Use of Echocardiography

Echocardiography creates an image of the heart using ultra-high-frequency sound waves, and is a similar technique to the ultrasound commonly used to visualize the fetus during pregnancy (3). It is one of the most commonly used diagnostic tests for heart disease. Occasionally, variations of the echocardiography test are used, such as Doppler echocardiography, which employs a special microphone that allows measurement of the direction and speed of blood flow through the blood vessels and heart valves. By assessing the speed of blood flow at different locations around an obstruction, it can help to precisely locate the obstruction. It can also detect and help evaluate regurgitation through the heart valves. Exercise echocardiograms, taken while the patient is exercising, allow doctors to detect heart problems that might not be evident when the body is at rest and needs less blood (3). For patients unable to exercise, drugs can be given which mimic the effects of exercise. Echocardiography is an extremely safe test because it is noninvasive and has no side effects.

Fetal cardiac abnormalities are usually not diagnosed by routine ultrasonography, but detailed fetal echocardiography is a costly procedure and is usually performed only in high risk cases (5). However, Stumpflen, Stumpflen, Wimmer and Bernaschek found that cardiac abnormalities could be detected in a high proportion

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cardiac defects and otherwise undiagnosable chromosomal abnormalities. In four cases, the diagnosis of an isolated cardiac malformation without any extracardiac abnormality by subsequent chromosomal analysis led to the detection of an abnormal karyotype. These cases would not have been diagnosed without detailed fetal heart echocardiography. Raymond, Simpson, Sharland and Ogilvie found that 25 percent of fetuses examined by echocardiography at 20 to 24 weeks of gestation had concomitant chromosomal abnormalities (4). The highest rate of abnormalities occurred in fetuses with atrioventricular septal defect. With such a high rate of chromosomal abnormalities in fetuses with cardiac abnormalities, fetal echocardiography becomes an important diagnostic tool for predicting these abnormalities. Borgida, Odibo, Egan, Esters and Campbell believe that fetal Echocardiography should be an important and routine test for determination of dextroposition, where a fetus= heart is on the right side of its chest since there are usually other abnormalities present when this occurs (1). When they examined 2882 echocardiograms done over a period of six years, they found 297 had abnormalities, and of these, 14 had dextroposition, more than hal
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