Echocardiography?

Echocardiography devices used today are generally two-dimensional systems. With the recent development of technology, 3D and 4D systems have been developed. It is not easy to image the heart, which is a highly mobile organ, with basic ultrasonographic systems. 3D echocardiographies show us the heart with a color and texture quality similar to the image seen by the surgeon when the rib cage is opened during heart surgery. The purpose of using this method is to provide a better image quality and a better examination, as well as to reveal some structural disorders that cannot be clearly revealed by 2D echocardiography.

Why is 4D Echocardiography Performed?

It provides more detailed information than 2D echocardiography, especially in the examination of intracardiac tumors, clots, holes and other structural disorders, and in the evaluation of natural and prosthetic valve diseases. It is important in making decisions about repairing natural but diseased valves during surgery or replacing them with a completely prosthetic valve. Again, 3D echocardiography is superior to 2D echocardiography in deciding whether to close the heart holes surgically or via catheter. Liv Hospital uses a 4D echocardiography device that can perform 3D examination live, during the procedure. With the 4-dimensional echocardiography device, heart imaging can be performed safely both through the chest wall and the esophagus.

What is Stress Echocardiography?

Stress echocardiography is an echocardiography application performed with exercise methods or drugs that increase heart rate. Exercise echocardiography is performed on a treadmill or on a bicycle. After the patient is exercised according to appropriate protocols, the necessary heart images are taken and recorded by echocardiography, and these images are compared with the images taken during rest. In cases where an exercise ECG test cannot be performed (leg vascular disease, muscle-bone structure limitation), medicated stress echocardiography is performed by using intravenous drugs such as dobutamine, adenosine, and dipyridamole in increasing doses at certain intervals to increase heart rhythm and contraction.

Why is Stress Echocardiography Performed?

Permanent pacemaker is a preferred alternative method when it is difficult to evaluate heart diseases with other methods due to the presence of left bundle branch block, left ventricular thickening and some special findings on the ECG (preexcitation). Stress echocardiography is most commonly applied to detect myocardial blood flow disorder and its severity, to determine risk after acute heart attacks and interventional procedures on coronary vessels, and to evaluate preoperative cardiac risk in patients who will undergo surgical intervention other than cardiac surgery.

How is Carotid Doppler Done?

Stroke is a life-threatening disease that has common risk factors with a heart attack and may impair the patient’s quality of life, with sequelae ranging from speech impairment to loss of motor movement. Therefore, when examining patients for cardiovascular disease, it is of great importance to evaluate the carotid and vertebral artery systems, which are the main arteries of the neck and responsible for the blood supply to the brain.

Carotid Doppler is performed with the help of a device based on ultrasonographic principles, just like echocardiography. It is a simple imaging examination that does not cause any harm to the patient. There is no risk of radiation. Some findings detected in the neck vessels (such as increased vessel wall thickness or atheroma plaque and stenosis…) may also be guiding in terms of cardiac vessels. Practically, it is inevitable that a person with atherosclerosis in the carotid vessels will have atherosclerosis in the coronary vessels, which are much smaller in diameter than the carotid artery and feed the heart.

Early Diagnosis of Heart Contraction Disorders

Some heart-related or non-heart-related diseases, medications, previous infections, radiation therapy, etc. can damage the heart and cause contraction disorders, even though the patient appears completely healthy and has no complaints. This situation cannot often be revealed by 2D echocardiographic examinations used in daily practice. For the diagnosis of heart contraction disorders that are not reflected in the clinic, detailed examination is required using high-tech devices and software programs. The echocardiography devices used at Liv Hospital have 4-dimensional imaging and strain imaging features and allow these analyzes to be performed.

For Whom Is It Important?

It is very important in the evaluation of patients who have received or will receive chemotherapy treatment due to cancer. Unfortunately, many cancer drugs, while killing cancer cells, also damage heart cells. For this reason, it is recommended to perform a detailed echocardiographic examination of the heart before cancer treatment and to repeat heart examinations within the recommended time periods in cooperation with oncology and cardiology.

Thus, early recognition and treatment of harmful effects on the heart muscle is important in preventing permanent heart muscle damage and heart failure that may develop in the future. Another advantage of these examinations is that, as a result of a detailed and meticulous follow-up in terms of the heart, it ensures that the patient takes the cancer medications at the required dose and duration without interrupting the treatment. Radiotherapy is another examination that may cause negative effects on the heart muscle. Apart from this, some rheumatic and neurological diseases, hypertension, diabetes and some lung diseases can also cause heart muscle contraction defects.