An echocardiogram (echo) is a simple test which uses sound waves (ultrasound) to take a moving picture of your heart. It allows your doctor to “see” how your heart muscle is working and how your heart valves are opening and closing.
There are 2 main types of echo:
Trans-thoracic echo (TTE): a doppler probe device is moved over your chest creating sound wave pictures of your heart through your chest wall
Trans-oesophageal echo (TOE): a smaller probe is passed down into your oesophagus allowing detailed pictures of the heart’s structures to be seen because your oesophagus is right behind the heart.
Why is it done
This common test is done to look at the size and functioning of your heart. It can ‘see’ how well the heart is pumping, whether the heart valves are opening and closing normally, determine if there is any clot in your heart, detect infection on your valves or fluid surrounding your heart and signs of heart failure.
Your doctor may suggest doing this test if he or she suspects problems with the heart valves or you have symptoms of shortness of breath or chest pain.
There are no risks involved in a standard trans-thoracic echocardiogram. You may feel some discomfort on your chest wall as the probe is moved around on your chest to get the best pictures.
If a trans-oesophageal echo is done, your throat may be sore for a few hours afterward. Rarely, the tube may scrape the inside of your throat leaving it sore a little longer.
The standard trans-thoracic echo involves you lying on your back or side. A technician or your doctor will put a special jelly on to a probe which is then placed on your chest and moved around until a good quality image of your heart is recorded.
Sometimes the images are difficult to get and the probe needs to be moved around so there may be some discomfort to the chest wall. Be sure to tell the operator if it is uncomfortable.
Many different views of your heart will be taken to give a better idea of what the heart looks like. The sound waves create images of your heart which you may be able to see on the monitor. You may hear a pulsing ‘whooshing sound’. This is the ultrasound recording the blood flowing through your heart. The technician will record the images of your heart.
The whole procedure may last up to 25 minutes and has no side effects.
For a trans-oesophageal echo your throat will be numbed with a numbing spray or gel first and you may be given medicine to help you relax. A flexible tube containing a transducer probe is then passed down your throat into your oesophagus. Once in place the probe can be positioned to obtain detailed images of your heart and heart valves.
Your oxygen level will be monitored during the exam to check for any breathing problems caused by sedation medication.
Once the test is complete you can usually resume your normal activities. If the echo is normal, you may not need any further tests. Depending on why you were having the test you may need to have it repeated in several months or on an annual basis.
Treatment depends on what the findings of the exam suggest and what your specific signs and symptoms are.
Often, the images are reviewed by the cardiologist at a later time and the report will be forwarded to your referring doctor with any recommendations of treatment if indicated.
Results may show:
Heart size – an enlarged heart or thickened walls of the heart can result from heart problems including damaged valves, high blood pressure, cardiomyopathy, atrial fibrillation.
Heart function – pumping strength of the heart muscle can be measured as a percentage of blood pumped out of the heart with each heartbeat. This is called the ejection fraction.
Damaged heart muscle – damage caused by a heart attack may be seen where isolated parts of the muscle wall move weakly or poorly.
Weakened or damaged valves – the valves don’t open wide enough to allow adequate blood flow through or they don’t close fully allowing blood to leak back.
Heart defects – problems with the chambers of the heart, abnormal connections between the chambers or the major blood vessels, and birth defects can be identified.
Heart & Stroke Conditions A-Z – see our range of guides.
Step by Step through Heart Attack – our patient information booklet
Step by Step through Stroke – our patient information booklet
Step by Step through Heart Medicines – our patient information booklet
Step by Step through Inherited Heart Disease – our patient information booklet
Step by Step through Heart Failure – our patient information booklet
Angina – our guide from symptoms to treatment
AF and You – our information booklet for people living with Atrial Fibrillation