Echocardiogram Test
Overview
An echocardiogram is a test that uses high-frequency sound waves to produce images of the heart. These pictures help show how the heart and its valves are working. Healthcare professionals use echocardiography to check for heart disease and understand heart function.
Other names for this test include:
| Name | Description |
|---|---|
| Heart ultrasound | Uses sound waves for images |
| Heart sonogram | Imaging test for the heart |
Different types of echocardiograms exist, and the choice depends on the patient’s health and specific medical needs. In some cases, healthcare professionals perform echocardiograms during exercise or pregnancy.
Reasons for Performing an Echocardiogram
Different Echocardiogram Types
Echocardiograms use sound waves to create images of the heart. This allows doctors to get a clear picture of the heart’s structure and how it works.
Standard Echocardiogram (Transthoracic or TTE): This is the most common type. A healthcare provider places a handheld device on the chest to examine the heart’s chambers, the movement of the heart wall, valves, and how blood travels through the heart. Some tests use a special dye to highlight certain heart areas.
Echocardiogram Through the Food Pipe (Transesophageal or TEE): This test gives a closer look at the heart, especially if the standard test does not give enough detail. A healthcare professional gently passes a thin, flexible tube down the throat and into the esophagus. The device at the end of the tube takes pictures from behind the heart. This method helps with checking the aorta and certain valves, especially the aortic valve.
Echocardiogram During Physical Stress (Stress Echocardiogram): Healthcare providers perform this test while the patient exercises or after they take a medicine that mimics exercise. It helps show how the heart reacts to stress and can find problems like blocked blood vessels or reduced heart function during activity.
Echocardiogram for the Unborn Baby (Fetal): During pregnancy, doctors use this type of echo to look at a baby’s heart by sliding a probe across the mother’s belly. This test finds heart problems in the baby before birth and does not use X-rays or surgery.
Each type has its own benefits and risks. The doctor selects the most appropriate type based on the person’s symptoms and the area of the heart that needs evaluation.
Approaches to Cardiac Ultrasound Testing
Doctors use several methods within echocardiograms to gather key details about heart health. Each method focuses on different aspects of heart function.
| Method | What It Looks At | Common Uses |
|---|---|---|
| 2D or 3D Imaging | Heart walls, chambers, valves, large blood vessels | Checks pumping strength, heart shape |
| Doppler Ultrasound | Speed and direction of blood flow using echo signals | Finds leaking, blocked, or narrowed valves; measures blood pressure in heart arteries |
| Color Flow Imaging | Blood flow patterns shown in color | Spots abnormal flow, valve issues |
- 2D imaging gives a moving, realistic view of most of the heart, while 3D imaging adds detail, especially in the heart’s lower left area.
- Doppler methods help identify issues like heart valve disease, where the valve may leak or not open well. The Doppler part measures how fast and in what direction blood is moving.
- Color flow imaging uses color to map blood as it moves through the heart. This helps spot areas where blood leaks backward or gets blocked.
These techniques often work together in one test to provide a comprehensive view of the heart’s appearance and function.
More Details About Echocardiogram Use
Echocardiograms help health professionals diagnose and manage many heart-related problems and medical conditions involving the heart or blood flow. Some conditions and problems often checked with echocardiograms include:
- Valve disorders (such as valve disease, mitral regurgitation, aortic valve stenosis)
- Changes in heart muscle strength (cardiomyopathy, enlarged heart)
- Diseases linked to blocked arteries (coronary artery disease, myocardial ischemia)
- Problems with heart rhythm (atrial fibrillation or flutter, ventricular fibrillation)
- Heart damage from infections or other illnesses (myocarditis, rheumatic fever)
- Birth defects affecting the heart (congenital heart disease, septal defects)
- Problems from high blood pressure or low blood pressure
- Detecting fluid around the heart (pericardial effusion)
- Clues after chest pain, heart attacks, or sudden cardiac events
A short list of other health issues where echocardiograms are helpful:
- Detecting blood clots, tumors, or infection in the heart
- Assessing lung disease that affects the heart
- Examining changes caused by genetic conditions (for example, Marfan syndrome, Ehlers-Danlos syndrome)
- Watching for issues during pregnancy (fetal heart development)
- Monitoring heart conditions in children and adults with lifelong heart disease
Key Uses of Echocardiograms
Find changes from heart disease early.
- Guide treatment decisions
- Check progress after procedures or medicine changes
- Avoid more risky or invasive tests
Echocardiograms do not use radiation. Doctors use sound waves and special imaging methods to see problems with the heart in a safe and detailed way.
Possible Issues
An echocardiogram uses ultrasound sound waves, which are considered safe and do not expose the body to radiation. Most people do not have any serious problems from a standard echocardiogram, though some mild discomfort can happen when the device is pressed against the chest.
This pressure is needed to get clear heart images. Contrast dye may be used in some cases. A small number of people may react to the dye with side effects like headaches, a rash, or back pain.
These reactions usually happen during the test while a healthcare provider is present. Severe allergic responses are very uncommon. For a test called transesophageal echocardiogram (TEE), there is a higher chance of experiencing mild problems after the test:
- Sore throat
- Hoarse or weak voice
- Difficulty swallowing
- Minor bleeding in the throat
- Spasms in throat or lung muscles
- Injury to mouth, teeth, or lips
The following table outlines rare but possible risks:
| Issue | Description |
|---|---|
| Esophageal perforation | A small hole in the esophagus |
| Irregular heartbeat (arrhythmia) | Fast or abnormal heart rhythm |
| Medication reactions | Nausea or allergic response |
During a stress echocardiogram, medicines or physical activity may temporarily cause flushing, low blood pressure, or a fast or unusual heartbeat. Major problems such as a heart attack are very rare. Most people complete the test with little or no discomfort.
