Echocardiogram
  • What Is Echocardiography?

    Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, is a painless test that uses sound waves to create pictures of your heart.

    The test gives your doctor information about the size and shape of your heart and how well your heart’s chambers and valves are working. Echo also can be done to detect heart problems in infants and children.

    The test also can identify areas of heart muscle that aren’t contracting normally due to poor blood flow or injury from a previous heart attack. In addition, a type of echo called Doppler ultrasound shows how well blood flows through the chambers and valves of your heart.

    Echo can detect possible blood clots inside the heart, fluid buildup in the pericardium (the sac around the heart), and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body.

    Types of Echocardiography

    There are several types of echocardiography (echo)—all use sound waves to create pictures of your heart. This is the same technology that allows doctors to see an unborn baby inside a pregnant woman.

    • Unlike x rays and some other tests, echo doesn’t involve radiation.
    • Transthoracic Echocardiography
    • Stress Echocardiography
    • Transesophageal Echocardiography
    • Fetal Echocardiography
    • Three-Dimensional Echocardiography

    Other Names for Echocardiography

    • Echo
    • Surface echo
    • Ultrasound of the heart

  • Who Requires An Echocardiography?

    Your doctor may recommend an echocardiography (echo) if you have signs and symptoms of heart problems. For example, shortness of breath and swelling in the legs can be due to weakness of the heart (heart failure), which can be seen on an echocardiogram.
    Your doctor also may use echo to learn about:

    • The size of your heart. An enlarged heart can be the result of high blood pressure, leaky heart valves, or heart failure.
    • Heart muscles that are weak and aren’t moving (pumping) properly. Weakened areas of heart muscle can be due to damage from a heart attack. Weakening also can mean that the area isn’t getting enough blood supply, which may be due to coronary artery disease
    • Problems with your heart valves. An echo can show whether any of your heart valves don’t open normally or don’t form a complete seal when closed.
    • Problems with your heart’s structure. An echo can detect many structural problems, such as a hole in the septum and other congenital heart defects. The septum is the wall that separates the two chambers on the left side of the heart from the two chambers on the right side. Congenital heart defects are structural problems present at birth. Infants and children may have echo to detect these heart defects.
    • Blood clots or tumors. If you’ve had a stroke, an echo might be done to check for blood clots or tumors that may have caused it.

    Your doctor may also use an echo to see how well your heart responds to certain heart treatments, such as those used for heart failure.

  • What To Expect Before An Echocardiography

    An echocardiography (echo) is done in a doctor’s office or a hospital. No special preparations are needed for most types of echo. Usually you can eat, drink, and take any medicines as you normally would.

    The exception is if you’re having a transesophageal echo. This test usually requires that you don’t eat or drink for 8 hours prior to the test.

    If you’re having a stress echo, there may be special preparations. Your doctor will let you know how to prepare for your echo test.

    What To Expect During An Echocardiography

    An echocardiography (echo) is painless and usually takes less than an hour to do. For some types of echo, your doctor will need to inject saline or a special dye into one of your veins to make your heart show up more clearly on the test images. This special dye is different from the dye used during angiography (a test used to examine the body’s blood vessels).

    For most types of echo, you’ll be asked to remove your clothing from the waist up. Women will be given a gown to wear during the test. You’ll lay on your back or left side on an exam table or stretcher.

    Soft, sticky patches called electrodes will be attached to your chest to allow an EKG/ECG (electrocardiogram) to be done.

    A doctor or sonographer (a person specially trained to do ultrasounds) will apply gel to your chest. The gel helps the sound waves reach your heart. A wand-like device called a transducer will then be moved around on your chest.

    The transducer transmits ultrasound waves into your chest. Echoes from the sound waves will be converted into pictures of your heart on a computer screen. During the test, the lights in the room will be dimmed so the computer screen is easier to see.

    The sonographer will make several recordings of the pictures to show various locations in your heart. The recordings will be put on a computer disc or videotape for the cardiologist (heart specialist) to review.

    During the test, you may be asked to change positions or hold your breath for a short time so that the sonographer can get good pictures of your heart.

    At times, the sonographer may apply a bit of pressure to your chest with the transducer. This pressure can be a little uncomfortable, but it helps get the best picture of your heart. You should let the sonographer know if you feel too uncomfortable.

