What Is an Echocardiogram?
An echocardiogram is a widely used test that creates moving images of your heart. Your cardiologist uses this information to diagnose your heart condition and determine your best course of treatment.
An echocardiogram is often ordered after an electrocardiogram (ECG) has been performed. An ECG uses electrodes to measure the heart's electrical activity. If the results of the ECG show unusual activity, your cardiologist may order an echocardiogram to get a more detailed picture of your heart.
How does an echocardiogram work?
An echocardiogram test uses ultrasound technology to create a multidimensional image of the heart's structure, rhythm, and blood flow. The test will assess the heart's size, shape, performance, valves, and chambers.
The most common type of echocardiogram is called a transthoracic echocardiogram (TTE). During a TTE, a transducer (like a microphone) is placed on your chest at certain locations and angles. The transducer sends out ultrasonic sound waves that move through the skin and other body tissues to the heart tissues, bouncing or "echoing" off the heart structures. These sound waves are sent to a computer that can create moving images of the heart walls and valves.
In some cases, your doctor may recommend a transesophageal echocardiogram (TEE). A TEE uses a specialized probe with an ultrasound transducer that is inserted into your esophagus to generate images of your heart.
What are the different types of echocardiograms?
- M-mode echocardiography — This produces an image that is like a tracing rather than an actual picture of heart structures.
- Doppler echocardiography — Measures the flow of blood through the heart's chambers and valves.
- Color Doppler — An enhanced form of Doppler echocardiography where different colors are used to designate the direction of blood flow.
- 2D (two-dimensional) echocardiography — Used to "see" the actual motion of the heart structures in real-time so that the heart's structures can be observed.
- 3D (three-dimensional) echocardiography — Captures three-dimensional views of the heart structures with greater depth than 2D ECHO.
- Stress echocardiogram — A test that measures how well your heart functions during physical activity or stress. You may be given an injection of dobutamine to increase your heart rate.
What does an echocardiogram show?
An echocardiogram is used to evaluate signs or symptoms of:
- Aneurysm — An aneurysm is a weakening of the artery walls, creating an artery bulge. The condition can be detected easily via a normal echocardiogram test.
- Atherosclerosis — Atherosclerosis is caused by plaque inside the arteries. An ECHO test will show the location of plaque buildup in the arteries.
- Cardiac tumor — Cardiac tumors are abnormal, cancerous or non-cancerous growths in the heart. An echocardiogram can detect the exact position of these growths.
- Cardiomyopathy&— Cardiomyopathy is an inherited disease that affects the heart muscle. The disease enlarges the muscle, making it harder for the heart to pump blood to the rest of the body. An ECHO test can detect cardiomyopathy by measuring the thickness of the heart muscle.
- Congenital heart disease — Congenital heart disease is a heart condition you are born with. A fetal echocardiography test can detect the disease in an unborn child at 22 weeks of pregnancy. A 3D ECHO test may be recommended for hard-to-detect cases.
- Heart failure (HF) — HF is a chronic condition that reduces your heart's ability to pump blood to the rest of your body. Over time, fluid may build up around the heart, causing it to malfunction. A 2D or Doppler echocardiography test is recommended for detecting CHF.
- Pericarditis — Pericarditis is an inflammation of the fibrous sac surrounding the heart (the pericardium). An echocardiogram test detects pericarditis.
- Valvular heart disease — This disease affects one or more valves of the heart. An echocardiogram is the main test recommended for diagnosing valvular heart disease.
An ECHO is not used to detect blockages in the arteries. The test to diagnose a blockage is called an angiogram.
Why Would I Need an ECHO Test?
An echocardiogram can show if your heart, heart valves, and blood pumping rate are normal or if you have heart disease or another heart condition.
Specifically, your doctor may recommend an ECHO test if you have:
- A heart condition like cardiomyopathy (heart muscle disease) or heart valve disease.
- A serious heart condition and are planning to undergo surgery.
- Had a heart attack or heart surgery.
- Signs and symptoms of a heart problem, like chest pain or pressure, shortness of breath, irregular heartbeats, or abnormal heart sounds.
What Are the Risks and Complications of an Echocardiogram?
Echocardiograms are generally safe, but certain types of ECHOs carry some risks.
Stress echocardiogram risks and side effects
- You may experience chest pain, dizziness, or shortness of breath while exercising.
