Из этой статьи вы узнаете: что такое ЭХОКГ сердца, и насколько этот метод важен в диагностике сердечной патологии. Какие параметры и структуры он позволяет оценить, какие заболевания выявить. Как подготовиться к исследованию, и как оно проходит.
Автор статьи: Нивеличук Тарас , заведующий отделением анестезиологии и интенсивной терапии, стаж работы 8 лет. Высшее образование по специальности "Лечебное дело".
Эхокардиография – один из самых информативных и безопасных методов диагностики патологии сердца. Это разновидность ультразвукового исследования, которая дает возможность визуально оценить структуру миокарда (сердечной мышцы), клапанов сердца, крупных сердечных сосудов и особенности кровообращения в них.
Существует несколько названий-синонимов: УЗИ или ЭХО сердца, ЭХО-КГ, эхокардиография или эхограмма сердца. Все эти названия – это одно и то же исследование. Его проведением и оценкой результатов могут заниматься врачи ультразвуковой диагностики, а также кардиологи и кардиохирурги, владеющие этим методом.
Суть метода, его польза
Эхокардиография сердца проводится при помощи специального ультразвукового оборудования, которое содержит:
- аппарат, издающий ультразвук;
- датчик который проводит через грудную клетку и регистрирует ультразвуковые волны;
- цифровой преобразователь, который показывает на мониторе изображение исследуемого органа.
Ультразвуковые волны, проходя через разные отделы сердца, по-разному поглощаются и отражаются ими. Чем точнее и современнее аппаратура, тем точнее можно увидеть (визуализировать) не только общую структуру, но и мелкие детали строения сердца и особенности кровообращения.
ЭХО-КГ наряду с ЭКГ (электрокардиографией) – самые простые, безвредные и доступные, но в то же время информативные методы диагностики, дающие исчерпывающую информацию о состоянии сердца.
Показания: кто нуждается в такой диагностике
УЗИ сердца показано всем больным с сердечной патологией, а также людям, имеющим такие симптомы:
- Боли в грудной клетке.
- Одышка при нагрузках, отеки на ногах и другие проявления сердечной недостаточности.
- Быстрая утомляемость, сопровождающаяся обмороками и усиленным сердцебиением.
- Перенесенный инфаркт миокарда и тромбоэмболия легочной артерии.
- Шумы при выслушивании (аускультации) сердца.
- Подозрения на врожденные и приобретенные сердечные пороки.
- Перенесенный ревматизм.
- Синюшность кожи в области лица, кончика носа и ушей, которая появляется либо усиливается при нагрузках.
- Выраженное повышение артериального давления.
Учитывая легкость выполнения и безопасность эхокардиографии, ее делают не только для того, чтобы следить, как протекает имеющаяся у человека сердечная патология, но даже при наличии подозрений на нее. Абсолютных противопоказаний нет.
Что показывает данная процедура, какие болезни выявляет
Диагностика сердца при помощи ультразвука может дать основную, но не всю информацию о состоянии этого органа.
| Что может определить эхокардиография | Что не может определить |
|---|---|
| Строение и функциональные способности предсердий, желудочков и клапанов | Характер ритма и электрической активности |
| Особенности кровообращения между ними | Состояние коронарных сосудов |
| Кровоснабжение миокарда |
В таблице описаны основные параметры для оценки при эхокардиографии и возможная патология, которая диагностируется на основании этих данных даже без учета результатов ЭКГ (электрокардиограммы).
