Echocardiography is a test that uses sound waves to produce live images of your heart. The image is called an echocardiogram. This test allows your doctor to monitor how your heart and its valves are functioning.
The images can help them get information about:
- blood clots in the heart chambers
- fluid in the sac around the heart
- problems with the aorta, which is the main artery connected to the heart
- problems with the pumping function or relaxing function of the heart
- problems with the function of your heart valves
- pressures in the heart
An echocardiogram is key in determining the health of the heart muscle, especially after a heart attack. It can also reveal heart defects in unborn babies.
Getting an echocardiogram is painless. There are only risks in very rare cases with certain types of echocardiograms or if contrast is used for the echocardiogram.
Your doctor may order an echocardiogram for several reasons. For example, they may have discovered an abnormality from other testing or while listening to your heartbeat through a stethoscope.
If you have an irregular heartbeat, your doctor may want to inspect the heart valves or chambers or check your heart’s ability to pump. They may also order one if you’re showing signs of heart problems, such as chest pain or shortness of breath.
There are several different types of echocardiograms.
This is the most common type of echocardiography. It’s 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.
If a transthoracic echocardiogram doesn’t produce definitive images or you need to visualize the back of the heart better, your doctor may recommend a transesophageal echocardiogram.
In this procedure, the doctor guides a much smaller transducer down your throat through your mouth. The doctor will numb your throat to make this procedure easier and eliminate the gag reflex.
The transducer 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 and visualize some chambers of the heart that are not seen on the transthoracic echocardiogram.
A stress echocardiogram uses traditional transthoracic echocardiography. However, the procedure is done before and after you’ve exercised or taken medication to make your heart beat faster. This allows your doctor to test how your heart performs under stress.
A three-dimensional (3-D) echocardiogram uses either transesophageal or transthoracic echocardiography to create a 3-D image of your heart. This involves multiple images from different angles. It’s used prior to heart valve surgery. It’s also used to diagnose heart problems in children.
Fetal echocardiography is used on expectant mothers sometime during weeks 18 to 22 of pregnancy. The transducer is placed over the woman’s abdomen to check for heart problems in the fetus. The test is considered safe for an unborn child because it doesn’t use radiation, unlike an X-ray.
Echocardiograms are considered very safe. Unlike other imaging techniques, such as X-rays, echocardiograms don’t use radiation.
A transthoracic echocardiogram carries no risk if it is done without contrast injection. There’s a chance for slight discomfort when the EKG electrodes are removed from your skin. This may feel similar to pulling off a Band-Aid.
If contrast injection is used, there is a slight risk of complications such as allergic reaction to the contrast. Contrast should not be used in pregnant patients who have an echocardiogram.
There’s a rare chance the tube used in a transesophageal echocardiogram may scrape the esophagus and cause irritation. In very rare cases, it can puncture the esophagus to cause a potentially life threatening complication called esophageal perforation. The most common side effect is a sore throat due to irritation of the back of the throat. You may also feel a bit relaxed or drowsy due to the sedative used in the procedure.
The medication or exercise used to get your heart rate up in a stress echocardiogram could temporarily cause an irregular heartbeat or precipitate a heart attack. The procedure will be supervised, which reduces the risk of a serious reaction.
Most echocardiograms take less than an hour and can take place in a hospital or doctor’s office.
For a transthoracic echocardiogram, the steps are as follows:
- You will need to undress from the waist up.
- The technician will attach electrodes to your body.
- The technician will move a transducer back and forth on your chest to record the sound waves of your heart as an image.
- You may be asked to breathe or move in a certain way.
For a transesophageal echocardiogram, the steps are as follows:
- Your throat will be numbed.
- You will then be given a sedative to help you relax during the procedure.
- The transducer will be guided down your throat with a tube and will take images of your heart through your esophagus.
The procedure of a stress echocardiogram is the same as a transthoracic echocardiogram, except a stress echocardiogram takes pictures before and after performing exercise. The duration of the exercise is usually 6 to 10 minutes but can be shorter or longer depending on your exercise tolerance and fitness level.
A transthoracic echocardiogram requires no special preparation.
However, if you undergo a transesophageal echocardiogram, your doctor will instruct you not to eat anything for a few hours before the test. This is to prevent you from vomiting during the test. You may also not be able to drive for a few hours afterward due to the sedatives.
If your doctor has ordered a stress echocardiogram, wear clothes and shoes that are comfortable to exercise in.
Generally, there is little to no recovery time needed for an echocardiogram.
For transesophageal echocardiogram, you may experience some throat soreness. Any numbness around your throat should go away within about 2 hours.
Once the technician has obtained the images, it usually takes 20 to 30 minutes to perform the measurement. Then, the doctor can review the images immediately and inform you of the results.
The results may reveal abnormalities such as:
- damage to the heart muscle
- heart defects
- abnormal cardiac chamber size
- problems with pumping function
- stiffness of the heart
- valve problems
- clots in the heart
- problems with blood flow to the heart during exercise
If your doctor is concerned about your results, they may refer you to a cardiologist. This is a doctor who specializes in the heart. Your doctor may order more tests or physical exams before diagnosing any issues.
If you’re diagnosed with a heart condition, your doctor will work with you to develop a treatment plan that works best for you.