Echocardiography

Why do I need an echo test?

Your doctor may use an echo test to look at your heart’s structure and check how well your heart is working. This test may be needed if:

• You have a heart murmur.

• You’ve had a heart attack.

• You have unexplained chest pains.

• You’ve had rheumatic fever.

• You have a congenital heart defect.

How does it work?

Echocardiography uses high-frequency sound waves (also called ultrasound) that can provide a moving picture of your heart. The sound waves are sent through the body with a device called a transducer. The sound waves bounce off of the heart and return to the transducer as echoes. The echoes are converted into images on a television monitor to produce pictures of your heart in motion.

One-dimensional or M-mode echocardiography is one beam of ultrasound directed toward the heart. Doctors most often use M-mode echocardiography to see just the left side (or main pumping chamber) of your heart.

Two-dimensional echocardiography produces a broader moving picture of your heart. Two-dimensional echocardiography is one of the most important diagnostic tools for doctors.

Doppler echocardiography measures blood flowing through the arteries and shows the pattern of flow through the heart.

The type of echocardiogram you have depends on the information your doctor needs.

Transthoracic echocardiogram

In this standard type of echocardiogram:

A technician (sonographer) spreads gel on a device (transducer).
The sonographer presses the transducer firmly against your skin, aiming an ultrasound beam through your chest to your heart.
The transducer records the sound wave echoes from your heart.
A computer converts the echoes into moving images on a monitor.
If your lungs or ribs block the view, you may need a small amount of an enhancing agent injected through an intravenous (IV) line. The enhancing agent, which is generally safe and well tolerated, will make your heart’s structures show up more clearly on a monitor.

Transoesophageal echocardiogram

If your doctor wants more-detailed images or it’s difficult to get a clear picture of your heart with a standard echocardiogram, your doctor may recommend a transoesophageal echocardiogram.

In this procedure:

Your throat will be numbed, and you’ll be given medications to help you relax.
A flexible tube containing a transducer is guided down your throat and into the tube connecting your mouth to your stomach (esophagus).
The transducer records the sound wave echoes from your heart.
A computer converts the echoes into detailed moving images of your heart, which your doctor can view on a monitor.

Doppler echocardiogram

Sound waves change pitch when they bounce off blood cells moving through your heart and blood vessels. These changes (Doppler signals) can help your doctor measure the speed and direction of the blood flow in your heart.

Doppler techniques are generally used in transthoracic and transoesophageal echocardiograms. Doppler techniques can also be used to check blood flow problems and blood pressure in the arteries of your heart — which traditional ultrasound might not detect.

The blood flow shown on the monitor is colorized to help your doctor pinpoint any problems.

Stress echocardiogram

Some heart problems — particularly those involving the arteries that supply blood to your heart muscle (coronary arteries) — occur only during physical activity. Your doctor might recommend a stress echocardiogram to check for coronary artery problems. However, an echocardiogram can’t provide information about any blockages in the heart’s arteries.

In a stress echocardiogram:

Ultrasound images of your heart are taken before and immediately after you walk on a treadmill or ride a stationary bike
If you’re unable to exercise, you may get an injection of a medication to make your heart pump as hard as if you were exercising

Echocardiogram will tell your doctor:

The size and shape of your heart
The thickness and motions of your heart walls
The heart’s pumping strength
The heart valves health status, including regurgitation (backflow of blood) or stenosis (valve narrowing)
Abnormal tumors or growths
Blood clots or abnormal fluid
Abnormal holes in the heart chambers
Dilation or problems with the large blood vessels inside of the heart.

How to Prepare for a Heart Ultrasound:

Test can take up to 45 minutes to complete.
No preparation or restrictions are needed.
may eat and drink as you normally do.

There are no risks, this test cannot harm you, and there are no side effects.

What happens after the echo?

Your sonographer will help you clean the gel from your chest.
Your doctor will talk with you after looking at your echo pictures and discuss what the pictures show.

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