| Что можно оценить | Частые отклонения от нормы | Заболевания, которые можно диагностировать |
|---|---|---|
| Размеры сердца | Увеличены | Кардиомиопатия, кардиомегалия, гипертрофия левого желудочка, миокардит, кардиосклероз |
| Характеристики миокарда | Утолщен | |
| Уплотнен, неоднородный | ||
| Истончен | Дилатационная кардиомиопатия, сердечная недостаточность | |
| Объем желудочков и предсердий | Увеличен | |
| Уменьшен | Рестриктивная кардиомиопатия | |
| Состояние клапанов (аорты, митрального) | Утолщенные | Эндокардит |
| Не смыкаются | Пороки – недостаточность клапана | |
| Не размыкаются | Пороки – стеноз клапанов, митральный пролапс | |
| Размер и стенка аорты | Увеличена, расширена | Аневризма аорты и сердца |
| Плотная | Атеросклероз | |
| Характеристики легочной артерии | Расширена, давление повышено | Признаки легочной гипертензии (тромбоэмболия, пневмофиброз) |
| Объем выброса | Уменьшен | Сердечная недостаточность, кардиомиопатия, пороки |
| Остаточный объем | Увеличен | |
| Полость перикарда | Перикард утолщен | Перикардит (воспаление), гидроперикард (выпот) |
| Наличие жидкости | ||
| Движение крови между предсердиями, желудочками и сосудами | Регургитация (обратный заброс крови) на клапанах | Пороки – недостаточность митрального и клапана аорты |
| Сброс между аортой и легочной артерией | Врожденный порок – открытый Боталлов проток | |
| Сброс в области овального окна | Открытое овальное окно, дефект межпредсердной перегородки | |
| Сброс между желудочками | Дефект межжелудочковой перегородки | |
| Дополнительные образования | Узлы, утолщения, тяжи, дополнительные тени | Опухоли, дополнительная хорда, аневризма левого желудочка, тромбы в просвете сердца и крупных сосудов |
Примерные нормы размеров структур сердца для расшифровки результатов УЗИ
По данным, полученным в ходе ЭХО сердца, некоторые диагнозы можно установить точно, а некоторые предположить. Во втором случае больные нуждаются в более расширенном обследовании в зависимости от предполагаемой патологии (ЭКГ, холтер, томография, анализы крови).
Разновидности эхокардиографии
Не всякая эхокардиография обладает всеми диагностическими возможностями ультразвуковой диагностики. В зависимости от класса ультразвукового оборудования и процедуры исследования существуют:
- Стандартная ЭХО-КГ – одномерное, двухмерное и трехмерное УЗИ. Его еще называют трансторакальным, так проводится через контакт с кожей в области грудной клетки. Дает информацию о строении сердца, но не может определить особенности кровообращения в нем.
- – исследование расширенное по сравнению со стандартным. Определяет характеристики кровотока в предсердиях, желудочках, клапанах и крупных сосудах.
- Стресс-эхокардиография – УЗИ сердца в ходе выполнения нагрузочных проб. Может потребоваться для диагностики лишь некоторых заболеваний (например, пороки клапанов).
- Чреспищеводное ЭХО – осмотр сердца специальным датчиком через стенку пищевода в ходе фиброгастроскопии. Требуется редко, но может дать важную информацию о патологии в глубоких отделах миокарда.
Золотой стандарт ультразвукового исследования сердца – двухмерное ЭХО с допплеровским и дуплексным усилением.
Подготовка и проведение исследования
Специальной подготовки к стандартной и допплеровской эхокардиографии сердца, как и к ЭКГ, не требуется. Это значит, что такое исследование может сделать любой человек, у которого есть показания в любое время без каких-либо ограничений. Единственные факторы, влияющие на достоверность результатов, – качество оборудования и квалификация специалиста-кардиолога.
Чреспищеводная ЭХО-КГ выполняется только натощак (последний прием пищи – за 8–10 часов). А когда требуется, чтобы больной находился в неподвижном положении с целью детального осмотра – исследование проводится под наркозом.
Процедура стандартной ЭХО-КГ технически простая и безвредная:
- Исследуемый ложится на кушетку. Обследование проводится в двух положениях: на спине и на левом боку.
- Врач настраивает аппарат и последовательно устанавливает датчик в нескольких точках грудной клетки в проекции сердца, аорты и легочной артерии. В это время исследуемый должен спокойно лежать и выполнять все команды врача (дышать плавно, задерживать дыхание на вдохе, изменять положение и т. д.).
- Для улучшения передачи ультразвуковых сигналов на кожу левой половины грудной клетки наносится специальный гель, по которому будет скользить датчик. По окончании исследования гель нужно вытереть полотенцем или салфеткой.
Общая продолжительность эхокардиографии – от 7–10 минут до получаса. Самое главное, что проводить ее можно столько раз, сколько требуется для оценки состояния сердца и динамики течения патологического процесса. Методика безвредная и безболезненная, поэтому абсолютных противопоказаний к ней не существует.
УЗИ сердца – высокоточный метод диагностики большого количества, но не всех сердечных заболеваний. Поэтому показания для ее выполнения и объем других обследований должен решать специалист!
