Echocardiography is the ultrasound examination of the heart. Depending on the used ultrasound system, echocardiograms can be two-dimensional slices or 3D real-time images of the heart. Based on the ultrasound principles the direction and speed of blood flow can be utilized e.g., to diagnose a leaking or stenosed valve or to identify intracardiac shunts.

Different types of echocardiography:
The transthoracic echocardiogram (images are taken through the chest wall) is a non-invasive, highly accurate and quick assessment of the overall health of the heart.
A more invasive method is to insert a specialized scope containing an echocardiography transducer (TEE probe) into the esophagus, and record images from there. The advantages are clearer images, since the transducer is closer to the heart.
Contrast echocardiogram (CE) is already a valuable tool to delineate endocardial borders, direct invasive procedures, detect intracardiac shunts, assess myocardial perfusion and viability, and quantify coronary flow reserve and blood volumes (see also hemoglobin). The mechanism of microbubble CE is based on the physical principles of rarefaction and compression, leading to volume pulsations of microbubbles, and it is this change that results in CE signal.
Stress echocardiograms are echocardiography exams used for detection of coronary artery disease.

See also Diastole, Bicycle Stress Echocardiography, Resistive Index, and M-Mode Echocardiography.

From Bayer Schering Pharma AG:
Echovist-200® was an effectively one-pass-only contrast medium for contrast sonography and Doppler-echocardiographic examinations for the detection, exclusion or follow-up of pathological states leading to hemodynamic changes. Because of the short intravascular life of the microparticles and microbubbles, transit through the pulmonary circulation is unusual. In cardiac evaluations Echovist-200® has been replaced by newer ultrasound contrast agents (USCA), therefore the manufacturing was discontinued.
Another range of echo contrast application is the female genital tract, in particular for the demonstration or exclusion of acquired or congenital changes of the uterine cavity and for the visualization of the Fallopian tubes and investigation of their patency.
1 g Echovist-200 granules contain 1 g D-galactose microparticles. 1 ml aqueous solution for production of the suspension contains 200 mg D-galactose.
Brand names in other countries: Ecovist.

Stress echocardiograms are used for detection of coronary artery disease, or to determine the cardiac performance. Stress echocardiograms are less performed to evaluate pulmonary artery pressures, pulmonary hypertension or the significance of valvular heart disease.
Stress increases the degree to which the heart contracts. After a myocardial infarction there will be a region of the heart muscle that contracts abnormal at rest. This area may worsen with stress. A coronary artery blockage most often do not impairs the function of the heart at rest. With stress, a region of the heart does not receive enough blood to work effectively and wall motion abnormalities occur. The echocardiographer compares rest and exercise and can determine the presence and severity of a coronary artery blockage.

Stress echocardiograms involve:
A bicycle stress echocardiogram involves transthoracic echocardiography performed at the rest baseline and after or during different stages of physical exercise.
A dobutamine stress echocardiography uses the drug dobutamine instead physical exercise.
Transthoracic echocardiograms are routinely performed during stress and rest.
Cardiovascular stress represents a minimal risk to the patient.

See also Transesophageal Echocardiography, Echocardiography, M-Mode, Curved Transducer, Doppler Ultrasound, History of Ultrasound and History of Ultrasound Contrast Agents.

The usual applications of endocavitary echography (also called internal echography / endoscopic ultrasound (EUS)) are examinations of the pelvic organs through internally introduced probes, which give a more precise and correct image.
Transrectal ultrasound is a well established method for rectal or prostate carcinoma assessment.
A transvaginal echography uses a small transducer that is inserted directly into the vagina.
Used are high-frequency (10-12 MHz) for superficial organs, endocavitary echography, and intraoperative laparoscopic ultrasound. A sterile cover is slipped over the probe, which is then covered with lubricating ultrasound gel and placed in the cavitary (see Equipment Preparation).

See also Endoscopic Ultrasound, Prostate Ultrasound, Interventional Ultrasound, Transurethral Sonography, Vaginal Probe, Rectal Probe.

M-mode (Motion-mode) ultrasound shows the motion of cardiac structures. M-mode echocardiography records the amplitude and rate of motion of a moving structure in real time by repeatedly measuring the distance of the object from the single transducer at a given moment. The single sound beam is transmitted and reflected signals are displayed as dots of varying intensities, creating lines across the screen. It yields a one-dimensional image, sometimes called an 'ice pick' view of the heart.
M-mode echocardiography is used to detect valvulopathies (calcifications, etc.) and cardiomyopathies (dyskinesis, aneurysm, etc.).

See also Bicycle Stress Echocardiography, Transthoracic Echocardiography, and Transesophageal Echocardiography.