On Monday, I go in for an echocardiogram. One of the chemo drugs I’m supposed to take, Herceptin, can have the rare side effect of interfering with the heart muscle’s ability to contract. Obviously, the whole point of chemo is to keep me alive, that is, to keep my heart beating. So the docs want to make sure that my heart is basically healthy before they start giving me poison that interferes with it. Thanks, I think.
An echocardiogram is just a fancy way of saying that they’re taking a sonogram, or an ultrasound, of my heart. I’ve talked about ultrasounds in an earlier post. Ultrasound machines send sound wave pulses through tissues. Depending on how the sound waves are reflected back, the machines can create an image of soft tissue. I’ve seen sonogram images of my breasts, my ovaries, my liver, my daughter’s heartbeat as a 7-week old fetus, the beginnings of her spinal column at about 20 weeks, all of her organs and bones when they did amniocentesis, her skull and her left ear just a month before she was born. But the sonogram of my heart, that is the all-time coolest so far. Here’s why:
Even a lay person can understand what’s going on. A sonogram image of a liver or of a breast is just blobular nonsense to the uninitiated, those of us who haven’t done four years of med school and many more years of a radiology fellowship. The heart, it’s more clear.
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On the sonogram, you can clearly see the atrium and ventricle, the two major cavities on each side. You can see them contract, relax, contract, relax. You can watch as the technician measures the outline of your left ventricle, fills it with a grid and lets the machine calculate the capacity. You can marvel that the machine can measure the “ejection rate” or “ejection fraction.” The left ventricle is my heart’s main pumping chamber, so that’s important in keeping me alive. An ventricle that pumps 55 to 70 percent is considered normal. Good enough for government work, I guess.
That’s cool enough, but the technician can push the sonogram probe firmly under my left breast to see my heart valves at work. This is a little ouchy, because I’ve still got hematoma gunk and other things in there since the surgery, but coolness factor more than makes up for it. The mitral valve on the left side is OK. It looks like a mouth opening and closing, a little too suggestive of wormy things in horror flicks to really win my emotional heart.
My favorite valve is the tricuspid valve on the right side. It’s got three little parts (the “tri” part of “tricuspid”) that look like the feet of a Dr. Seuss character. These clap together in a boom-da-da-boom sort of rhythm. They make me smile. These little feet are doing a jig inside my chest every moment that I am alive. I’m dancing even when I’m not dancing.
But that’s not even the coolest thing, the sonogram machine can measure the whoosh, whoosh of my blood though my vena cava and my aorta. A Doppler sensor—you know the Doppler effect that makes passing helicopters sound funny, Doppler like you studied in high school physics and like the weathermen are always talking about—can measure of the direction of the blood flowing through my heart. Red is one direction, blue is the other. I’m not sure if the colors correspond to oxygenated (which I would think should be red) and non-oxygenated (which should be blue to my mind). Anyway, I can watch the blood coursing through these major, major blood thoroughfares that keep me alive. Watching it is almost as cool as an E-ticket at Disneyland.
Whoosh. Whoosh. Boom-da-da-boom. Whoosh. Whoosh. Jiggity-jig. Open. Close. Open. Close.
This is a moment-to-moment miracle. It is worth the fight.
My Left Breast 