What Is Echocardiography?
Echocardiography (EK-o-kar-de-OG-ra-fee) is a
painless test that uses sound waves to create images of your heart. It provides
your doctor with information about the size and shape of your heart and how
well your hearts chambers and valves are working.
The test also can identify areas of heart muscle
that arent contracting normally due to poor blood flow or injury from
previous
heart
attack(s). In addition, a type of echocardiography called Doppler
ultrasound shows how well blood flows through the chambers and valves of your
heart. Echocardiography can detect possible blood clots inside the heart, fluid
buildup in the sac around the heart (pericardium), and problems with the aorta
(the main artery that carries oxygen-rich blood out of the heart).
Who Needs Echocardiography?
Your doctor may recommend echocardiography if
youre suffering from signs and symptoms of heart problems. For example,
symptoms such as shortness of breath and swelling in the legs can be due to
weakness of the heart (heart
failure), which can be seen on an echocardiogram.
Doctors also use echocardiography to provide
information on:
- The size of your heart. An enlarged heart can be
the result of
high
blood pressure, leaky heart valves, or heart failure.
- Heart muscles that are weak and arent
moving (pumping) properly. Weakened areas of heart muscle can be due to damage
from a heart attack. Or weakening could mean that the area isnt getting
enough blood supply, which can be due to
coronary
artery disease.
- Problems with your hearts valves.
Echocardiography can show whether any of the valves of your heart dont
open normally or dont form a complete seal when closed.
- Abnormalities in the structure of your heart.
Echocardiography can detect a variety of heart abnormalities, such as a hole in
the septum (the wall that separates the two chambers on the left side of the
heart from the two chambers on the right side) and other
congenital
heart defects (structural problems present at birth).
- The aorta. Echocardiography is commonly used to
assess and detect problems with the aorta such as
aneurysm
(abnormal bulge or ballooning in the wall of an artery).
- Blood clots or tumors. If you have had a stroke,
echocardiography might be done to check for blood clots or tumors that may have
caused it.
Doctors also use echocardiography to see how well
your heart responds to certain heart treatments, such as treatment for heart
failure.
Types of Echocardiography
There are several different types of
echocardiographyall use sound waves to create images your heart. This is
the same technology that allows doctors to see an unborn baby inside a pregnant
mother. Unlike x rays and some other tests, echocardiography doesnt
involve radiation.
Transthoracic Echocardiography
Transthoracic (tranz-thor-AS-ik) echocardiography is
the most common type of echocardiogram test. Its painless and
noninvasive. Noninvasive means that no surgery is done and no
instruments are inserted into your body.
This type of echocardiography involves placing a
device called a transducer on your chest that sends special sound waves, called
ultrasound, through your chest wall to your heart. Ultrasound
waves cant be heard by the human ear. As the ultrasound waves bounce off
the structures of your heart, a computer in the echocardiography machine
converts them into pictures on a screen.
Stress Echocardiography
This is an echocardiography test thats done as
part of a cardiac stress test.
During a cardiac stress test, you exercise or take medicine (given by your
doctor) to make your heart pump harder and beat faster. Some heart problems,
such as
coronary
artery disease, are easier to diagnose when the heart is beating fast and
pumping hard.
Transesophageal Echocardiography
With standard transthoracic echocardiography, it can
be difficult to see the aorta and certain other parts of your heart. If your
doctor needs a better look at these areas, he or she may recommend
transesophageal (tranz-ih-sof-uh-JEE-ul) echocardiography.
In this test, the transducer is attached to the end
of a flexible tube thats guided down your throat and into your esophagus
(the tube leading from your mouth to your stomach) to get a more detailed image
of your heart.
Fetal Echocardiography
This type of echocardiography is used to look at an
unborn babys heart. A doctor may recommend this test to check the baby
for heart problems. Fetal echocardiography is commonly performed during
pregnancy at about 18 to 22 weeks.
Other Names for Echocardiography
- Ultrasound of the heart
- Echo
- Surface echo
What To Expect Before Echocardiography
Echocardiography can be performed in a doctors
office or a hospital. No special preparations are needed for most types of
echocardiography. Usually you can eat, drink, and take any medicines as you
normally would. The exception is if youre having a transesophageal
echocardiography. This test usually requires that you dont eat or drink
for 8 hours prior to the test.
