Echocardiography in Turkey

Stress Echocardiography: Combines echocardiographic imaging with cardiac stress (exercise or pharmacological) to detect wall motion abnormalities that indicate myocardial ischaemia — areas of the heart where coronary supply is inadequate under demand.

• Exercise stress echo: Patient exercises on a treadmill or cycle ergometer to peak exercise; images acquired at rest, peak exercise, and recovery
• Dobutamine stress echo (DSE): Dobutamine infused in incremental doses (10–40 mcg/kg/min) for patients unable to exercise; atropine added if target heart rate not reached
• Sensitivity 80–85%, specificity 85–90% for detecting significant coronary artery disease — superior to exercise ECG (treadmill test) alone
• Also used for valve assessment under stress (mitral stenosis, low-gradient aortic stenosis) and viability assessment in ischaemic cardiomyopathy (low-dose dobutamine echo)

Strain Echocardiography (Speckle Tracking): Quantifies myocardial deformation (global longitudinal strain, GLS) — detects subtle LV dysfunction before the ejection fraction falls. Particularly useful for:

• Cardiotoxicity monitoring in cancer patients receiving chemotherapy
• Early cardiomyopathy detection
• Risk stratification in valve disease

3D Echocardiography: Volumetric acquisition provides more accurate LV and RV volumes, more precise valve orifice areas (3D planimetry of MVA), and surgical-view imaging of the mitral valve en face — critical for mitral valve repair planning.

Bubble Contrast Echo: Agitated saline injected IV during Valsalva manoeuvre to detect right-to-left shunts (PFO, ASD) — seen as microbubbles crossing to the left heart. Used to investigate young stroke patients and paradoxical embolism.

Contrast Echo (Optison/Definity): Ultrasound contrast agents improve endocardial border definition in technically difficult studies — providing diagnostic-quality images where unenhanced TTE was non-diagnostic. Important for accurate EF measurement.

Report quality: Echo reports from BB Global Health partner hospitals are written by consultant cardiologists with specialist echocardiography accreditation (British Society of Echocardiography accreditation or European equivalent). Reports include:

• Quantitative measurements (EF, volumes, valve gradients, areas, Doppler indices)
• Structured interpretation by cardiac structure
• Clinical conclusion and recommendations
• Representative digital images stored for comparison

Report delivery: Full written report available typically same day or next morning. High-resolution digital echocardiographic images (DICOM or video clips) provided — suitable for second-opinion review by your home cardiologist or cardiac surgeon.

Combining echo with other cardiology testing: Echocardiography is frequently combined with other cardiac diagnostics in a single Turkey visit:

• Echo + coronary angiography: for valve + coronary disease assessment before cardiac surgery
• Echo + stress echo: baseline TTE then stress echo on the same day
• TOE + AF ablation: TOE same morning as ablation to exclude LAA thrombus before proceeding
• Echo + cardiology consultation: comprehensive one-stop cardiac assessment

Cost comparison: TTE Turkey: €300–600 (included in cardiology consultation packages); UK private: £600–1,200. TOE Turkey: €500–900; UK private: £1,200–2,000. Stress echo Turkey: €700–1,200; UK private: £1,500–2,500.