An echocardiogram is an ultrasound test that checks the structure and function of your heart. An echo can diagnose a range of conditions including cardiomyopathy and valve disease. There are several types of echo tests, including transthoracic and transesophageal. Talk with your provider about the type that’s best for you.
An echocardiogram (echo) is a graphic outline of your heart’s movement. During an echo test, your healthcare provider uses ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest to take pictures of your heart’s valves and chambers. This helps the provider evaluate the pumping action of your heart.
Providers often combine echo with Doppler ultrasound and color Doppler techniques to evaluate blood flow across your heart’s valves.
Echocardiography uses no radiation. This makes an echo different from other tests like X-rays and CT scans that use small amounts of radiation.
A technician called a cardiac sonographer performs your echo. They’re trained in performing echo tests and using the most current technology. They’re prepared to work in a variety of settings including hospital rooms and catheterization labs.
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There are several types of echocardiogram. Each one offers unique benefits in diagnosing and managing heart disease. They include:
Several techniques can be used to create pictures of your heart. The best technique depends on your specific condition and what your provider needs to see. These techniques include:
An echocardiogram usually takes 40 to 60 minutes. A transesophageal echo may take up to 90 minutes.
An echocardiogram and an electrocardiogram (called an EKG or ECG) both check your heart. But they check for different things and produce different types of visuals.
An echo checks the overall structure and function of your heart. It produces moving pictures of your heart.
An EKG checks your heart’s electrical activity. It produces a graph, rather than pictures of your heart. The lines on this graph show your heart rate and rhythm.
Your provider will order an echo for many reasons. You may need an echocardiogram if:
An echocardiogram can detect many different types of heart disease. These include:
An echo can also show changes in your heart that could indicate:
A transthoracic echo is the type most people think of when they hear “heart echo.” It’s also the type most often used. It’s performed outside your body.
A sonographer places a hand-held wand (called a transducer) on the outside of your chest to send sound waves to your heart. These sound waves bounce off the different parts of your heart.
These “echoes” then appear as pictures on the sonographer’s computer screen. These pictures can also be saved for your cardiologist and physician to review later.
There’s not much you need to do to prepare for this type of echo. In general:
A transthoracic echo includes the following steps:
You should feel no major discomfort during the test. You may feel a coolness on your skin from the gel on the wand. You may also feel a slight pressure of the wand against your chest.
A transesophageal echo takes pictures from inside your chest, rather than from the outside. It can show your heart and valves in greater detail than a transthoracic echo. That’s because your body’s bones and tissues aren’t in between the transducer and your heart.
For this test, the sonographer guides a small transducer down your throat and esophagus (food tube) using a long, flexible tube. This minimally invasive procedure may cause mild, temporary discomfort. But it has a low risk of serious problems.
This type of echo may be used:
As you prepare for your echo, tell your doctor if you have:
It’s also important to share if you take medication for:
Preparations for the day of your test include:
A transesophageal echo includes the following steps:
An exercise stress echo, sometimes simply called a stress echo, shows how your heart works when it’s taxed. The test resembles a traditional exercise stress test. A technician will monitor your heart rate and rhythm as well as your blood pressure (this is standard during a stress test). But they’ll also use echo imaging (which isn’t normally used during a stress test).
This test shows how well your heart can withstand activity. Your sonographer takes pictures before you start exercising and then right after you’re done.
In some cases, you won’t exercise. Instead, your provider will give you medication to make your heart work harder as if you were exercising. The goal is to force your heart to need more oxygen.
When your heart is under stress, your sonographer can see details they might not be able to see if you were lying on the exam table. These include problems with your coronary arteries or the lining of your heart.
Your provider will give you detailed instructions on how to prepare for your test. An exercise stress echo needs more preparation than other types of echo testing. These include:
Ask your provider when and how to take your usual medications. You may need to avoid taking certain heart medications on the day of your test. You may also need to change your dose of diabetes medication. Closely follow your provider’s guidance.
You won’t be sedated, but you still may want to ask someone to drive you to and from the appointment. You may feel tired after the test.
Plan to wear comfortable clothes and shoes. You’ll need to walk or ride a stationary bike during the test, so wear what feels good for you.
The exercise stress echo will include the following steps:
If you were given medication to stress your heart, the process will be a bit different. You won’t be on a treadmill or bike. Talk to your provider to learn what to expect and how you might feel during this type of test.
After your cardiologist reviews your test, they’ll enter the results into your electronic medical record. Your primary care provider will have access to the results, too. You’ll discuss the results with one or both of these providers.
Ask any questions you’d like about the pictures and what they mean. Your provider will explain what the pictures show and whether you need follow-up tests or treatment.
It depends on which type of echo you’re having done. Check with your provider to learn exactly what you should avoid. Things you may need to avoid before your echo include:
You may need to adjust your medication schedule before your echo. Don’t stop taking any medications or make any changes until you talk with your provider.
A note from Cleveland Clinic
An echocardiogram is an important test that can reveal a lot about your heart’s structure and function. If your provider recommends an echo for you, ask about what type you’ll be receiving and what you can expect. You may need more than one echo, or multiple tests with different techniques, so your provider can get enough details about your heart.
Ask your provider to explain the pictures to you and help you understand what they mean. Taking an active role in your diagnosis and care can help you feel comfortable with each step of the process.
Last reviewed by a Cleveland Clinic medical professional on 05/09/2022.
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