If youre having a stress echocardiography,
there may be special preparations. Your doctor will advise you on how to
prepare for your echocardiography test.
What To Expect During Echocardiography
Echocardiography is painless and usually takes less
than an hour to perform. For some tests, the doctor will need to inject saline
or a special dye into your vein that makes your heart show up more clearly on
the test images. This special dye is different from the dye used during an
angiogram test.
For most types of echocardiography, you will be
asked to remove your clothing from the waist up. Women will be given a gown to
wear during the procedure. You will lay on your back or left side on an exam
table or stretcher.
EKG electrodes will be attached to your chest to
allow an EKG to be done. A doctor or sonographer (a person specially trained to
do ultrasounds) will apply a gel to your chest that helps the sound waves reach
your heart. A wand-like device called a transducer will then be moved around on
your chest.
The transducer transmits ultrasound waves into your
chest. Echoes from the sound waves will be converted into pictures of your
heart on a computer screen. During the test, the lights in the room are dimmed
so the computer screen is easier to see.
The sonographer will make several recordings of the
images to show different locations in your heart. The recordings will be put on
a computer disc or videotape for the cardiologist (a doctor who specializes in
treating people who have heart problems) to review.
During the test, you may be asked to change
positions or hold your breath for a short time so that the sonographer can get
good pictures of your heart. At times, the sonographer may apply a bit of
pressure to your chest with the transducer. This pressure can be a little
uncomfortable, but it helps the sonographer get the best picture of your heart.
You should let him or her know if you feel too uncomfortable.
Echocardiography is similar for fetal
echocardiography, except in that test the transducer is placed over the
location of the developing babys heart.
Transesophageal Echocardiography
Transesophageal echocardiography (TEE) is used when
the doctor needs a more detailed view of your heart. This may be necessary to
look for blood clots in the heart or if transthoracic echocardiography
doesnt provide a good enough view of certain parts of the heart. A
doctor, not a sonographer, performs this type of echocardiography.
The test uses the same technology as transthoracic
echocardiography, but the transducer is attached to the end of a flexible tube.
The tube is guided down your throat and into your esophagus (the tube leading
from your mouth to your stomach) to get a more detailed image of the heart and
major blood vessels leading to and from the heart.
For TEE, you will probably be given medicine through
a needle inserted in one of your veins to help you relax during the test. Your
blood pressure, the oxygen content of your blood, and other vital signs will be
monitored during the test. You will be given oxygen through a tube to your
nose. If you wear dentures or partials, you will have to remove them.
The back of your mouth is numbed with a gel or a
spray so that you dont gag when the transducer is put down your throat.
The tube with the transducer on the end is gently placed in your throat and
guided down until its in place behind the heart. The images of your heart
are then recorded as the doctor moves the transducer around in your esophagus
and stomach. You shouldnt feel any discomfort as this happens. Although
the imaging usually takes less than an hour, you may be monitored for a few
hours at the doctors office or hospital after the test.
Stress Echocardiography
Stress echocardiography is a transthoracic
echocardiogram combined with either an exercise or chemical stress test. For an
exercise stress test, you walk or run on a treadmill or pedal a stationary
bicycle to make your heart beat fast and pump hard. For a chemical stress test,
youre given medicine to make your heart beat fast and pump hard.
The Diseases and Conditions Index
Stress Testing article provides
additional information on what to expect during a cardiac stress test.
What You May See and Hear During
Echocardiography
As the doctor or sonographer moves the transducer
around, different views of your heart can be seen on the screen of the
echocardiography machine. The structures of the heart will appear as white
objects, while any fluid or blood will appear black on the screen.
Doppler ultrasound techniques are often used during
echocardiography tests. Doppler ultrasound is a special ultrasound that shows
how blood is flowing through the blood vessels. This allows the sonographer to
see the blood flowing in different speeds and directions. The speeds and
directions appear as different colors moving within the black and white
images.
The human ear is unable to hear the sound waves used
in echocardiography. If Doppler ultrasound is used, however, you may be able to
hear a whooshing sound as the echocardiography machine converts the
echoes into sounds that can be heard and which the doctor can use as
information about the flow of blood through your heart.
