What should I expect at an aortic ultrasound?

I’m due for an aortic ultrasound soon, as part of a screening program. What can I expect? How much clothing is removed? A friend of mine just had to take off his t-shirt. Another one claimed he had to unzip his jeans and pull down underwear to his pubes.

I’m due for an aortic ultrasound soon, as part of a screening program. What can I expect? How much clothing is removed? A friend of mine just had to take off his t-shirt. Another one claimed he had to unzip his jeans and pull down underwear to his pubes.

I think your friends might have answered your question.

I don't know if I can help you much. I've had three of them done. My doctor has one taken every two years.But anyway I've never had to do anything other than remove my shirt. I suppose this depends on who is doing it. Once I had a iv put in so the tech could inject some dye to see something better. But it was not a big deal my thoughts on this are if it is your heart. It is probably important enough to get it done. It takes maybe an hour and is painless.

I’m due for an aortic ultrasound soon, as part of a screening program. What can I expect? How much clothing is removed? A friend of mine just had to take off his t-shirt. Another one claimed he had to unzip his jeans and pull down underwear to his pubes.

@Mesterton So how did it go and how much DID you have to take off

I’m due for an aortic ultrasound soon, as part of a screening program. What can I expect? How much clothing is removed? A friend of mine just had to take off his t-shirt. Another one claimed he had to unzip his jeans and pull down underwear to his pubes.

@Mesterton,

I’ve had them too and done quite a few myself as a cardiac anesthesiologist. I’d ask your friend if they were kidding about their jeans and underwear. For an abdominal ultrasound it would be reasonable, but for selective aortic or complete cardiac echocardiography the lowest skin needed is just below the xiphoid or middle of your chest bones.

So how did your aortic echo go? If you don’t mind, as a retired anesthesiologist I’m interested in your outcome and welfare. Many thanks,

Eric, MD

It depends. I had examinations of the abdominal, femoral and carotid arteries. For the femoral arteries, I first lowered my pants, but then the doctor also lowered my underwear a little, but not completely, and put a paper to protect it.

"Aortic ultrascan" can mean a lot of things? The aorta extends from the aortic valve in the heart as blood leaves the left ventricle, goes to the aortic arch and the aortic artery extends down to about the pelvis where it branches into the right and left iliac at the right and left legs.

They could be doing and echocardiogram and looking at the aortic valve for stenosis/regurgitation. From what i have seen, MRI is used to diagnose aortic extravasation/aneurysm at the arch or abdomen, another thing we see not uncommonly.

I'm happy I found this, it sounds like it might be something I want to know about. I just went for my annual check up with my cardiologist last week. He said something about fixing or replacing the valve. He plans to discuss it next year and do an ekg and stress test. I don't think he's familiar with my records because I just had both in the past year and the same about 7 years ago. Last year they remarked that nothing has changed since I had bypass surgery 27 years ago. Every time they do a test I hear "35% ejection factor" mentioned which I think has something to do with that aortic valve. They all find it remarkable that I'm still the same as when I got out of the bypass surgery. 6x bypass

When I went to the surgeon 27 years ago who fixed my plumbing, to have the staples removed from my arm where they harvested an artery to get the replacement plumbing, I asked him what I could/couldn't do now? His reply "As far as I'm concerned you're as good as new and you can do anything you want". (He died earlier this year) So when they keep telling me I'm the same as I was after the surgery, that makes me pretty happy. I also have to wonder if he has read my records/history.

When I first met the cardiologist (about 2016) that was the first time I've been to one since the surgery in 1996. I liked him right away. When he entered the office where I was waiting his attention getter was: "You should be dead. Most people who had what you had, come back for more in 10 years and they don't make it to 20."

So I don't know why he's talking the same tests again but the stress test is fun. I get to meet an old friend who was one of the drill sergeants at cardiac rehab almost 30 years ago. She even holds my hand when they shoot me the juice that's supposed to make me feel like I can't breathe --- it doesn't.

Some doctors will have you strip naked and get an enema and then a huge plug in your bum , then a team of 12 nurses age 24 - 30 will assist the doctor for the ultra sound , but most likely you will see a Tech and just have to remove your top

I have a family history of AAA - Abdominal Aortic Aneurysm, so I've had two ultrasounds to check for signs.

It is an abdominal exam. For the first one, all I had to do was raise my shirt up basically above my ribs and unfasten/unzip my pants. The ultrasound tech placed a towel across my belt line and tucked it in under the waistband of my underwear. He then lowered the towel/waistband to about the top of my pubic hair. The actual exam was conducted from the xyphoid to where he had the towel.

