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What is an echocardiogram? — An echocardiogram, or "echo," is an imaging test that creates pictures of your heart as it beats. During an echo, a doctor, nurse, or technician uses a thick wand, called a "transducer," to send sound waves into the heart. The sound waves create images that show the size of the heart chambers, how well the heart pumps, and how well the heart valves work (figure 1).
Doctors also use the term "transthoracic" echo for this type of test. This means that they do the test by putting the transducer on the outside of your chest.
Sometimes, doctors do a test called a "stress test" along with the echo. A stress test measures how well the heart works when it pumps very fast. When the heart pumps fast, it needs more blood. A stress test shows if the heart gets enough blood during these times. When a stress test is done with an echo, it's called a "stress echo."
Why might my doctor do an echo? — Your doctor might do an echo to:
●Look for a problem in the heart or in the blood vessels around the heart
●Check on a known heart problem or condition
●Try to find the cause of symptoms, such as shortness of breath, leg swelling, or irregular heartbeat
●Check your heart after a heart attack or heart surgery
●Check how well your heart medicines are working
Your doctor might order a stress echo to:
●Check for heart problems that get worse or are visible only when the heart pumps fast
●See if you can safely exercise after a heart attack
How do I prepare for an echo? — You do not need to do anything special to prepare for an echo.
For a stress echo, your doctor will probably ask you not to eat, drink, or smoke for 3 hours beforehand. They might also change or stop some of your heart medicines, if you take any.
What happens during an echo? — Before the echo starts, the doctor, nurse, or technician will put some stickers on your chest to monitor your heartbeat (figure 2). Then:
●You might get an "IV," which is a thin tube that goes into a vein. The IV can be used to inject something called "contrast." This can improve the images of your heart.
●You will lie on your back or left side.
●The doctor, nurse, or technician will put a small amount of gel on your chest. Then, they will press the transducer against your chest and move it around. They might ask you to hold your breath or change positions during the test.
●Images of your heart will appear on a computer screen (figure 3).
If you have a stress echo, the doctor, nurse, or technician will do an echo while you are resting. Then, they will "stress" your heart and raise your heart rate with 1 of the following:
●Have you run or walk on a treadmill (figure 4)
●Have you pedal a stationary bike (a bike that doesn't move, except for the pedals)
●Give you medicine to make your heart pump faster – People who can't run or walk can get medicine instead of exercising.
Immediately after these, while your heart is still pumping fast, they will do another echo.
What are the risks of an echo? — An echo has no downsides for most people. Some people find the pressure of the transducer on the chest uncomfortable.
A stress echo can also have downsides. But they are caused mainly by the stress test and not by the echo. When people exercise and their heart pumps very fast, they can have symptoms that include:
●Feeling dizzy or faint
The contrast sometimes used for an echo has no downside for most people. But in rare cases, it can cause a serious reaction. People with an allergy to the contrast, or to something called polyethylene glycol ("PEG"), should not get this type of echo.
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