An echocardiogram test gives good information about the structure and function of the heart.
Note: the information below is a general guide only. The arrangements, and the way tests are performed, may vary between different hospitals. Always follow the instructions given by your doctor or local hospital.
What is an echocardiogram?
An echocardiogram is an ultrasound scan of the heart. It is sometimes just called an 'echo'. Ultrasound is a very high-frequency sound that you cannot hear but it can be emitted and detected by special machines. The scan can give accurate pictures of the heart muscle, the heart chambers and structures within the heart such as the valves.
Why is an echocardiogram done?
An echocardiogram can be carried out for many different reasons. It may be done to check how well your heart is working after a heart attack, or to look at how well the valves are moving inside the heart. An echocardiogram can also help to see any fluid that may have collected around the heart.
What happens during the test?
You will need to undress to the waist and lie on the couch. A probe is placed on your chest (it is a bit like a very thick blunt pen). Also, lubricating jelly is put on your chest so the probe makes good contact with the skin. The probe is connected by a wire to the ultrasound machine and monitor. Pulses of ultrasound are sent from the probe through the skin towards your heart. The ultrasound waves then 'bounce back' (echo) from the heart and various structures in the heart.
By Tech Sgt Luke Thelen, via Wikimedia Commons
The amount of ultrasound that echoes back depends on the density of the tissue the sound has hit. Therefore, the different structures send back different echoes. For example, ultrasound travels freely through fluid so there is little echo from blood in heart chambers. But, heart valves are dense tissues so ultrasound hitting a valve will echo back clearly.
The echoes are detected by the probe and are sent to the echocardiogram machine. They are displayed as a picture on the monitor. The picture is constantly updated so the scan can show movement as well as structure. (For example, the valves of a heart opening and closing.) The operator moves the probe around over the skin surface to obtain views from different angles. Some abnormalities can be seen quite clearly. For example, damaged heart valves, thickened heart muscle, some congenital heart defects, etc.
The test is painless and takes about 15-30 minutes. You may have to turn on to your side during the test so that the operator can scan the heart from different angles.
You do not need any special preparation before the test. You eat and drink normally before and after the test. Continue to take your usual medication.
Other forms of echocardiography
This can measure variations in blood flow in different parts of the heart. For example, if can detect any abnormal flow of blood next to a damaged valve. It can assess how well the heart valves are working. You do not need any special preparation before this test.
This test is done to see how the heart responds to 'stress' such as exercise. In this test your doctor may do an echocardiogram, as described above, during or soon after exercise. Or you may be given a medication that causes the heart to beat harder and faster.
In this test you swallow a probe that is attached to a thin tube connecting it to an ultrasound machine. This views the heart from within the gullet (oesophagus) which lies just behind the heart. This can give a clearer view of the heart than normal echocardiography. It is done in situations where a very detailed picture is needed. For example, to assess valves before surgery is done to repair damaged valves, or to assess the extent of infection of a heart valve.
Further reading and references
; Transoesophageal echocardiography. Heart. 2005 Apr91(4):541-7.
; Basic transthoracic echocardiography. BMJ. 2005 Jun 18330(7505):1432-6.
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