10 years later, I had another one, but at a different hospital. This one was a little more in depth. They had me strip to my underwear and put on a gown. Lying on the table with the gown in place, the tech places a towel across my thighs, then proceeded to push the gown up with the towel trailing behind. When she reached my waist, she let go of the towel and pushed the gown up over my chest, exposing my belly with the towel covering my underwear. Same deal, towel tucked into the waistband of my underwear and pulled down to the top of my pubic hair. This time though, after the abdominal ultrasound was complete, they did an ultrasound on my femoral arteries, pushing the towel up but not exposing anything, although her hand/ultrasound wand made repeated contact with my genitals (well, with an inch or two of bunched up towel in between). When she was done, she wiped up the goop with a differeny towel handed me a couple of clean ones to finish wiping up.

I'm sure for another one in about 6 years.

Last year they remarked that nothing has changed since I had bypass surgery 27 years ago. Every time they do a test I hear "35% ejection factor" mentioned which I think has something to do with that aortic valve. They all find it remarkable that I'm still the same as when I got out of the bypass surgery. 6x bypass

When I went to the surgeon 27 years ago who fixed my plumbing, to have the staples removed from my arm where they harvested an artery to get the replacement plumbing, I asked him what I could/couldn't do now? His reply "As far as I'm concerned you're as good as new and you can do anything you want". (He died earlier this year) So when they keep telling me I'm the same as I was after the surgery, that makes me pretty happy. I also have to wonder if he has read my records/history.

When I first met the cardiologist (about 2016) that was the first time I've been to one since the surgery in 1996. I liked him right away. When he entered the office where I was waiting his attention getter was: "You should be dead. Most people who had what you had, come back for more in 10 years and they don't make it to 20."

So I don't know why he's talking the same tests again but the stress test is fun. I get to meet an old friend who was one of the drill sergeants at cardiac rehab almost 30 years ago. She even holds my hand when they shoot me the juice that's supposed to make me feel like I can't breathe --- it doesn't.

i read echo cardiogram reports on a daily basis as a critical care nurse. The "35%" they are referring to is your ejection fraction (not "factor" :-)) It refers to the percentage of blood ejected from (in this case) one of the chambers in your heart (there are 4, 2 atrium, 2 ventricles). Typically the number refers to the left ventricle ejection fraction (LVEF) since that's the part of the heart that supplies the whole body. "Normal" EF is 52-72%, 30-40% is "moderately abnormal," so your EF is "moderately abnormal" at 35%. https://my.clevelandclinic.org/health/articles/16950-ejection-fraction

The heart is complex. i'm not a cardiologist, that's about 15 years of education just to qualify, then you want someone with several years of experience on top of that education. i've been working with lots of heart patients for 10 years in a critical care setting and i learn new things all the time, there are new innovations, treatments. i get to see a lot being in a teaching hospital. That to say, this is not easy stuff to grasp, and i'm just skimming the surface, no doctor can give us complete understanding or the benefit of their education and experience in a 15 minute conversation. Trust is a big factor. That said:

6x bypass is extensive, so you are indeed doing well for that to have sustained 27 years. Bypass is about fixing the blood supply going to your heart, EF is about the blood your heart muscle pumps to the rest of your body. Two different things. An echo can show a lot about the heart muscle, things like the four heart valves, the muscle it self, but not the blood supply going to the heart. The most definitive test for blood supply to the heart is a heart catheterization.

It sounds like your doctor may be talking about fixing/replacing your aortic valve, that's a pretty common heart valve replacement due to stenosis and regurgitation. An echo will give a visual of that valve and show things like stenosis and regurgitation. The stress test shows pretty much what the name implies, how your heart and body respond to stress. They may put you on a treadmill or give you adenosine to stimulate your heart, then take pictures with dye. There's different levels of tests that can give info about the heart. EKG/ECG is basic electrical, but it can tell us stuff about infarction, ischemia, dysrhythmia to name a few. Blood tests can tell us things like fluid overload with a BNP (common in heart failure) a test like troponin for myocardial infarction (heart attack), those are more during the event tests. Stress test is the next level up, echo, then heart cath is the most definitive. i'm way over simplifying and leaving a lot out.

If your aortic valve is not functioning well enough, they may med manage you or suggest replacement. Aortic valve replacement can involve open heart surgery similar to what you went through with bypass surgery, where the sternum is split and chest opened, etc.. Another method would be a TAVR (transcatheter aortic valve replacement). The second method is MUCH less intrusive and typically involves accessing vasculature from the groin, very similar to a heart catheterization, it's a wonderfully elegant, and comparatively simple procedure i my opinion.