    This process is similar for fetal echo. However, in that test the transducer is placed over the pregnant woman’s belly at the location of the baby’s heart.

    Transesophageal Echocardiography

    A transesophageal echo (TEE) is performed when your doctor needs a more detailed view of your heart. For example, a TEE may be used to look for blood clots in your heart. A doctor, not a sonographer, performs this type of echo.

    The test uses the same technology as a transthoracic echo, but the transducer is attached to the end of a flexible tube. The tube will be guided down your throat and into your esophagus (the passage leading from your mouth to your stomach). From this angle, your doctor can get a more detailed image of the heart and major blood vessels leading to and from the heart.

    For a TEE, you’ll likely be given medicine to help you relax during the test. The medicine will be injected into one of your veins. Your blood pressure, the oxygen content of your blood, and other vital signs will be checked during the test. You’ll be given oxygen through a tube in your nose. If you wear dentures or partials, you’ll have to remove them.

    The back of your mouth will be numbed with a gel or a spray so that you don’t gag when the transducer is put down your throat. The tube with the transducer on the end will be gently placed in your throat and guided down until it’s in place behind the heart.

    The pictures of your heart are then recorded as your doctor moves the transducer around in your esophagus and stomach. You shouldn’t feel any discomfort as this happens.

    Although the imaging usually takes less than an hour, you may be watched for a few hours at the doctor’s office or hospital after the test.

    Stress Echocardiography

    A stress echo is a transthoracic echo combined with either an exercise or pharmacological (FAR-ma-ko-LOJ-i-kal) stress test.

    For an exercise stress test, you’ll walk or run on a treadmill or pedal a stationary bike to make your heart work hard and beat fast. For a pharmacological stress test, you’ll be given medicine to make your heart work hard and beat fast.

    A technician will take pictures of your heart using an echo before you exercise and as soon as you finish.

    What You May See and Hear During An Echocardiography

    As the doctor or sonographer moves the transducer around, different views of your heart can be seen on the screen of the echo machine. The structures of the heart will appear as white objects, while any fluid or blood will appear black on the screen.

    Doppler ultrasound techniques often are used during echo tests. A doppler ultrasound is a special ultrasound that shows how blood is flowing through the blood vessels.

    This test allows the sonographer to see blood flowing at different speeds and in different directions. The speeds and directions appear as different colors moving within the black and white images.

    The human ear is unable to hear the sound waves used in echo. When a Doppler ultrasound is used, you may be able to hear “whooshing” sounds. Your doctor can use these sounds to learn about blood flow through your heart.

    What To Expect After An Echocardiography

    You usually can go back to your normal activities right after having an echocardiography (echo).

    If you have a transesophageal echo (TEE), you may be watched for a few hours at the doctor’s office or hospital after the test. Your throat might be sore for a few hours after the test.

    You also may not be able to drive right after a TEE. Your doctor will let you know whether you need to arrange for someone to take you home.

  • What Does An Echocardiography Show?

    An ecardiography (echo) shows the size, structure, and movement of the various parts of your heart. This includes the valves, the septum (the wall separating the right and left heart chambers), and the walls of the heart chambers. A doppler ultrasound shows the movement of blood through the heart.

    Echos can be used to:

    • Diagnose heart problems
    • Guide or determine next steps for treatment
    • Monitor changes and improvement
    • Determine the need for more tests

    Echos can detect many heart problems. Some may be minor and pose no risk to you. Others can be signs of serious heart disease or other heart conditions. Your doctor may use echos to learn about the following:

    • The size of your heart. An enlarged heart can be the result of high blood pressure, leaky heart valves, or heart failure.
    • Heart muscles that are weak and aren’t moving (pumping) properly. Weakened areas of heart muscle can be due to damage from a heart attack. Weakening also could mean that the area isn’t getting enough blood supply, which may be due to coronary heart disease.
    • Problems with your heart’s valves. An echo can show whether any of the valves of your heart don’t open normally or don’t form a complete seal when closed.
    • Problems with your heart’s structure. Echos can detect many structural problems, such as a hole in the septum and other congenital heart defects. Congenital heart defects are structural problems present at birth.
    • Blood clots or tumors. If you’ve had a stroke, an echo may be done to check for blood clots or tumors that may have caused it