3D Echocardiogram Patient Preparation: Complete Pre-Procedure Checklist

3D Echo (real-time volumetric) requires optimal acoustic windows and patient cooperation.

Pre-Procedure Checklist

1. Indication Confirmation: Valvular (mitral, tricuspid), congenital, LV volume/function, LA appendage, masses.
2. Medication Review: Hold beta-blockers/CCBs if stress echo; anticoagulants per protocol (usually continue).
3. Fasting: 4–6 hrs if TEE (transesophageal) or contrast; TTE (transthoracic) — light meal OK.
4. IV Access: 18–20G for contrast (Definity/Lumason) or sedation.
5. ECG Monitoring: 3-lead for gating.
6. Clothing: Gown; remove necklaces, electrodes from chest wall.
7. Bladder: Empty (TEE especially).
8. Dentures/Prostheses: Remove for TEE.
9. Allergies: Contrast (perflutren), latex, sedatives.
10. Sedation (TEE): Midazolam ± fentanyl; monitoring (SpO₂, BP, ECG); recovery 30–60 min.
11. Position: Left lateral decubitus (TTE); supine/slight left lateral (TEE).
12. Breath-Hold Coaching: End-expiration apnea for 3D acquisition (4–7 beats). Practice beforehand.

Contrast Use

IV perflutren microbubbles enhance endocardial border detection; contraindicated in R→L shunt, severe pulmonary hypertension, acute MI.

Post-Procedure

Resume normal activity (TTE). Post-TEE: NPO 1 hr, no driving 12 hrs if sedated.