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Echocardiogram

Written by Brian Krans | Published on June 12, 2012
Medically Reviewed by Peter Rudd, MD

What Is an Echocardiogram?

An echocardiogram is a test that uses sound waves to produce live images of your heart, allowing your doctor to monitor how your heart and its valves are functioning.

An echocardiogram, also referred to as “echo,” can help spot blood clots in the heart, fluid in the sac around the heart, and problems with the aorta (the main artery connected to the heart).

It is a key test in determining the health of heart muscle, namely after a heart attack. It also helps doctors discover heart defects in unborn babies.

An echocardiogram is painless, but does have some risks, although rare.

Why an Echocardiogram Is Performed

Your doctor may order an echocardiogram if you are showing symptoms of heart problems. This may include inspecting irregular heartbeat caused by problems with the heart valves or chambers, or by your heart’s ability to pump.

You may have undergone other testing that was inconclusive, or your doctor simply found problems while listening to your heartbeat though a stethoscope.

Types of Echocardiogram

There are several different types of echocardiogram your doctor may use.

Transthoracic Echocardiography (TTE)

This is the most common type of echocardiography. It is painless and noninvasive.

A device called a transducer will be placed on your chest over your heart. The transducer sends ultrasound waves through your chest toward your heart. A computer interprets the sound waves as they bounce back to the transducer. This produces the live images that are shown on a monitor.

Transesophageal Echocardiogram (TEE)

If a transthoracic echocardiogram doesn’t produce the definitive images, your doctor may recommend a transesophageal echocardiogram. In this procedure, a much smaller transducer is guided through a thin, flexible tube in your mouth and down your throat. (Your throat will be numbed to make this procedure easier.)

This tube is guided through your esophagus (the tube that connects your throat to your stomach). With the transducer behind your heart, your doctor can get a better view of any problems.

Stress Echocardiogram

Stress echocardiogram uses a traditional transthoracic echocardiogram, but it is done after exercise or in tandem with medication to make your heart beat faster. This allows your doctor to check how your heart performs under stress.

Three-Dimensional Echocardiography

A three-dimensional echocardiogram uses either transesophageal or transthoracic echocardiography to create a 3-D image of your heart. This involves multiple images from different angles. It is used to diagnose heart problems in children or prior to heart valve surgery.

Fetal Echocardiography

Fetal echocardiography is done on an expectant mother sometime during weeks 18 to 22 of pregnancy. The transducer is placed over the woman’s belly to check the fetus for heart problems. As the test doesn’t use radiation (such as X-rays), the test is considered safe for the unborn child.

The Risks of an Echocardiogram

Unlike other imaging techniques, such as X-rays, echocardiograms do not use radiation and are therefore considered safe.

A transthoracic echocardiogram carries no risk. There is a chance for slight discomfort—like pulling off a Band-Aid—when the electrodes are removed from your skin.

For a transesophageal echocardiogram, there is a rare chance the tube may scrape the side of your esophagus, causing irritation. The most common side effect is a sore throat or feeling a bit funny because of the sedative used in the procedure.

In a stress echocardiogram, the medication or exercise used to get your heart rate up could cause an irregular heartbeat temporarily. Major risks are reduced because the activity and medication are done under supervision.

How to Prepare for an Echocardiogram

A transthoracic echocardiogram requires no special preparation.

If you undergo a transesophageal echocardiogram, you may be instructed to fast for a few hours before the test. This is required in order to prevent you from vomiting during the test. You also may not be able to drive for a few hours after the test due to the sedatives.

If your doctor has ordered a stress echocardiogram, wear clothes and shoes that are comfortable to exercise in.

After an Echocardiogram

After your test, your doctor will review the findings. This could include issues regarding:

  • damage to heart muscle
  • heart defects
  • heart size
  • pumping strength
  • valve problems

If your doctor detects serious problems, he or she may refer you to a cardiologist (a doctor specializing in the heart).

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