- An abnormal heart rhythm can occur from exercise or dobutamine, which usually goes away when the test is over.
- In rare cases, a heart attack can occur (1 in 1,000 cases).
Transesophageal echocardiogram (TEE) risks and side effects
- Discomfort in your mouth or throat.
- Minor throat bleeding.
- Trouble breathing.
- In rare cases, the probe may tear or puncture your esophagus.
- Contrast agents used for echocardiograms have a 1 in 10,000 risk of series allergic reaction.
What Should I Expect from An Echocardiogram?
How to prepare for an echocardiogram?
Your cardiologist will explain the procedure to you and answer any questions you might have.
- Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
- Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
- Fasting is not required for most echocardiograms, but you will have to fast for a stress ECHO or a transesophageal ECHO.
How to prepare for a stress echocardiogram
- Do not eat a heavy meal for four hours before your test to avoid feeling sick to your stomach while you exercise.
- Wear flat, comfortable shoes and loose, lightweight clothing.
- Ask your doctor if it is safe for you to take your regular medications prior to your test.
How to prepare for a transesophageal echocardiogram (TEE)
- Do not eat or drink for six hours prior to your test.
- Tell the echocardiography staff if you have dentures or dental prostheses, or medical problems of the throat, esophagus, or stomach.
- You will not be able to drive for 12 hours following the test, so make sure you arrange for someone to give you a ride home.
How long does an echocardiogram procedure take?
Your echocardiogram test will take about 30 to 60 minutes.
What to expect during your echocardiogram?
Before the test, you will remove any clothing above your waist and put on a hospital gown.
You may receive an IV that injects contrast material in order to get a better picture of your heart. The contrast material does not contain iodine and will not injure the kidneys.
What to expect during your transthoracic echocardiogram (TTE)
- A technologist will place sticky patches (called electrodes) on your chest. These will record your heart’s rate, rhythm, and electrical activity in an electrocardiogram (EKG).
- You will lie on your left side, and the technologist will put gel on your chest, which may feel cold.
- The technologist will press a small device called a transducer against your chest and move it back and forth to take pictures of your heart.
- You will need to lie still and may need to hold your breath for very short periods during the test.
- The test usually takes about 30 to 60 minutes.
What to expect during your stress echocardiogram
- A technologist will place sticky patches (called electrodes) on your chest. These will record your heart’s rate, rhythm, and electrical activity in an electrocardiogram (EKG).
- The technologist will take a TTE before your activity or medicine-induced stress.
- You will walk on a treadmill or pedal a stationary bike to make your heart work harder.
- If you cannot exercise, you will get an infusion of medicine called dobutamine through an IV to make your heart work harder.
- Throughout the activity or stress portion of the test, the technologist monitors your heart’s rate, rhythm, and electrical activity through an EKG.
- After activity or stress, the technologist will take another TTE.
- The test usually takes about 60 minutes.
What to expect during your transesophageal echocardiogram (TEE)
- To relax your gag reflex, the technologist will spray your throat with an anesthetic.
- You will receive medicine via an IV placed in your arm to help you relax and be comfortable during the test.
- We will monitor your heart rate, breathing rate, blood pressure, and the amount of oxygen in your blood throughout the test.
- You will lie on your left side, and your doctor will guide a narrow, lubricated probe into your mouth and down into your esophagus to the level of your heart.
- The test usually takes about 1 hour, but the probe is only in place for 10 to 20 minutes.
Recovery after an echocardiogram
After the procedure is complete, the technologist will wipe the gel from your chest and remove the EKG electrode pads.
You may resume your usual diet and activities unless your doctor advises you differently. Generally, there is no special type of care following an echocardiogram. However, depending on your diagnosis or physical condition, your doctor may give you additional or alternate instructions after the procedure.
What do echocardiogram results mean?
Normal results mean that:
- Heart chambers and valves are working properly.
- The amount of blood your heart pumps is normal.
- There is no extra fluid around your heart.
- There are no tumors or blood clots present.
Abnormal results can vary depending on your specific condition and may include:
- Your heart chambers or valves are not working properly.
- The amount of blood your heart pumps is not enough to support your body’s needs.
- There is extra fluid around your heart.
- A tumor or blood clot is present.
By UPMC Editorial Staff. Last reviewed on 2024-10-01.
