Looking inside your heart

20 June 2017

Interview with

Clare Ward-Jones, Phillips Healthcare

One of the tools available to doctors to see the heart in action is the echocardiogram. This uses ultrasound waves to image the heart as it beats, so the cardiologist can tell whether it’s contracting correctly and that the heart muscle is a healthy shape. Tom Crawford volunteered to be a guinea pig…

Clare - I’m Clare Ward-Jones; I work for Phillips Healthcare and my role is a cardiac ultrasound applications specialist. That means I come into hospitals and train people to use our products. We’ve got a machine the ETHIC and that is the supreme ultrasound machine for cardiology. We can do a 2D scan on you, we can also do 3D images so we can get a 3D model of the heart.

Tom - From my point of view, looking at the machine, it kind of looks like I’m going to go in for a baby scan. So is it the same kind of thing?

Clare - Correct. They’re the same machine with just a different software and a different transducer that we’d use on the machine, but they look identical.

Tom - When you say transducer - is that the bit that you’re rubbing around on me?

Clare - Yeah. The echo probe or the transducer is the bit we put the jelly on we’ll put on your chest.

Tom - What sort of signal is it that’s sent out from this probe?

Clare - They’re ultrasound beams. The ultrasound beams are sent out from the transducer and they will bounce back when they hit structures in the body. So depending on the structures they hit, they come back at different times and that’s what makes up the image on the screen when they’re received back in the transducer.

Tom - Fantastic - Shall we get cracking?

Clare - Yeah. What we need to do first of all is you need to get onto couch and you need to lie on your left side. What that does is it brings your heart closer to the front of your chest wall so there’s less distance for the ultrasound to travel so it should produce a better image on the screen.

Tom - It’s quite comfy actually.

Clare - I’m going to put three stickers on you now to monitor your heart rate while we do the scan.

Tom - Okay. These are like circular plaster with little metal clips on?

Clare - Yes. We call them electrodes.

Tom - These wires you’re clipping to me, they’re going to monitor the electric signal of my heartbeat?

Clare - Yep. You can see this line here - this is your heart rate going along the screen. It give us a number - 87 beats a minute, and each time you see this complex, that’s every time the heart beats you'll see one of those.

Tom - Is 86 normal?

Clare - Normal sinus rhythm is between 60 and 100. Something within that range is what we’d expect.

Tom - Awesome. Good to know.

Clare - This is the ultrasound probe which I’m going to put on your chest. It’s not too big and we’ll put some jelly on this bit here which is the imaging footprint and then that will go onto your chest.

Tom - Almost like a circular probe with a flat bit on the end that I assume is going to be the bit that’s going to be rub rubbed around.

Clare - This is the jelly which is also what you’d use on a baby scan; this gives us a better picture. Ultrasound doesn’t travel through air so we need to get rid of any air between the probe and your skin. It’s a bit cold…

This is where we start the scan and we have the image on the screen here.

Tom - Oh Wow!. That’s literally my heart - that’s amazing.

Rick - My name is Rick Steeds; I’m a consultant cardiologist. I’m particularly interested in cardiovascular imaging and I’m the current President of the British Society of Echocardiography.

Tom - We’re looking at images on the screen here from the echo sound that I’ve just had done of my heart, so could you tell us a little bit more about what it is I’m looking at?

Rick - It’s very good at showing the structure of the heart; how strong the muscle is; whether the valves work; whether they leak or whether they’re narrowed, and whether there’s damage to the heart, for example, from a heart attack. You’ll be glad to know that this looks entirely normal.

Tom - That is very good to hear. We can see two chambers there and there’s a valve between them that is opening and closing with my heartbeat.

Rick - On the left hand side of the screen you see the two walls of the left ventricle. The main floppy thing in the middle is the mitral valve. Then to the right hand side of the screen you can see the left atrium. So blood comes back from the lungs into the left atrium, down the pulmonary veins having picked up oxygen, it’s passed into the main pumping chamber of the left ventricle. Then just above the mitral valve you can see two leaflets of the aortic valve and then the start of the aorta. So then the oxygenated blood is pumped through the aortic valve, out of the aorta, and then it feeds your brain, heart, and kidneys, and everything else going with it’s oxygen.

At the top of the screen you can see a little bit of the right ventricle, which is the chamber that feeds deoxygenated blood back into the lungs, so that’s where it picks up all of it’s nutrients then back into the heart. This is a great picture of the engine of your body.

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