What is an Echocardiogram?
An echocardiogram (often called an 'echo') is a painless, non-invasive test that uses sound waves (ultrasound) to create moving pictures of your heart. Just like ultrasound used during pregnancy, an echocardiogram allows doctors to see your heart beating and pumping blood in real time.
This test provides detailed information about the size and shape of your heart, how well your heart chambers and valves are working, and how blood flows through your heart. It's one of the most commonly performed heart tests and provides valuable information that other tests cannot.
Types of Echocardiograms
Several types of echocardiograms are available, each offering different views and information about your heart:
Common Types
- Transthoracic Echocardiogram (TTE): The most common type, performed by moving a transducer across your chest
- Transesophageal Echocardiogram (TEE): Provides more detailed images by passing a probe down your esophagus
- Stress Echocardiogram: Images taken before and after exercise or medication that makes your heart work harder
- Doppler Echocardiogram: Measures the speed and direction of blood flow through the heart
- 3D Echocardiogram: Creates three-dimensional images for even more detailed views
- Fetal Echocardiogram: Examines a baby's heart before birth
Why You Might Need This Test
Your doctor may order an echocardiogram for many reasons, including:
- To evaluate heart murmurs (unusual sounds heard through a stethoscope)
- To check for heart valve problems (stenosis or regurgitation)
- To assess heart function after a heart attack
- To evaluate symptoms like chest pain, shortness of breath, or swelling
- To monitor heart conditions like heart failure or cardiomyopathy
- To check for blood clots or tumors in the heart
- To evaluate the effectiveness of medications or procedures
- To assess congenital heart defects (present from birth)
- To check heart function before surgery
- To investigate the cause of stroke or mini-stroke
- To evaluate the heart's pumping strength (ejection fraction)
Preparing for Your Echocardiogram
Preparation for a transthoracic echocardiogram (the most common type) is minimal:
- No special preparation is usually needed
- You can eat and drink normally before the test
- Take your regular medications unless told otherwise
- Wear comfortable, loose-fitting clothing with easy access to your chest
- Avoid applying lotions, oils, or powder to your chest on the day of the test
Special Preparation for TEE
If you're having a transesophageal echocardiogram (TEE), you'll need to fast for several hours beforehand, and you may receive sedation. Your doctor will provide specific instructions for this more specialized test.
What to Expect During the Test
For a standard transthoracic echocardiogram, here's what typically happens:
The Procedure
- Duration: The test usually takes 30-60 minutes
- Position: You'll lie on your left side on an exam table in a dimmed room
- Electrode patches: Small sticky patches may be placed on your chest to record your heart rhythm
- Gel application: Cool gel is applied to your chest to help the transducer make contact with your skin
- Transducer placement: The technician moves a small device (transducer) across different areas of your chest
- Pressure: You may feel some pressure as the transducer is pressed against your chest for better images
- Position changes: You may be asked to move or breathe in certain ways to get different views
- Sound: You may hear whooshing sounds—these are the sounds of blood flowing through your heart
- Painless: The test is completely painless, though the gel may feel cold
After the Test
After a transthoracic echocardiogram, you can immediately resume normal activities. The gel will be wiped off your chest, though you may want to shower to remove any residue.
A cardiologist will analyze the images and measurements and send a detailed report to your doctor, typically within a few days. Your doctor will then discuss the results with you and explain what they mean for your heart health and treatment plan.
Understanding Your Results
An echocardiogram provides extensive information about your heart, including:
- Heart size: Whether chambers are normal, enlarged, or thickened
- Pumping strength: How well your heart pumps blood (ejection fraction)
- Valve function: Whether valves open and close properly
- Blood flow: Direction and speed of blood flow through chambers and valves
- Heart muscle: Areas of damage from heart attack or other conditions
- Pressure: Estimates of pressure within the heart and pulmonary arteries
- Fluid: Presence of fluid around the heart (pericardial effusion)
Interpreting Findings
Your doctor will explain what the findings mean for your specific situation. Normal results mean your heart appears to be pumping and functioning properly. Abnormal results might indicate valve problems, heart failure, cardiomyopathy, or other conditions that may require treatment.
Advantages and Limitations
Echocardiograms offer several advantages:
- Completely painless and non-invasive
- No radiation exposure (unlike X-rays or CT scans)
- Provides real-time, moving images
- Can be performed at bedside if needed
- Relatively quick and affordable
- No recovery time needed
Test Limitations
However, there are some limitations. In people with obesity or lung disease, it may be harder to get clear images. In these cases, other imaging tests or a transesophageal echocardiogram may be recommended for better visualization.