Эхокардиогра́фия (греч. ἠχώ — отголосок, эхо + καρδία — сердце + γράφω — писать, изображать) — метод УЗИ, направленный на исследование морфологических и функциональных изменений сердца и его клапанного аппарата. Основан на улавливании отражённых от структур сердца ультразвуковых сигналов. [1]
Содержание
История [ править | править код ]
С момента появления технических возможностей для производства ультразвуковых аппаратов они стали использоваться в медицинской визуализации, в том числе и для визуализации сердца и его клапанного аппарата. Так возникло отдельное направление ультразвуковой диагностики — эхокардиография.
Принцип действия [ править | править код ]
Принцип действия метода основан на способности ультразвука отражаться при взаимодействии со средами разной акустической плотности. Отражённый сигнал регистрируется, и из него формируется изображение.
Возможности [ править | править код ]
Данный метод позволяет установить состояние мягких тканей, определить толщину стенок сердца, состояние клапанного аппарата, объём полостей сердца, сократительную активность миокарда, увидеть работу сердца в режиме реального времени, проследить скорость и особенности движения крови в предсердиях и желудочках сердца.
Материалы и методы [ править | править код ]
Для проведения манипуляции нужен ультразвуковой аппарат. Он состоит из 3 основных блоков:
- Излучатель и приёмник ультразвука
- Блок интерпретации сигнала
- Средства ввода-вывода информации
Показания [ править | править код ]
Эхокардиография (ЭхоКГ) показана при ишемической болезни сердца, болях неизвестной природы в области сердца, врождённых или приобретённых пороках сердца. Поводом для его проведения может быть и изменение электрокардиограммы, шумы в сердце, нарушение его ритма, гипертоническая болезнь, наличие признаков сердечной недостаточности.
Особенно важно проводить эхокардиографию с диагностической целью в детском возрасте, так как в процессе интенсивного роста и развития у ребёнка могут возникать различные жалобы.
- людям с жалобами на одышку
- головокружение
- слабость
- случаи потери сознания
- чувство учащённого сердцебиения или «перебоев» в работе сердца, боли в области сердца и др.
- шумов в сердце
Противопоказания [ править | править код ]
Абсолютных противопоказаний к проведению ЭхоКГ не существует. Проведение исследования может быть затруднено у следующих категорий пациентов:
- Хронические курильщики, лица, страдающие бронхиальной астмой / хроническим бронхитом и некоторым другими заболеваниями дыхательной системы
- Женщины со значительным размером молочных желез и мужчины с выраженным оволосением передней грудной стенки
- Лица со значительными деформациями грудной клетки (реберный горб и т.д.)
- Лица с воспалительными заболеваниями кожи передней грудной клетки
- Лица, страдающие психическими заболеваниями, повышенным рвотным рефлексом и/или заболеваниями пищевода (только для проведения чрезпищеводной ЭхоКГ)
Время проведения: 45 минут.
Введение контраста: не выполняется .
Подготовка к обследованию: не требуется.
Наличие противопоказаний: нет.
Ограничения: воспалительные заболевания кожи грудной клетки.
Стоимость исследования: 3 400
УЗИ сердца / Эхокардиография (ЭХОКГ) – это ультразвуковое исследование сердца. Неинвазивная, то есть не повреждающая ткани и органы методика, позволяет выявить широкий спектр изменений в работе сердца, которые не проявляются в виде болезненных ощущений и не обнаруживаются во время ЭКГ.
Основная цель ультразвуковой диагностики – это оценка работы сердца. С помощью Эхо-КГ определяют объем, размер полостей органа, толщину его стенок, выявляют структурные изменения клапанов и других частей сердца.
Зачем проводят Эхо-КГ
Основные цели обследования – это всегда оценка механической работы сердца и его морфологических характеристик.
С помощью ЭХО сердца стало возможным:
- получать информацию о размерах сердца, объемах его полостей;
- определять состояние оболочек органа (перикарда);
- фиксировать сведения о толщине стенок сердца;
- обнаруживать рубцовые изменения в миокарда;
- исследовать сократительную функцию миокарда, то есть способность к сокращению мышцы желудочков;
- анализировать работу и состояние клапанов органа;
- оценивать внутрисердечный кровоток, определять наличие патологического кровотока, измерять кровяное давление в сердечных камерах;
- оценивать состояние самых крупных сосудов органа.
С помощью проведения ЭхоКГ врачи выявляют целый комплекс заболеваний сердца и патологических состояний, среди которых:
- ишемическая болезнь;
- перикардит миокарда, то есть воспалительный процесс;
- аневризмы любой степени;
- гипертрофия и дилатация сердечных камер;
- поражение сосудов органа;
- поражение клапанов сердца;
- наличие внутрисердечных тромбов, опухолей сердца;
- выявление уровня давления в легочной артерии.
