Patient education: Echocardiogram (The Basics)

What is an echocardiogram? — 

An echocardiogram, or "echo," is an imaging test that creates pictures of the heart as it beats.

During an echo, a doctor, nurse, or technologist 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).

If the test is done by putting the transducer on the outside of the chest, it is called a "transthoracic" echo.

Sometimes, doctors do 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 I get an echo? — 

Your doctor might do an echo to:

●Look for a problem in your heart or in your blood vessels around your 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 the test.

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, the doctor, nurse, or technologist will put some stickers on your chest called "electrodes" (figure 2). These monitor your heartbeat. Then:

●You might get an "IV," which is a thin tube that goes into a vein. The IV can be used to inject "contrast." This can improve the images.

●You will lie on your back or left side.

●The doctor, nurse, or technologist 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.

If you have a stress echo, the doctor, nurse, or technologist 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 3)

●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 is safe for most people. Some find the pressure of the transducer on the chest uncomfortable.

A stress echo can have some risks. But they are caused mainly by the stress test and not the echo. When people exercise and their heart pumps very fast, they can have symptoms that include:

●Abnormal heartbeat

●Trouble breathing

●Feeling dizzy or faint

●Chest pain

The contrast sometimes used for an echo has no risks for most people. But in rare cases, it can cause a serious reaction. People with an allergy to the contrast, or to polyethylene glycol ("PEG"), should not get this type of echo.

Sometimes, people with an allergy to the contrast used for CT scans or MRIs wonder if they will be allergic to the dye used for echoes. These are different types of contrast. So these people are not more likely than others to have an allergic reaction.

More on this topic

Patient education: ECG and stress test (The Basics)
Patient education: Mitral regurgitation (The Basics)
Patient education: Heart attack (The Basics)
Patient education: Hypertrophic cardiomyopathy in adults (The Basics)
Patient education: Coronary artery disease (The Basics)
Patient education: Heart failure (The Basics)
Patient education: Chest pain (The Basics)
Patient education: Heart murmurs (The Basics)
Patient education: Mitral valve prolapse (The Basics)
Patient education: Mitral stenosis in adults (The Basics)

Patient education: Mitral regurgitation (Beyond the Basics)
Patient education: Heart attack (Beyond the Basics)
Patient education: Hypertrophic cardiomyopathy (Beyond the Basics)
Patient education: Heart failure (Beyond the Basics)
Patient education: Chest pain (Beyond the Basics)