Echocardiography and Cardiac Imaging

The UCSF Echocardiographic Laboratory has held a place as one of the leading clinical academic laboratories in the United States for more than 30 years. Annually, the lab performs approximately 25,000 echocardiograms. The laboratory is ICAEL (Intersocietal Commission for the Accreditation of Echocardiography Laboratories) accredited. UCSF was one of the first sites in the country to initiate transesophageal echocardiography and three-dimensional echocardiography.

Our faculty members lecture nationally and internationally and have been active in developing national guidelines and standards for the application of echocardiography. The laboratory has special expertise in the evaluation and diagnosis of congenital heart disease, valvular heart disease including interventional (structural echocardiography), hypertrophic cardiomyopathy, cardio-oncology and diastolic dysfunction. It is also one of the foremost programs in the world pioneering the use of Artificial Intelligence to improve the use of echocardiography in the diagnosis of heart conditions.

The UCSF Cardiac MRI/CT program is composed of internationally recognized clinical imagers and researchers focused on noninvasive cross-sectional cardiac and vascular imaging. The program offers a wide breadth of clinical indications and research opportunities.

The UCSF Nuclear Cardiology program performs more than 2,000 procedures per year. The faculty members are internationally recognized for the development of national guidelines and imaging applications. Through close collaboration with Lawrence Berkeley National Laboratory, the program has been and remains at the forefront in the development of imaging technology. There are extensive opportunities for basic and clinically oriented research with a vigorous group of researchers.

Our Services Include: 

Cardiac MRI - uses a strong magnet to produce images; no radiation is involved. During imaging, patients are placed within the magnet for a variable amount of time ranging from 10 minutes to one hour, during which time they remain relaxed and still. The scan is painless, although people occasionally have a slight flushing feeling in their face. The injection of intravenous contrast may be required in certain cases. This is given through a small intravenous line that is placed by one of the radiology nurses or technologists.

Cardiac CT - uses ionizing radiation to produce images. The radiation imparted by CT scans varies depending upon why the CT is being obtained. More information on CT radiation can be found at the UCSF Radiation Safety website (http://www.radiology.ucsf.edu/patient-care/patient-safety/radiation). CT scans are much quicker than MRI, and usually only takes a few minutes to perform. Intravenous contrast is required for the majority of cardiac examinations, with the exception of coronary calcium screening.

Contrast echocardiogram - may be performed if the echocardiographic images are not clear, or if your there is suspicion of a communication between the chambers of your heart. In this case, a nurse will place an intravenous line to inject the contrast. This contrast differs from X-ray contrast and may consist of saline solution or a special agent designed for use with echocardiography. History of allergy to X-ray contrast is not a contraindication to contrast echocardiography.

Stress echocardiography - may require you to exercise, or may be done with a medication that increases your heart rate and blood pressure if you are unable to exercise. If any form of stress echocardiography has been ordered, you cannot eat for four hours prior to the examination. If you are performing exercise, you should wear comfortable clothes. Even if you are performing exercise, you may have an intravenous catheter placed to improve the imaging of your heart or to gain additional information about heart function.

Transesophageal echocardiogram (TEE) - is a test that uses a special scope fitted with an ultrasound transducer that is placed in the esophagus after numbing the back of throat with lidocaine and sedating you with medications. You must fast for a minimum of six hours before coming to the laboratory, and someone must be with you to accompany you home. You cannot drive after receiving the sedation. There are many reasons to perform this test, but the most common ones are to investigate possible infection of the heart valves (endocarditis), to evaluate a defect in the wall between the upper chambers of the heart (atrial septal defect), to investigate a possible reason for a stroke in younger patients, and to evaluate heart valves, both artificial and native valves.

Transthoracic echocardiogram (TTE) - is performed by placing a transducer on your chest wall in a variety of locations. There is no special preparation for this examination, and the only discomfort you may feel is some pressure on your chest. The examination typically lasts one hour or less and the results will be available to your physician within 48 hours. Your doctor will receive information about the function of your heart, including the cardiac chambers and the heart valves, and will gain information about the pressures in your heart.