На сегодняшний день Эхо-КГ (УЗИ сердца) – это единственная методика информативной и точной диагностики приобретенных или врожденных пороков сердца.
Обследование используется не только при диагностике функциональных нарушений органа. Также оно незаменимо и в профилактической кардиологии. С помощью данной процедуры можно выявить даже малейшие отклонения в функционировании сердца, предупредить широкий спектр патологий и предотвратить их дальнейшее развитие.
С помощью данной процедуры можно выявить даже малейшие отклонения в функционировании сердца, предупредить широкий спектр патологий и предотвратить их дальнейшее развитие.
Преимущества УЗИ сердца (ЭхоКГ сердца) в «СМ-Клиника»
УЗИ сердца в Москве в «СМ-Клиника» проводится с помощью новейших цифровых аппаратов – эхокардиографов экспертного уровня от известных производителей оборудования для медицины. Современные аппараты позволяют выполнять обследование с высокой скоростью и получать безупречное качество обработки данных. Именно поэтому исследование обеспечивает получение высокоточных результатов. ЭхоКГ в «СМ-Клиника» проводят врачи-диагносты высшей квалификационной категории, которые прошли обучение ультразвуковой диагностике в кардиологической области и имеют сертификаты, подтверждающие данную специализацию. Наши специалисты обладают большим практическим опытом в проведении функциональных обследований.
Особенности проведения ультразвукового исследования сердца в «СМ-Клиника»:
- эхокардиографические аппараты, которые используются для исследования, позволяют получать изображение в четырех взаимоперпендикулярных плоскостях, что гарантирует максимальную точность диагностики;
- с помощью допплер-эхокардиографии определяется скорость, направление кровотока в сердечных клапанах, отслеживается динамика изменений данных параметров;
- исследование абсолютно безопасно для пациента, никакого воздействия на организм не осуществляется;
- Эхо сердца имеет цену, доступную для большинства пациентов клиники.
Показания к ЭхоКГ
ЭхоКГ – это обязательное ежегодное исследование для людей, у которых установлен диагноз «порок сердца» или есть подозрения на него, а также другие патологии сердечно-сосудистой системы. Эхо-КГ сердца также назначают людям, которые профессионально занимаются спортом, и пациентам, имеющим постоянные физические нагрузки.
ЭхоКГ обязательно проводится после хирургических вмешательств на сердце или, при необходимости, в период подготовки к операции.
Кроме того, пройти обследование рекомендуется при наличии следующих симптомов:
- одышка;
- общая слабость;
- внезапные боли, дрожь в груди;
- отечность щиколоток;
- частая тошнота и рвотные позывы.
К обязательным показаниям для проведения ЭхоКГ относятся следующие:
- подозрения на расширение грудной аорты (аневризму);
- подозрения на наличие новообразований в области сердца;
- высокое артериальное давление;
- перенесенный инфаркт миокарда;
- любые изменения, которые были выявлены при проведении ЭКГ.
Противопоказания к эхокардиографии
Абсолютных противопоказаний для проведения УЗИ сердца нет. За три часа до процедуры рекомендуется ограничить себя в приеме пищи. Иначе из-за высокого расположения диафрагмы полученная информация может исказиться.
Проходить диагностику не рекомендуется пациентам с деформациями грудной клетки, воспалительными заболеваниями кожного покрова в области грудного отдела. Эти патологии также негативно сказываются на точности результатов обследования.
ЭКГ и ЭхоКГ: в чем различия
Существует четыре основных различия между процедурами:
ЭхоКГ выполняется с помощью преобразователя, который прикладывается в области сердца к груди пациента. Преобразователь ловит ультразвуковые волны, которые проходят через стенки сердца, а затем отражает их и получает возвращенные сигналы. Их обрабатывает компьютер. ЭКГ выполняется по другому принципу: пациенту на грудь крепят специальные датчики. Они измеряют активность сердца. Датчики (электроды) подключают к специальному аппарату, который выводит график, указывающий характер и силу полученных электрических сигналов.
С помощью ультразвукового исследования сердца определяется, насколько хорошо орган качает кровь. С помощью такой диагностики также можно выявить нарушения данной функции, которые указывают на сердечную недостаточность. Электрокардиография, в свою очередь, только измеряет уровень сигнала и проверяет, посылает ли сердце устойчивые импульсы.
