Echocardiogram

An echocardiogram (echo) is a safe and effective test that helps in the diagnosis and monitoring of heart disease. An echocardiogram shows the size, structure, and movement of various parts of your heart, including the heart valves, the septum (the wall separating the right and left heart chambers), and the walls of the heart chambers. Doppler ultrasound shows the movement of blood through your heart. Your doctor may use echo to:

• Diagnose heart problems
• Guide or determine next steps for treatment
• Monitor changes and improvement
• Determine the need for more tests
• Learn about the size of your heart
• Assess heart muscles that are weak and aren't pumping well
• See whether your heart valves open and close properly
• Detect congenital heart defects
• Check for blood clots or tumors

What happens during an echocardiogram?

For most types of echo, you will remove your clothing from the waist up and lie on your back or side. (For some types of echo, a special dye may be injected into one of your veins so your heart shows up more clearly on the pictures.) A sonographer will apply gel to your chest to help the sound waves reach your heart. A device called a transducer will then be used to transmit ultrasound waves into your chest. A computer will convert echoes from the sound waves into pictures of your heart on a screen.

A stress echocardiogram is a transthoracic echo combined with a stress test. During a stress test, you exercise or take medicine to make your heart work hard and beat fast. A technician will use echo to create pictures of your heart before you exercise and as soon as you finish. For an exercise stress test, you'll walk or run on a treadmill or pedal a stationary bike to make your heart work hard and beat fast. For a pharmacological stress test, you'll be given medicine to increase your heart rate.

Transesophageal echo (TEE) is used if your doctor needs a more detailed view of your heart. For example, your doctor may use TEE to look for blood clots in your heart. A doctor, not a sonographer, will perform this type of echo. During a TEE test, the transducer is attached to the end of a flexible tube which is guided down your throat and into your esophagus. From this angle, your doctor can get a more detailed image of the heart and major blood vessels leading to and from the heart.

The pictures of your heart are then recorded as your doctor moves the transducer around in your esophagus and stomach. You shouldn't feel any discomfort as this happens. Although the imaging usually takes less than an hour, you may be watched for a few hours at the doctor's office or hospital after the test.

A three-dimensional (3D) echo creates 3D images of your heart. These detailed images show how your heart looks and works. During a transthoracic echo or TEE procedure, 3D images can also be captured. Doctors may use 3D echo to diagnose heart problems in children. They also may use 3D echo for planning and overseeing heart valve surgery.