For some reason I made a too-limiting assumption about OP’s question. Since I had done many echocardiograms for aortic valve imaging but not aortic ultrasounds in my anesthesia practice, I automatically interpreted the OP query as aortic valve ultrasound. The other member comments reminded me that it could have meant aortic ultrasound of the aortic vessel, not just your valve. One track mind. I gave anesthesia for aortic valve surgery as well as aortic vessel repair, but many more AVRs than AAAs or dissections. As the other posters pointed out, ultrasound of the aorta below the rib cage would likely require more exposure than just your shirt off.

Eric

@tallslenderguy : Thank you very much for the explanation. I did know it was fraction but don't know how that got in there as faction. I probably did it but sometimes my computer changes things and I don't notice it.

6x bypass is extensive, so you are indeed doing well for that to have sustained 27 years. Bypass is about fixing the blood supply going to your heart, EF is about the blood your heart muscle pumps to the rest of your body. Two different things. An echo can show a lot about the heart muscle, things like the four heart valves, the muscle it self, but not the blood supply going to the heart. The most definitive test for blood supply to the heart is a heart catheterization.

They seem to have a habit of doing all those tests whenever I go in to the ER. Last year I had cellulitis, twice, about 5 months apart and I was in once for what I believe was food poisoning as they found nothing. I sat in the ER for 5 hours before they got to me and it was nearly gone by that time but they did a head scan to rule out a stroke. The nurse finally came in saying "good news, there's nothing in your noggin" but they held me over night to do another stress test because they already had the connections on me from the EKG. Another meeting with that machine that starts clicking on my left side and when it gets to the right makes a loud click to wake me up and heads the other way. Then it's off to see my old friend for the stress test.

My father had a heart attack in 1953 at exactly the same age as me so in 1996 when I was having back pain one night I went right to the ER where I had one after I got there. I was told I had no heart damage, all I got from it was an inverted "T". They sent me to the cath lab where I couldn't see the monitor then right up to the hospital that does bypass surgery.

It sounds like your doctor may be talking about fixing/replacing your aortic valve, that's a pretty common heart valve replacement due to stenosis and regurgitation. An echo will give a visual of that valve and show things like stenosis and regurgitation. The stress test shows pretty much what the name implies, how your heart and body respond to stress. They may put you on a treadmill or give you adenosine to stimulate your heart, then take pictures with dye. There's different levels of tests that can give info about the heart. EKG/ECG is basic electrical, but it can tell us stuff about infarction, ischemia, dysrhythmia to name a few. Blood tests can tell us things like fluid overload with a BNP (common in heart failure) a test like troponin for myocardial infarction (heart attack), those are more during the event tests. Stress test is the next level up, echo, then heart cath is the most definitive. i'm way over simplifying and leaving a lot out.

Everyone I was with in cardiac rehab who had a valve replaced was dead in a few years. He's going to have a tough time talking me into that. I'm certainly not interested in that skilsaw up the chest again, not when my tests show I haven't changed since I got home from the bypass. Plus, thanks to a zoning change the town destroyed my retirement plan and I have to work now. I'm not in my mid fifties now so I expect I'd be out of work for quite a while. I was back to work in about 3 weeks after the bypass.

If your aortic valve is not functioning well enough, they may med manage you or suggest replacement. Aortic valve replacement can involve open heart surgery similar to what you went through with bypass surgery, where the sternum is split and chest opened, etc.. Another method would be a TAVR (transcatheter aortic valve replacement). The second method is MUCH less intrusive and typically involves accessing vasculature from the groin, very similar to a heart catheterization, it's a wonderfully elegant, and comparatively simple procedure i my opinion.

He might be able to talk me into that, we'll see what he comes up with. He said in a couple years he wants to talk about it.

Thanks again

@Annie2

Some doctors will have you strip naked and get an enema and then a huge plug in your bum , then a team of 12 nurses age 24 - 30 will assist the doctor for the ultra sound , but most likely you will see a Tech and just have to remove your top

I understand it takes 1 to move his penis and 1 on his balls to move them around where the doctor wants them but what do the other 10 do? With a plug already in his ass they don't need one with her finger in there. Maybe they're to relieve the first 2 when they get tired?

I think I know you Annie2. You're the one who stripped me naked to check me over before I could get in the bed at the hospital. Then left me standing there naked while you left the room for 10 to 15 minutes with a half dozen girls coming and going getting the room ready.