Sound waves produce images of heart structure and movement
An echocardiogram or echo is an imaging technique that uses ultrasound (sound waves) to take pictures of your heart while it’s beating. An echo shows all aspects of the heart, including the chambers, valves and vessels, and how they’re moving together. Your doctor may suggest an echocardiogram to look for signs of heart disease. You may also need an echocardiogram to see how well the heart is functioning or to monitor the heart’s progress over time. This test can also help doctors see how well medical or surgical devices or treatments are working.
Different types of echocardiograms
There are different types of echocardiograms used for different purposes. Depending on your condition and what your doctor is looking for, you may need:
- Dobutamine stress echocardiogram – This type of echo may be done if you are unable to perform the exercise stress echocardiogram (due to too much stress on the heart). The drug dobutamine makes the heart work harder, imitating what it does during exercise. Electrodes (sticky patches with metal inside) are placed at different spots on the chest to conduct the electrical currents of the heart. The person administering the test (sonographer) then uses a transducer (wand that puts out ultrasound waves) over your chest area to capture images of the heart. Your doctor may ask you to not eat or drink anything for a few hours before the test. It is also recommended that you avoid caffeine or alcohol beforehand as these may interfere with your heart rate.
- Exercise stress echocardiogram – This test is performed while you’re walking on a treadmill or riding an exercise bike. It is used to measure how the heart performs when you’re physically active. Some symptoms only occur when the heart is stressed in this way. With the exercise stress echo, electrodes are also placed on the chest to help measure the heart’s conductivity while you’re moving. You’ll need to wear comfortable shoes for this test and your doctor may prefer you don’t eat or drink anything for several hours beforehand.
- Transesophageal echocardiogram – In some cases, your doctor may need to get a more detailed look at your heart and vessels. This type of test involves guiding a thin tube with a transducer on the end down your throat and into your esophagus where it can take more exact images. You will be awake during the procedure but the throat will be numbed and you will receive medication (anesthesia) to help you relax. You’ll be advised not to drink or eat anything beforehand and to arrange for someone to drive you afterwards since you’ll have had some anesthesia.
- Transthoracic echocardiogram – This is a standard echocardiogram involving the use of electrodes and a transducer placed against the skin of your chest in different positions to get multiple images of the heart. The procedure is done with or without contrast, which is a special liquid that may be injected via intravenous (IV) line to your heart, to make a sharper image.
Vascular ultrasound is a related type of imaging test that focuses specifically on the veins and arteries.
Risks associated with echocardiograms are rare. You may have some mild discomfort, for example when the electrodes are removed from your skin or when the tube is removed after a transesophageal echo. Your doctor will review your echocardiogram and explain the results to you. Your doctor will then make treatment recommendations based on your age, current health condition, lifestyle and other factors.