Echocardiogram

An echocardiogram uses sound waves to produce images of your heart. This commonly used test allows your doctor to see how your heart is beating and pumping. Your doctor can use these images to identify various abnormalities in the heart muscle and valves.

Depending on what information your doctor needs, you may have one of several types of echocardiograms. Each type of echocardiogram has few risks involved.

Why it’s done:
Your doctor may suggest an echocardiogram if there is a suspicion a problem involving the valves, chambers or pumping ability.

Depending on what information needed, you may have one of the following kinds of echocardiograms:

  • Transthoracic echocardiogram. This is a standard, noninvasive echocardiogram. A technician (sonographer) spreads gel on your chest and then presses a device know as a transducer firmly against your skin, aiming an ultrasound beam through your chest to your heart. The transducer records the sound wave echoes your heart produces. A computer converts the echoes into moving images on a monitor. If your lungs or ribs block the view, a small amount of intravenous dye may be used to improve the images.
  • Transesophageal echocardiogram. If it’s a difficult to get a clear picture of your heart with a standard echocardiogram, your doctor may recommend a transesophageal echocardiogram. In this procedure, a flexible tube containing a transducer is guided down your throat and into your esophagus, which connects your mouth to your stomach. From there, the transducer can obtain more-detailed images of your heart. Your throat will be numbed, and you’ll have medications to help you relax during a transesophageal echocardiogram.
  • Doppler echocardiogram. When sound waves bounce off blood cells moving through your heart and blood vessels, they change pitch. These changes (Doppler signals) can help your doctor measure the speed and direction of the blood flow in your heart. Doppler techniques are used in most transthoracic and transesophageal echocardiograms, and can check blood flow problems and blood pressures in the arteries of your heart that traditional ultrasound might not detect.
  • Stress echocardiogram. Some heart problems – particularly those involving the coronary arteries that supply blood to your heart muscle – occur only during physical activity. For stress echocardiogram, ultrasound images of hour hear are taken before and immediately after walking on a treadmill. If you’re unable to exercise, you may get an injection of a medication to make your heart work as hard as if you were exercising.

Risks:
There are few risks involved in a standard transthoracic echocardiogram. If you have a transesophageal echocardiogram, your throat may be sore for a few hours afterward. Rarely, the tube may scrape the inside of your throat. Your oxygen level will be monitored during the exam to check for any breathing problems caused by sedation medication.

During a stress echocardiogram, exercise or medication – not the echocardiogram itself – may temporarily cause an irregular heartbeat.

Read complete instructions on preparing for your echocardiograph here.

How you prepare:
No special preparations are necessary for a standard transthoracic echocardiogram. Your doctor will ask you not to eat for a few hours beforehand if you’re having a transesophageal or stress echocardiogram. If you’ll be working on a treadmill during a stress echocardiogram, wear comfortable shoes. If you’re having a transesophageal echocardiogram, you won’t be able to drive afterward because of the sedating medication you’ll receive. Be sure to make arrangements to get home before you have your test.

What you can expect:
An echocardiogram can be done in the doctor’s office or a hospital. After undressing from the waist up, you’ll lie on an examining table or bed. The technologist will attach sticky patches (electrodes) to your body to help detect and conduct the electrical currents of your heart.

If you’ll have a transesophageal echocardiogram, your throat will be numbed with a numbing spray or gel. You’ll likely be given a sedative to help you relax.

Most echocardiograms take less than 30 minutes, but the timing may vary depending on your condition. During a transthoracic echocardiogram, you may be asked to breathe in a certain way or to roll onto your left side. Sometimes the transducer must be held very firmly against your chest. This can be uncomfortable – but it helps the technician produce the best images of your heart.

Read full Echocardiogram preparation instructions here.

Results:
Your doctor will look for health heart valves and chambers, as well as normal heartbeats. Information form the echocardiogram may show:

  • Heart size
  • Pumping strength
  • Damage to the heart muscle
  • Valve problems
  • Heart defects