Результат ЭКГ представлен на графике, а ЭхоКГ – в виде фотографий.
Электрокардиограмма позволяет выявить аритмию, тахикардию, нарушенный ритм сердца, брадикардию. ЭхоКГ оценивает состояние функции сердца после приступов, сердечных клапанов, возможную локализацию тромбов и прочие нарушения в работе органа.
Виды ЭхоКГ
Практически всегда исследование проводят через грудную клетку. Этот метод называется трансторакальным. Трансторакальная эхокардиография, в свою очередь, делится на двухмерную и одномерную.
При одномерной диагностике сведения выводятся в виде графика на монитор компьютера. С помощью такого исследования можно получить информацию о размерах предсердия, желудочков, оценить их работоспособность.
При двухмерном обследовании информация предоставляется в виде изображения органа. Двухмерное ЭхоКГ дает возможность получить точную картину работы сердца, определить его размер, толщину стенок, объем камер.
Также существует допплер-эхокардиография – исследование, с помощью которого проверяют, насколько хорошо происходит кровоснабжение органа. Например, при процедуре врач наблюдает за движением крови в сосудах и отделах сердца. В норме кровоток должен двигаться в одном направлении, но при нарушении работы клапанов можно наблюдать обратное течение крови.
Допплеровское исследование обычно назначают в комплексе с одномерным или двухмерным ультразвуковым обследованием.
Подготовка к обследованию
Как проходит ЭхоКГ
Перед проведением процедуры пациент раздевается до пояса. После этого врач-диагност наносит на область грудной клетки специальный акустический гель и располагает обследуемого на кушетке в позе полулежа на левом боку. Далее специалист устанавливает датчики эхокардиографа в нескольких позициях. Данное положение наиболее удобно для пациента. Кроме того, оно необходимо для проведения точной диагностики, так как сердце, которое находится у переднебоковой грудной стенки, именно в этом месте менее всего прикрыто легочной тканью.
Когда человек лежит на левом боку, происходит расширение акустического окна, поэтому ультразвуковые датчики улавливают любые колебания и шумы структур органа. Эхокардиограф выполняет свою работу на протяжении 15 минут. Он обрабатывает, синхронизирует данные, полученные с датчиков через электрокардиографический канал. В это время пациент может расслабиться, так как процедура безболезненна и не доставляет дискомфорта.
Результаты диагностической процедуры
После завершения манипуляции врач-диагност «СМ-Клиника» анализирует полученные результаты. Он определяет толщину сердечных перегородок, размер и состояние сердца, его топографическое положение в рамках анатомического строения. Также специалист оценивает работу сердечных клапанов и прочих функциональных структур, состояние мягких тканей. На основании полученных результатов врач обозначит возможные патологии.
После ультразвукового исследования сердца в «СМ-Клиника» пациент получает:
- эхокардиограмму – визуализацию мягких рентгенонегативных тканей на фотобумаге или ультразвуковое изображение сердца;
- заключение врача-диагноста.
Также в протоколе ЭхоКГ обязательно обозначают нормы для людей, которые соответствуют определенной половозрастной группе. При написании заключения эти нормы берут в расчет и соотносят с полученными результатами.
Диагностику в «СМ-Клиника» проводят квалифицированные специалисты с внушительным опытом практической работы. Наличие современного оборудования, а также высокая квалификация врачей-диагностов гарантируют получение максимально точных результатов обследования.
Сделать ЭХО сердца в Москве недорого можно у нас – в «СМ-Клиника». Мы выполняем исследования по оптимальной цене и быстро выдаем результаты диагностики пациентам.
Узнать все интересующие вас подробности, уточнить стоимость УЗИ сердца и другие сведения, а также записаться на обследование можно у операторов Контакт-центра «СМ-Клиника».
Цены на УЗИ сердца / Эхокардиография (ЭХОКГ) в «СМ-Клиника»
| Наименование услуги | Цена (руб.)* |
| Эхокардиография (УЗИ сердца) | 3 400 |
* Администрация клиники принимает все меры по своевременному обновлению размещенного на сайте прайс-листа, однако во избежание возможных недоразумений, советуем уточнять стоимость услуг в регистратуре или в контакт-центре по телефону +7 (495) 777-48-49.
Размещенный прайс не является офертой. Медицинские услуги оказываются на основании договора.
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