Stroke Prevention
The Silent Warning Signs of Stroke — and How a 45-Minute Scan Can Detect Them
Most people have heard of an echocardiogram but have never had one — and have little idea what the test actually reveals. Here's everything you need to know in plain language, without the medical jargon.
An echocardiogram is one of the most information-rich tests in cardiovascular medicine. In 30 to 45 minutes, it produces a real-time moving picture of your heart: valves opening and closing, chambers filling and emptying, walls contracting with every beat. Yet most people who have had one received their results without a clear explanation of what was actually being measured. This guide changes that.
An echocardiogram uses high-frequency sound waves to create detailed images of the heart. Because sound reflects differently off moving tissue, blood, and structural boundaries, the machine calculates dimensions, velocities, and pressure gradients without any radiation, contrast agents, or invasive procedures.
The sonographer acquires images from multiple windows on the chest wall where the ultrasound beam has a clear path to the heart. The parasternal long-axis view shows the left ventricle and mitral valve together. The apical four-chamber view shows all four chambers simultaneously. Together, these create a comprehensive structural and functional portrait.
Ejection fraction (EF) measures what percentage of blood the left ventricle pumps out with each beat. A normal EF is 55 to 70 percent, according to the American Heart Association.[1] When it falls below 40 percent, the heart is pumping less than half of what it contains. This is called reduced ejection fraction heart failure, or HFrEF. Values between 40 and 55 percent represent a borderline zone that warrants close monitoring.
A normal EF does not mean the heart is perfectly healthy. Heart failure with preserved ejection fraction (HFpEF) occurs when the EF is normal but the heart stiffens and cannot relax properly.[2] This is common in older women and requires findings beyond EF alone to diagnose.
The heart has four valves: mitral, aortic, tricuspid, and pulmonic. The echo evaluates all of them. Two primary problems are detected. Stenosis is narrowing that restricts flow. Regurgitation is leaking where blood flows backward. Both can be mild and monitored over years, or severe enough to require surgical repair or replacement.
Aortic stenosis is particularly common in older adults. The aortic valve gradually calcifies and stiffens over decades. An echocardiogram calculates the pressure gradient across the valve to determine severity and guide the timing of intervention before the heart muscle is irreversibly damaged from compensating.[3]
Each segment of the heart wall should contract with uniform strength during every beat. When a segment moves poorly or not at all, it is called a wall motion abnormality. This suggests that region of muscle is not receiving adequate blood flow. It can indicate a prior heart attack, even one the patient did not know they had, or active ischemia from coronary artery disease.
A wall motion abnormality is one of the most clinically significant findings an echo can produce and frequently changes the patient management plan immediately. Finding one does not require the patient to have had symptoms. Many are discovered incidentally during routine screening.
BlackPoint performs echocardiograms at your home using hospital-grade phased-array transducers. Every study is interpreted by Dr. Glenn Gandelman MD FACC and the written report is delivered within 24 to 48 hours. $397, no referral required.
Book your screening or reach out with any questions about your cardiovascular health.
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