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Echocardiogram

An echocardiogram is a painless procedure that uses ultrasound to produce a moving 'real-time' image of the inside of your heart.

This is similar to the procedure carried out to check a growing baby during pregnancy. It's sometimes referred to as an echo.

  • About echocardiograms
  • What are the alternatives?
  • Preparing for your procedure
  • About the procedure
  • Getting your results
  • What are the risks?
  • Further information
  • Sources
  • Related topics

About echocardiograms

An echocardiogram is a useful test for checking the structure of your heart and how well it is functioning. It uses an ultrasound probe, which is run over your chest to get a moving picture of your heart.

The test can also be carried out with the heart under stress, to see how the heart copes. This is called a stress echocardiogram.

Why do I need an echocardiogram?

Reasons for having an echocardiogram include:

to check the pumping function of the heart (for example if you have had a heart attack or have symptoms of heart failure)

to look for damage to the heart valves

to diagnose coronary heart disease (a stress echocardiogram is useful for this)

to check for heart defects in newborn babies and young children

to look for heart defects in unborn babies (fetal echocardiogram)

What are the alternatives?

Alternative imaging procedures to an echocardiogram include:

  • a transoesophageal echocardiogram (TOE) - this is another type of echocardiogram, in which images are taken from a probe placed inside your oesophagus (the pipe that goes from your mouth to your stomach)
  • a radionuclide test - this is a test in which you are injected with a harmless, radioactive substance that is picked up on a special camera as it travels through your heart
  • cardiac MRI (magnetic resonance imaging) test - this uses magnets and radiowaves to produce images of the inside of your heart

Your doctor will advise you which procedure is most suitable for you.

Preparing for your procedure

Echocardiograms are carried out in hospital by a cardiologist (a doctor specialising in conditions of the heart) or a technician trained in the procedure (a sonographer).

You will be asked to attend the hospital as an out-patient and should follow any instructions given to you in your appointment letter. If you are having a stress echocardiogram, it is normal to stop taking certain medicines before the procedure.

About the procedure

The test normally takes between 15 and 45 minutes. At the hospital, you will be asked to undress to the waist. The doctor or technician will then rub a clear gel over the left side of your chest. This is to make sure there will be a good, airtight contact between your skin and the probe. Sticky patches called ECG electrodes will be attached to your chest. These give a record of the electrical activity in your heart, and allow the doctor or technician to see how the moving images of your heart relate to your heart rhythm.

You will be asked to lie on a couch, turned on your left side. The probe will put in position over your skin. When the ultrasound machine is switched on, the probe will start to give out ultrasound waves (you won't be able to feel these). As the probe is moved across your chest, the ultrasound waves will pass into your body and bounce off the different structures in your heart, and back into the probe.

The echocardiogram machine can detect the ultrasound waves that have bounced back, creating a moving image of your heart on a screen. You will hear whooshing noises as the flow of blood through the heart is measured with the ultrasound beam. If a doctor is doing the test, he or she may be able to tell you straight away how your heart is functioning and whether there is any structural abnormality present.

Stress echocardiogram

This is carried out in exactly the same way as described, except that your heart will be examined while under stress. This is achieved in one of the following ways.

  • You may be asked do some exercise, such as walking on a treadmill. An echocardiogram will then be carried out immediately afterwards.
  • You may have a medicine injected into a vein in your arm to increase your heart rate while the echocardiogram is carried out. The dose of medicine will be gradually increased every few minutes so that the doctor can see what effect it has on your heart. This test can take up to an hour.

Getting your results

The results of your echocardiogram may be discussed with you immediately after the examination. Alternatively, your results may be sent to the doctor who requested you have the test (for example, your GP), who will discuss them with you at your next appointment.

What are the risks?

An echocardiogram is painless and safe. It does not use radiation and so carries none of the associated risks.

Stress echocardiograms that use a drug to increase your heart rate can occasionally cause rhythm problems or chest pains. The staff at the hospital will be fully trained in deal with problems such as this. There is also a small risk that you might get slight bruising in the area where you have the injection, and a very small chance that you may be allergic to the injection.

The exact risks are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

Further information

British Cardiac Patients Association

British Heart Foundation

Sources

  • Kumar P, Clark M. Echocardiography, in Clinical Medicine. 6th ed. London: Elsevier, 2005:749-755
  • Tests for heart conditions. British Heart Foundation, May 2004, health information series number 9. www.bhf.org.uk
  • Simon C, Everitt H, Kendrick T. Oxford handbook of general practice. 2nd ed. Oxford: Oxford University Press, 2005
  • Stress echocardiogram. British Cardiovascular Society, 2001. www.bcs.com
  • Echocardiography, cardiac ultrasound. British Cardiac Patients Association. www.bcpa.co.uk, accessed 30 January 2008
  • Kasper DL, Fauci AS, Longo DL, et al. Harrison's Principles of Internal Medicine. 16th ed. New York: McGraw-Hill, 2005: 1320-1323

Related topics

  • Diagnosing heart conditions
  • Electrocardiogram
  • Heart attack
  • Heart failure
  • Heart valve disease