16948 Echocardiogram With Strain Imaging

Overview

An echocardiogram with strain imaging is a painless ultrasound scan of the heart. A small handheld probe sends sound waves into the chest and creates moving pictures. Strain imaging is a computer-based extra step that measures how well the heart muscle stretches and squeezes. It can show subtle changes that a standard scan might miss.

Echocardiograms are very common. Strain imaging is an add-on analysis that is being used more often, especially in heart muscle checks and in monitoring during or after some cancer treatments.

Anyone can be offered this test, from babies and children to older adults. It is done when a clinician needs a closer look at how the heart muscle is working.

Symptoms

Common symptoms

• The test itself does not cause symptoms.
• Breathlessness, especially with activity
• Unusual tiredness
• Swelling in the legs or ankles
• Palpitations (a feeling of a fast, fluttering, or pounding heartbeat)
• Dizziness or light-headedness
• Chest discomfort
• No symptoms at all — it may be done as a routine check

Symptoms in children

• Poor feeding or slow weight gain in babies
• Tiredness or sweating during feeding or play
• Fast breathing
• Blue or grey lips or skin — seek emergency help
• Fainting or dizzy spells

Symptoms in older adults

• Breathlessness on mild activity
• Swelling in the legs or ankles
• Low energy or tiredness
• Palpitations
• Dizziness or falls
• Chest discomfort

Causes

Main causes

• The test is not caused by anything. It is used to look into possible heart problems.
• To check the heart muscle in heart failure or cardiomyopathy (a disease of the heart muscle)
• To look for early heart muscle changes before symptoms appear
• To monitor the heart during or after some cancer treatments
• To assess valve disease, heart rhythm problems, or congenital heart disease (a heart problem present from birth)
• To check the heart after a heart attack or before some treatments

Risk factors

• High blood pressure
• Diabetes
• High cholesterol
• Family history of heart muscle disease or sudden cardiac death
• Previous heart attack or heart disease
• Some cancer treatments
• Heavy alcohol use
• Pregnancy-related heart problems
• Being very overweight

When to see a doctor

See a doctor urgently if:

• New or worsening shortness of breath
• Swelling in the legs or ankles that is getting worse
• A heartbeat that feels fast or irregular and does not settle
• Dizziness or feeling like you might faint
• Fever with breathlessness
• Chest discomfort that is mild but new

Book a routine appointment if:

• You have been referred for an echocardiogram
• You need follow-up for a known heart condition
• You are being monitored during or after certain treatments
• A family member has a heart muscle condition and you are advised to be checked

Diagnosis

This test is part of diagnosis, not a disease itself. Your clinician uses the pictures and strain numbers together with your symptoms, exam, and other tests to understand how your heart is working. The report is sent to the doctor who ordered it.

Tests that may be done

• Echocardiogram with strain imaging — the main test
• Standard echocardiogram — ultrasound pictures of heart chambers and valves
• Electrocardiogram (ECG) — a quick tracing of the heart's electrical rhythm
• Blood tests — to check for strain on the heart or other causes
• Heart rhythm monitor — worn for a day or more if palpitations are a problem
• Stress test — checks the heart during exercise or with medicine
• Cardiac MRI or CT scan — more detailed heart pictures in some cases

What to expect at your appointment

You will usually lie on a couch in a dim room. You may need to remove clothes from the waist up and wear a gown. Sticky patches may be placed on your chest for an ECG. The sonographer puts gel on a probe and moves it over your chest and sometimes under your breast or neck. You may be asked to hold your breath for short moments or lie on your left side. You may hear whooshing sounds; these are normal. The test does not hurt. It takes about 45 to 60 minutes. You can usually go home and eat normally afterwards. Results are not ready straight away; a specialist reviews the images and sends a report to your doctor.

Treatment

There is no treatment for the test itself. After the results, your clinician will explain what they mean and whether any action is needed. Treatment is based on the findings, your symptoms, and your overall health.

Self-care at home

• Usually no special preparation is needed. Eat and drink normally unless your clinic tells you otherwise.
• Wear a loose two-piece outfit so you can change comfortably.
• Bring a list of your medicines, allergies, and past heart tests.
• Arrive a little early and ask questions if you feel unsure.
• You can go back to normal activities right after the scan.

Medical treatments

If the test finds a heart problem, treatment may include lifestyle support, medicines chosen by your clinician to control blood pressure or fluid, devices, procedures, or a cardiac rehabilitation programme. Your care team will tailor any plan to you. This article does not recommend any specific medicine or dose.

When is surgery considered?

If the scan shows a valve problem, a blocked artery, or a heart structure issue, a procedure or surgery may be discussed. Most people do not need surgery just because they had this test. Your clinician will explain the benefits and risks.

Living with this condition

Most people go home and carry on with their day after the scan. The gel wipes off. You may have a small mark from sticky patches. Waiting for results can feel stressful; ask when to expect them and who will explain them.

Lifestyle tips

• Do not smoke, and avoid secondhand smoke.
• Stay active within the advice from your clinician.
• Eat vegetables, fruit, whole grains, beans, nuts, and fish; limit salt and highly processed foods.
• Limit alcohol.
• Try to sleep 7 to 9 hours a night.
• Manage stress with gentle activity, relaxation, or talking to someone.
• Take medicines exactly as prescribed.

Diet and exercise

A heart-healthy eating pattern is rich in vegetables, fruit, whole grains, beans, nuts, and fish, and low in salt and highly processed foods. Ask your clinician what exercise is safe. Start slowly if you have been unwell. Stop and get advice if you get chest pain, severe breathlessness, or dizziness.

Mental health and emotional wellbeing

It is normal to feel worried before or after a heart test. You may feel relieved, confused, or low. Talk to your clinician if worry is affecting sleep or daily life. If you feel in crisis or have thoughts of harming yourself, contact your local emergency number or a local crisis support service right away.

Prevention

You cannot prevent the need for this test, but you can lower the risk of some heart problems it looks for. Keep blood pressure, cholesterol, and blood sugar in a healthy range, avoid smoking, stay active, and attend routine checks.

Vaccines

Keep up to date with vaccinations your clinician recommends, such as flu and other routine vaccines.

Screening programmes

Routine checks for blood pressure, cholesterol, and diabetes are important. If you have a family history of heart muscle disease, ask your clinician whether relatives should be screened.

Complications

If left untreated

• Strain imaging itself has no known complications.
• If a heart muscle problem is found and not managed, it can lead to heart failure, rhythm problems, valve damage, or other heart complications.
• Some heart problems can raise the risk of stroke or sudden collapse if left untreated.

Long-term outlook

Strain imaging can pick up subtle changes early, when monitoring or treatment may work best. Many heart conditions can be watched and managed for years. Your care team will make a plan based on your results.

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