Getting Ready
Eating and taking medicines
Ask your healthcare provider if you should take your usual medicines before the echocardiogram. Bring a list of all medicines, including any over-the-counter products, so the team can review them.
For most standard transthoracic echocardiograms, eating and drinking as normal is fine. If a transesophageal echocardiogram is planned, you may need to stop eating and drinking some hours before the exam.
If sedation is used, arrange a ride home since you will not be able to drive afterward. Always follow detailed instructions from your healthcare professional for the safest experience.
What You Can Expect
Regular Heart Ultrasound Test
For a regular heart ultrasound, called a transthoracic echocardiogram, patients usually change into a gown and lie down. Healthcare staff place sticky sensors, called electrodes, on the chest (sometimes on the legs) to record the heart’s electrical signals using an ECG monitor. A healthcare worker uses a small ultrasound wand, also called a transducer, to take pictures of the heart from outside the chest.
They apply gel to the wand and move it over the chest to help capture clearer images. The transducer sends sound waves into the chest and collects echoes from the heart. A nearby computer turns these echoes into moving pictures that show the heart’s valves, chambers, and blood flow in real time on a screen.
Patients may be asked to take deep breaths or roll onto their side for better views. Sometimes, a special dye or saline is given through an IV to highlight heart structures or detect holes in the heart. The imaging is painless, though some pressure from the transducer may be felt.
Key Equipment Table
| Equipment | Purpose |
|---|---|
| Transducer wand | Sends/receives sound waves. |
| Gel | Helps improve image quality. |
| ECG electrodes | Monitors the heart’s electrical activity. |
| Computer/Monitor | Displays moving heart images. |
| IV Contrast/Dye | Improves visibility of heart structures. |
Heart Imaging Through the Esophagus
For a more detailed look at the heart, called a transesophageal echocardiogram (TEE), healthcare staff take images from inside the chest. Before the test, a healthcare worker places a needle in the arm or hand to give sedative medicine that helps the patient relax. Numbing medicine is also applied to the throat. Oxygen is provided through a mask or small nasal tube.
A healthcare professional guides a thin tube through the mouth and down the throat into the food pipe near the heart. The ultrasound probe, known as the TEE probe, slides through the tube to get closer to the heart. From there, it sends and collects sound waves, capturing clear, close-up images of the heart’s valves and chambers.
A nurse or doctor monitors the patient’s oxygen level throughout the test. This type of imaging is especially helpful for spotting problems like valve disease or blood clots that may not show clearly on standard surface scans.
Heart Ultrasound with Exercise or Medicine
A stress echocardiogram shows how the heart functions under stress, such as during exercise. Healthcare staff first take baseline images of the heart, similar to a regular echocardiogram. Then, the patient walks on a treadmill or pedals a stationary bike while connected to an ECG monitor.
Heart images are taken before and immediately after the activity. If exercise isn’t possible, the patient receives medicine that mimics the effects of exercise by stressing the heart. The healthcare team compares the images to see how the heart responds and to spot problems that only appear when it’s working harder.
Common Uses of Stress Echo
- Find out if chest pain is due to blocked arteries.
- See how well the heart pumps under stress.
- Check for issues that show up only with activity.
What Happens When the Test is Over
Most heart ultrasound tests, including the standard echo, stress echo, and esophagus test, take less than an hour. With the transesophageal test, healthcare staff may monitor the patient longer afterward due to the sedative. After imaging, a provider checks whether more scans are needed. Patients usually wait briefly after the test, and most can return to their daily routine soon.
If results are normal, no further checks may be needed. If the images suggest a heart problem, the provider may order more tests. If the patient isn’t already seeing a heart specialist, a visit to a cardiologist may be recommended for expert evaluation and treatment.
Summary Table: After Each Type of Echocardiogram
| Test Type | Recovery Needs | Return to Activities |
|---|---|---|
| Transthoracic Echo | Minimal, if any | Same day |
| Transesophageal Echo | May need a few hours’ observation | Same or next day |
| Stress Echo | Usually none | Same day |
Findings
Echocardiogram results give detailed information about heart structure, heart muscle, blood flow, and heart function. This test identifies abnormalities that affect how the heart works and shows important details about the health of the major blood vessels connected to the heart. Key observations include:
- Heart Size and Structure: The images show if the heart walls are abnormally thick or if the chambers have expanded. Long-term high blood pressure, weakened heart valves, or other heart conditions can cause these changes.
- Heart Muscle Performance: Measurements like ejection fraction and cardiac output indicate how efficiently the heart pumps blood. Results outside the normal range may indicate heart failure or heart muscle damage.
- Valve Function: The test checks if the heart valves open and close properly. It detects valve diseases such as regurgitation (leaky valves) or stenosis (narrowed valves).
- Structure at Birth: Echocardiograms highlight any congenital defects, like abnormal connections between heart chambers or blood vessels, and spot shunts where blood moves between heart structures in unusual ways.
| Area Examined | What the Echocardiogram Shows |
|---|---|
| Heart Walls | Thickness, strength, and motion |
| Heart Chambers | Size and function |
| Blood Vessels | Connections and flow |
| Heart Valves | Movement and leakage or narrowing |
| Blood Flow | Speed and direction through heart structures and vessels |
| Shunts | Unusual blood flow patterns |
