What is an Echocardiogram?
An echocardiogram is a test that uses ultrasound waves to examine the heart.
Because it is a non-invasive test, it is a safe and painless way to help
doctors diagnose a number of abnormalities of the heart.
Is the Echocardiogram Safe?
The echocardiogram is very safe. It is a non-invasive procedure using
ultrasound waves. There are no known risks from the ultrasound waves.
The echocardiogram is also painless, although you may feel slight discomfort
when the transducer is held firmly against the chest.
What Does It Show?
Doctors can see how well your heart functions during exertion by studying
what happens during the exercise test.
- Size and shape of the heart. The images may be used to measure the
size of the heart chambers and thickness of the heart muscle.
- Pumping efficiency of the heart. The images show the efficiency
with which the heart pumps blood, as well as whether the heart is pumping at
full strength or is weakened. The scans may also show whether the various
parts of the heart pump equally.
- Valve abnormalities. An echocardiogram shows the shape and motion
of the heart valves. It can reveal if a heart valve is narrowed or leaking
and show how severe the problem is.
- Other uses. The test may also detect the presence of fluid around
the heart; blood clots, or masses inside the heart; and abnormal holes between
Preparing For A Test
- Do not eat or drink 3 hours prior to the test. This will prevent
the possibility of nausea, which may accompany vigorous exercise after
eating. If you are diabetic and take medications for diabetes, get special
instructions from your doctor.
- If you are currently taking any heart medications, check with your
doctor. You may be asked to stop certain medications a day or two before
the test. This can help get more accurate test results.
- Wear loose, comfortable clothing that is suitable for exercise. Men
usually don't wear a shirt during the test, and women generally wear a bra
and a lightweight blouse or a hospital gown. You should also wear comfortable
walking shoes or sneakers.
- Before the test, you will be given an explanation of the test and asked
to sign a consent form. Feel free to ask any questions about the
- Several areas on your chest and shoulders will be cleansed with
alcohol and an abrasive lotion, to prepare the skin for the electrodes. Men
may need to have areas of their chest shaved, to ensure that the electrodes
stay in place.
What Happens During the Test?
The echocardiogram can be performed in the doctor's office or at the
hospital. No special preparation is necessary for this test. If you are
scheduled for an exercise echocardiogram, however, you will be given special
You will be asked to remove clothing above the waist, and put on a hospital
gown or a sheet to help keep you warm and comfortable. You will then lie on
an examination table.
Electrodes (small sticky patches) and wires will be attached to your chest
and shoulders to record your electrocardiogram (ECG or EKG). The ECG shows
your heart's electrical activity during the test.
Next, you will lie on your back or on your left side. To improve the quality
of the pictures, a colorless gel is applied to the area of the chest where
the transducer will be placed.
A technician moves the transducer over the chest, to obtain different views
of the heart. He or she may ask you to change positions. You may also be
asked to breathe slowly or hold your breath, in order to get a better
picture. A thorough examination usually takes from 20 minutes to an hour,
depending on the number of views and whether the Doppler echo is used.
How Does An Echocardiogram Work?
An echocardiogram works very much like sonar. Ultrasound waves are
transmitted into the chest and the reflection of these waves off the various
parts of the heart is analyzed by sophisticated equipment.
A transducer, which is a small microphone-like device, is held against
the chest. The transducer sends and receives the ultrasound waves. By moving
the transducer to various positions on the chest, different structures of the
heart may be analyzed.
A computer assembles the reflected ultrasound waves to create an image of
the heart. These images appear on a television screen. The images may be
recorded on videotape or printed on paper for review by the cardiologist.
An echocardiogram study typically involves three different techniques. The
most basic technique, called M-mode echo, produces an image that appears as a
tracing than an actual heart. The exact size of the heart chambers may be
measured using the M-mode echo technique.
Two-dimensional (2-D) echo shows the actual shape and motion of the
different heart structures. This advanced technique provides images that
represent "slices" of the heart in motion.
Doppler echo is a third technique that portrays the flow of blood
through the heart. The images representing the flow of blood through the
heart may be displayed as a series of black-and-white tracings or as color
images on the television screen.
During a Doppler echo procedure, you will hear some unusual sounds. These
whooshing or pulsating sounds are computer-generated to provide the
technologist with audio feedback. They are not the sounds of your heart.
A Major benefit of the echocardiogram is that it gives information about the
heart's structures and blood flow without anything other than sound waves
entering the body. The information gained from the echocardiogram allows your
doctor make an accurate diagnosis and develop a treatment plan that is best
for you. The major limitation is that it is often difficult to obtain good
quality images from persons who have broad chests, are obese, or are
suffering from chronic lung disease.
Typically, the doctor will review the images at a later time and prepare a
report detailing his findings. This may take several days before the completed
report is ready.