What To Expect After Echocardiography
You usually can go back to your normal activities
immediately after the test. You may not be able to drive after a
transesophageal echocardiography. Your doctor will let you know whether you
need to arrange for someone to take you home.
What Does Echocardiography Show?
An echocardiography shows the size, structure, and
movement of the different parts of your heart, including the valves, the septum
(the wall separating the chambers on the right and left sides of the heart),
and the walls of the heart chambers. The Doppler ultrasound technique shows the
movement of blood through the heart.
Echocardiography can be used to:
- Diagnose heart problems
- Guide or determine next steps for treatment
- Monitor changes and improvement
- Determine the need for additional tests
Echocardiography can detect many different types of
heart problems. Some of these can be minor and pose no risk to you. Others can
be signs of serious heart disease or other heart problems. An echocardiography
can provide information on:
- The size of your heart. An enlarged heart can be
the result of
high
blood pressure, leaky heart valves, or
heart
failure.
- Heart muscles that are weak and arent
moving (pumping) properly. Weakened areas of heart muscle can be due to damage
from a
heart
attack. Or weakening could mean that the area isnt getting enough
blood supply, which can be due to
coronary
artery disease.
- Problems with your hearts valves.
Echocardiography can show whether any of the valves of your heart dont
open normally or dont form a complete seal when closed.
- Abnormalities in the structure of your heart.
Echocardiography can detect a variety of heart abnormalities, such as a hole in
the septum (the wall that separates the two chambers on the left side of the
heart from the two chambers on the right side) and other
congenital
heart defects (structural problems present at birth).
- The aorta. Echocardiography is commonly used to
assess and detect problems with the aorta such as
aneurysm
(abnormal bulge or ballooning in the wall of an artery).
- Blood clots or tumors. If you have had a stroke,
echocardiography might be done to check for blood clots or tumors that may have
caused it.
What Are the Risks of Echocardiography?
There are no risks associated with transthoracic or
fetal echocardiography. If you have a transesophageal echocardiography, there
are some risks associated with medicine given to help you relax. These include
a bad reaction to the medicine, difficulty breathing, or nausea. Your throat
also might be sore for a few hours after the test. On rare occasions, the tube
can cause a minor throat injury.
There are risks associated with stress
echocardiography, but these are related to the exercise or medicine used to
raise your heart rate, not to the echocardiography part of the test. Serious
complications from cardiac stress tests are very uncommon. See the Diseases and
Conditions Index Stress Testing
article for more information about the risks of that test.
Key Points
- Echocardiography is a painless test that uses
sound waves to create images of your heart.
- This test provides your doctor with information
about the size and shape of your heart and how well your hearts chambers
and valves are working. In addition, a type of echocardiography called Doppler
ultrasound shows how well blood flows through the chambers and valves of your
heart.
- Your doctor may recommend echocardiography if
youre suffering from signs and symptoms that heart problems could cause.
The test can be used to confirm a diagnosis, determine the status of an
existing problem, or help guide treatment.
- There are different types of echocardiography.
Transthoracic and stress echocardiographies are standard types of the test.
Transesophageal echocardiography (TEE) is used if the standard tests dont
produce clear results. A fetal echocardiography is used to look at an unborn
babys heart.
- Echocardiography takes place in a doctors
office or hospital. The test usually takes up to 1 hour. A standard
echocardiography doesnt require any special preparations or followup. If
youre having a TEE, you usually shouldnt eat or drink for 8 hours
prior to the test.
- During a standard echocardiography, the doctor or
sonographer will move a wand-like device called a transducer around on your
chest to get images of your heart. During a TEE, the transducer will be put
down your throat to get a better view of your heart.
- A cardiologist will analyze the results from your
echocardiography.
- You usually can go back to your normal activities
immediately after having an echocardiography.
- There are no risks associated with transthoracic
or fetal echocardiography. If you have TEE, there are some risks associated
with the medicine given to help you relax. On rare occasions, the tube used in
TEE can cause minor throat injury. The risks for stress echocardiography are
related to the exercise or medicine used to raise your heart rate. Serious
complications from a stress echocardiography are rare.
Links to Other Information About
Echocardiography
NHLBI Resources
Non-NHLBI Resources
Clinical Trials
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