Echocardiogram in Pokhara: Your Complete Heart Ultrasound Guide
An echocardiogram (cardiac echo) is the definitive non-invasive test for assessing the structure and function of the heart. At A&B International Hospital, Pokhara, 2D echocardiography with colour Doppler is available with same-day reporting. This article explains what the test measures, how it differs from an ECG, who needs one, and how to understand your echo report.
What Is an Echocardiogram and What Does It Measure?
An echocardiogram is an ultrasound of the heart that produces real-time images of cardiac chambers, walls, and valves. It measures the heart’s physical dimensions, how well it contracts and relaxes, whether valves open and close normally, and whether fluid surrounds the heart.
Unlike an ECG, which only records electrical signals, an echocardiogram shows what the heart actually looks like — its size, shape, and movement. The two tests are complementary, not interchangeable.
Key measurements an echo provides:
- Ejection fraction (EF%): The percentage of blood pumped out of the left ventricle with each beat. Normal is 55–70%. Below 40% indicates heart failure with reduced ejection fraction.
- Left ventricular dimensions: End-diastolic and end-systolic diameters assess chamber size and hypertrophy from hypertension.
- Wall motion: Segments of the left ventricle that move poorly (hypokinesia) or not at all (akinesia) indicate areas of prior infarction or current ischaemia.
- Valve assessment: Stenosis (narrowing) and regurgitation (leaking) of all four valves — aortic, mitral, tricuspid, and pulmonary.
- Pericardial effusion: Fluid around the heart. Small effusions may be normal; large effusions can cause cardiac tamponade, a life-threatening compression of the heart.
What Is the Difference Between an ECG and an Echocardiogram?
ECG and echocardiogram are frequently confused, but they measure entirely different things:
| Feature | ECG | Echocardiogram |
|---|---|---|
| What it records | Electrical activity | Structural anatomy and function |
| Duration | 5 minutes | 20–30 minutes |
| Information | Rate, rhythm, ischaemia, LVH | EF, valve function, wall motion, effusion |
| Radiation | None | None |
| Cost | Lower | Moderate |
An ECG can suggest left ventricular hypertrophy by showing voltage criteria, but only an echo can confirm the actual degree of hypertrophy and assess whether diastolic function is impaired. An ECG cannot assess ejection fraction or valve function at all.
What Are 2D Echo and Doppler Echo?
2D echocardiography produces cross-sectional images of the heart from multiple acoustic windows — typically the parasternal, apical, subcostal, and suprasternal positions. Each window reveals different structures. The parasternal long-axis view is the standard view for measuring left ventricular and aortic root dimensions.
Colour Doppler overlays colour-coded flow information onto the 2D image. Red indicates flow toward the probe; blue indicates flow away. Turbulent jets through leaking or narrowed valves appear as mixed colour mosaics. This allows quantification of regurgitation severity and estimation of pressure gradients across stenotic valves.
Pulsed wave Doppler and continuous wave Doppler analyse blood flow velocities at specific points, enabling calculation of valve areas and intracardiac pressures.
Who Needs an Echocardiogram?
An echocardiogram is indicated in the following clinical situations:
Heart Failure Symptoms
Shortness of breath at rest or on exertion, ankle swelling, orthopnea (inability to lie flat), and paroxysmal nocturnal dyspnoea all warrant echo assessment. Echo distinguishes heart failure with reduced ejection fraction (systolic dysfunction) from preserved ejection fraction (diastolic dysfunction) — the two require different treatment strategies.
Cardiac Murmur
A murmur detected on stethoscope examination may be innocent (particularly in children and pregnancy) or may represent valve disease. Echo is the definitive test to determine the cause, severity, and haemodynamic significance of any murmur.
Shortness of Breath
Not all breathlessness is cardiac in origin — lung disease, anaemia, and deconditioning are common alternatives. Echo is used alongside chest X-ray and spirometry to determine whether a cardiac cause is contributing.
Hypertension Management
Long-standing hypertension causes left ventricular hypertrophy and, eventually, diastolic dysfunction. Echo quantifies the degree of hypertrophy and guides the intensity of antihypertensive treatment. Concentric hypertrophy on echo is an independent risk factor for cardiac events.
Before Surgery
Patients with known cardiac disease or suspected significant murmur require pre-operative echo to assess cardiac risk and guide anaesthetic planning. The surgeon and anaesthetist use the ejection fraction and valve findings to determine surgical feasibility and appropriate perioperative monitoring.
Atrial Fibrillation
Patients newly diagnosed with AF need echo to identify the underlying cause (valve disease, hypertensive heart disease, cardiomyopathy), assess left atrial size (a key predictor of AF recurrence), and evaluate left ventricular function before antiarrhythmic therapy.
How to Prepare for an Echocardiogram
- No fasting is required for a standard transthoracic echocardiogram.
- Wear clothing that allows the chest to be easily uncovered.
- ECG leads will also be placed to provide cardiac cycle timing.
- The examination is performed in the left lateral decubitus position (lying on your left side) for the apical views, and lying flat for parasternal and subcostal views.
- Gel is applied to the chest — it is water-soluble and wipes off easily.
- The entire examination takes 20–30 minutes.
How to Understand Your Echo Report
A standard echo report from A&B will include:
- LVEDD/LVESD: Left ventricular end-diastolic and end-systolic diameters. Normal LVEDD is approximately 42–58 mm.
- IVS/PW thickness: Interventricular septum and posterior wall thickness. Values above 12 mm indicate hypertrophy.
- EF% (ejection fraction): Greater than 55% is normal. 41–54% is mildly reduced. 40% or below indicates significant systolic dysfunction.
- Mitral valve: E/A ratio assesses diastolic filling. E/e’ ratio estimates filling pressures.
- Aortic valve: Valve area and peak/mean gradient if stenosis is suspected.
- Pericardial effusion: Described as absent, trace, mild, moderate, or large.
- Impression: The sonologist’s summary including any recommendations.
Is Echocardiogram Covered Under ECHS at A&B?
Echocardiography is included in the ECHS treatment schedule for armed forces beneficiaries. ECHS cardholders receive cashless echo at A&B upon presentation of a valid referral where applicable. Emergency cardiac echo is accessible 24/7.
Book Your Echocardiogram in Pokhara
Advance booking is recommended. Same-day appointments are often available. Call +977 061-412512 or visit A&B during OPD hours.
Get Your Echocardiogram at A&B International Hospital
A&B International Hospital
Pokhara-02, Bindhyaabasini Way to Sarangkot
Phone: +977 061-412512
2D echocardiography with colour Doppler. Same-day reports. ECHS cashless service. 24/7 emergency cardiac assessment available.
