Diagnosing Hypertrophic Cardiomyopathy: How A Phased Array Ultrasonic Exam Helps Confirm Diagnoses

What is the one thing doctors will tell patients every time? "Nothing is certain, until it is." That is the hopeful approach all doctors take to helping patients with potentially unpleasant diagnoses. Cancer is not certain until the biopsy says so. Pulmonary embolisms are not really there until either surgery or medication proves it. The same is true of any physical ailment or disease until tests prove otherwise. 

That is why, when a doctor tells a child or teen (or even a young adult, if the young adult lives that long) that he/she may have a disorder known as hypertrophic cardiomyopathy, you wait until it can be proven. Symptoms for this genetic congenital disorder may all be present, but the disorder is not real until all possible tests confirm it. An EKG or ECG are both common with this type of heart problem, as is an ultrasound, if the heart can withstand it. However, short of open heart surgery, which no one undergoes unless they have to, the only other way to confirm this heart problem is with a phased array ultrasonic examination. Here is how that works. 

The Phased Array Ultrasound Machine

This machine is similar to an ultrasound machine in that it uses radio waves to detect tissue depth, bone density, and thicknesses. The difference here is that waves travel in a phased array, either in shorter or longer bursts and waves that are stretched to a certain size before emitting, or shrunk to a certain size before emitting. A trained ultrasonographer will know exactly how to set up the machine for minimum depth, wavelength, and phase length. As the waves pass through the chest wall to the heart, the wave reports back the muscle structure of the intercostal muscles of the ribs and the heart muscle itself. 

What the Phased Array Ultrasound Can "See" That Other Tests and Machines Cannot

A phased array ultrasound is akin to the machines treasure hunters use to echo-locate sunken ships on the bottom of the ocean floor. Both the treasure hunting machine and its sound waves and the phased array ultrasound are sending waves through substances and causing the waves to bounce off thicker, heavier objects. In this case, with a heart, the thicknesses detected in a normal heart will register at just a couple millimeters thick through the heart walls and a wee bit thicker at the apex (or bottom point) of the heart muscle where the ventricles meet.

In a heart that has cardiomyopathy, the phased array ultrasound's waves will detect much thicker muscle tissue, sometimes almost an inch or two thick. It is this super thick, very inflexible muscle tissue of the cardiomyopathic heart that prevents the patient from having decent blood circulation and from breathing easily and freely. Hence, the phased array ultrasound confirms the diagnosis. 

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