Imaging

Liv Hospital Heart Imaging Department offers services with cutting-edge equipment and a team of experts in the field of heart imaging.

•    ECG/Effort Test
•    Echocardiography (2D)
•    Transesofageal Echocardiography (via esophagus)
•    4-Dimensional Echocardiography
•    Stress Echocardiography (Medicated and exertion)
•    Carotid Doppler Examination
•    Early Diagnosis of Non-clinical Heart Contraction Disorders (Strain imaging)
•    Thallium Scintigraphy
•    Coronary CT Angiography adn Calcium Scoring



 

Echocardiography

Echocardiography is the examination of the structure and functions of the heart's cavities, valves and heart vessels using sound waves. Echocardiography devices used in this method, which is based on the principle of ultrasound, are highly advanced devices compared to regular ultrasound devices due to the fact that the heart is a very mobile organ. Imaging is performed from various areas of the chest wall using a device called transducer, which transmits sound waves. This allows the heart to be examined from different angles and its structure and functions are evaluated. Because it is an ultrasound method, it involves no risk for the patient, does not contain radiation and is a painless procedure. Application time varies from 15 minutes to 30 minutes depending on the disease.
 

Why is it performed?

Echocardiography is often used to assess heart structure and function in patients presenting with complaints such as chest pain, shortness of breath, palpitation, fainting, and heart murmurs that are detected during listening. Thus, it is possible to evaluate the size of heart cavities, the structure and functions of heart valves, and the contraction of the heart. Evaluation of valve functions in patients with prosthetic valves is very important in patients with coronary artery balloon or stents and in patients undergoing coronary bypass surgery to evaluate cardiac functions and cardiac wall movements. 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 large vessels emerging from the heart.     
        
 

Transesofageal Echocardıography (via esophagus) TEE

 In some cases where transthoracic echocardiography through the chest wall is insufficient, echocardiographic examination is performed through the esophagus to examine the heart more closely and in more detail. This examination is similar to gastric endoscopy. In our center, this procedure is performed by mildly anesthetizing the patient in order to ensure patient comfort, safety and a better examination. Thus, the patient has no discomfort associated with the procedure.

 

Why is it performed?

If chest x-ray imaging shows signs of clot, mass, or infection in the heart, TEE should be performed for a detailed examination. It should be used for a detailed examination of prosthetic valves, diagnosis of congenital heart holes and other heart disorders and when there's a suspicion of main artery (aorta) dilatation or tears. If the patient cannot be adequately imaged by transthoracic echocardiography due to obesity, lung disease or chest disorders, this method should be chosen again. This procedure is also used in cardiac surgery during valve repair and/or replacement, and in catheter valve replacement procedures to guide the practitioner and improve procedure success.
 
 

4-Dimensional Echocardiography

Today, echocardiography devices are generally two-dimensional systems. With recent advances in technology, 3-D and 4-D systems have been developed. It is not easy to image the heart, which is a highly mobile organ, with basic ultrasound systems. 3-dimensional echocardiography shows the heart in the same color and texture quality as the image of the heart seen by the surgeon's eye during the heart surgery. The purpose of this method is to provide a better image quality, to provide a better examination and can also reveal some structural defects that cannot be clearly determined by 2D echocardiography.
 
 

Why is it performed?

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

 

Stress Echocardiography

Stress echocardiography is a type of echocardiography performed using exercise methods or drugs that accelerate heart rate. Exercise echocardiography is performed on a treadmill or exercise bicycle. After the patient has been exercised within the appropriate protocols, the necessary heart images are taken by echocardiography and these images are compared with the images taken at rest. In cases where exercise ECG cannot be performed (leg vein disease, muscle bone structure restriction), medicated stress echocardiography is performed by increasing doses of drugs such as dobutamine, adenosine, dipridamol, which increase heart rhythm and contraction at certain intervals.
 
 

Why is it performed?

This is the alternative method that is preferred when it is difficult to evaluate heart diseases through other methods due to conditions such as permanent pacemakers, left branch obstruction or left ventricle thickening in ECG or other special findings (preexcitation). Stress echocardiography is most commonly used to determine the risk and severity of myocardial blood supply disorders after acute heart attacks and interventional procedures for coronary vessels, and to evaluate preoperative cardiac risk in patients undergoing surgery other than cardiac surgery.
 
 

Carotid Doppler Examination

Stroke is a disease that has common risk factors with heart attack, is life-threatening and as a result can disrupt the quality of life of the patient, and can progress with sequelae from speech impairment to motor motion loss. For this reason, it is of great importance to evaluate the carotid and vertebral arteries, the main arteries of the neck, which are responsible for the blood supply of the brain, while investigating patients' cardiovascular disease.
 
Carotid doppler is performed using a device based on ultrasonographic methods just like echocardiography. It is a simple imaging method with no side effects for the patient. There is no radiation risk. A number of findings in the neck vessels (such as increased vessel wall thickness or atheroma plaque or stenosis) can also be guiding in terms of cardiac vessels. Practically, atherosclerosis in coronary arteries that are much smaller than the carotid artery and that feed the heart is inevitable in a person with atherosclerosis in the carotid arteries.
 
 

Early Diagnosis of Non-Clinical Heart Contraction Disorders

Certain conditions, such as diseases, medications, past infections, radiation therapy, which may or may not be related to the heart, may cause contraction disorders by causing damage to the heart, even though the patient appears completely healthy and has no complaints. This often cannot be identified by 2D echocardiographic examinations used in daily practice. In order to diagnose non-clinical cardiac contraction disorders, detailed examination using high-tech devices and software programs is necessary. The echocardiography devices used in Liv Hospital have 4-dimensional imaging and strain imaging capabilities, and allow these analyzes to be performed.

 

For whom is it important?

Primarily, it is very important in the evaluation of patients who received chemotherapy treatment due to cancer. Unfortunately, many cancer drugs damage the heart cells while killing cancerous cells. For this reason, it is recommended to perform a detailed echocardiographic examination of the heart before cancer treatment and to repeat the heart tests in the recommended periods, in cooperation with oncology and cardiology departments. Diagnosing and treating the harmful effects on heart muscles in the early period is thus important to prevent permanent heart muscle damages and heart failures that may develop in the future. Another advantage of these examinations is that the patient receives the cancer drugs in the appropriate dose and duration without interruption, as a result of a detailed and meticulous heart follow-up. Radiotherapy is another method that can have adverse effects on the heart muscle. In addition, some rheumatic and neurological diseases, hypertension, diabetes and some lung diseases can also cause cardiac muscle contraction defects.