What is an Echocardiogram?
An echocardiogram, also called an “echo,” uses high-frequency sound waves (ultrasound) to take moving pictures of your heart. An echo can be used to show:
- The size and shape of your heart.
- If there is a tumor or infection near your heart.
- How well the chambers and valves in your heart are working.
- Areas of poor blood flow or injury in your heart.
- Possible blood clots inside the heart, extra fluid in the heart, and problems with the aorta (the main artery in your heart).
- Heart problems in infants and children.
Who needs an echocardiogram?
Your provider may order an echocardiogram if you are having signs or symptoms of a heart problem. Signs and symptoms of a heart problem might include shortness of breath, chest pain or tightness, swelling in the legs, high blood pressure, or heart murmur (abnormal heart sounds). Your provider may also order an echo to see how well your heart is responding to certain heart medications, or before you start certain cancer treatments to make sure your heart is healthy.
What are the types of echocardiogram?
- Transthoracic Echo: The most common type of echo. The technician places a small handheld device called a transducer (like a wand) on your chest and moves it around. A lubricating gel may be used. The transducer sends painless soundwaves through your chest to your heart. As these ultrasound waves bounce off your heart, an image is created on the screen. Some testing machines can create 3D images during this type of echo.
- Transesophageal Echo (TEE): If your provider is having a hard time seeing parts of your heart with a transthoracic echo, a transesophageal echo may be ordered. During a TEE, the transducer is attached to a flexible tube. The provider will guide this tube down your throat and into your esophagus. You may be given a medication to help you relax, as well as numbing spray or gel to make your throat numb. You will be awake enough to swallow if needed. Some testing machines can create 3D images during this type of echo.
- Stress Echo: During a stress test, you will be asked to exercise so that your heart beats faster and works harder. If you are unable to exercise, you may be given medication to make your heart beat faster. A transthoracic echo will be done just before you exercise or take the medication, and again just after you exercise or take the medication. Your provider will compare the images of your heart and can see how your heart acts under stress.
*This article will focus on transthoracic echocardiogram, as this is the most common type.
What should I expect?
Before an echo: The echo may be done in your provider’s office or in the hospital. For a transthoracic echo, there is nothing special to do before the test. You can eat and drink as normal before the echo. Ask your provider if you should take your normal medications before the test.
During an echo: The echo itself takes about an hour. You will lie on a table or bed on your side. The room will be dark so that the technician can see the computer screen. You may have EKG electrodes placed on your chest. These electrodes are stickers that are attached to wires that connect to an EKG machine. The EKG machine keeps track of how fast your heart beats. The technician will put gel on your chest or on the transducer, which helps the sound waves pass through your skin. To get the best pictures of your heart, you may be asked to hold your breath or move positions, and the technician may need to press firmly on the transducer. Tell the technician if you are uncomfortable. The moving pictures of your heart show up on the screen and can be saved for your provider to look at later.
After an echo: The technician will help clean off any leftover gel on your chest. The EKG electrodes will be removed. Your provider will get a copy of the images. You can often go back to normal activities after an echo. Ask your provider if it is safe for you to do so.
What are the risks of echocardiogram?
There are no risks linked to a transthoracic echocardiogram. There is no radiation used during this test.
If your provider has ordered an echocardiogram for you, be sure to ask why this test is being ordered and what other tests might be needed.
American Heart Association. (2015). Echocardiogram (Echo). Retrieved from https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/echocardiogram-echo
National Institutes of Health: National Heart, Lung, and Blood Institute. (2019). Retrieved from https://www.nhlbi.nih.gov/health-topics/echocardiography
Wang, C., Chu, P. (2016). Echocardiography for Evaluation of Oncology Therapy-Related Cardiotoxicity. Acta Cardiologica Sinica, 32(5), 560-564. doi: 10.6515/ACS20151024A