Echocardiogram

What is it?

According to the NHS: an echocardiogram is a heart test carried out to see how well it is working, and relies on ultrasound, the same technology used in pregnancy scans.

According to the NHS: the most common type is the transthoracic echo (TTE) performed from outside the body on the chest. The other types are: transoesophageal echo (TOE), stress echo, and contrast echo.

According to MedlinePlus: the echo of the sound waves is converted into moving two- or three-dimensional images depending on the part of the heart being examined, and a Doppler test assesses the movement of blood through the heart.

Why is it done?

According to the NHS the test is carried out to check whether symptoms may be caused by heart disease, and to see how well the heart is working in someone with a known heart problem, and is used after a heart attack or to diagnose heart failure, valve diseases and congenital defects.

According to MedlinePlus the test assesses the heart valves, chambers and pericardium (the membrane surrounding the heart). It reveals, for example, abnormal valves, congenital heart disease, damage to the heart muscle after a heart attack, heart murmurs, pericarditis and fluid around the heart, infective endocarditis, pulmonary hypertension, the severity of heart failure, and sources of clots after a stroke or transient ischaemic attack.

Preparation

According to the NHS: you can usually eat and drink as normal before the test, and fasting is only required for the transoesophageal echo (TOE). You can ask for a chaperone during the test.

According to MedlinePlus: no special steps are needed for the transthoracic echo, whereas for the transoesophageal (TEE) you will not be able to eat or drink for several hours before the test.

Ask the testing centre for their specific instructions, as these are the ones that apply in your case.

How is it done?

The steps of the transthoracic echo according to the NHS: you remove your upper clothing and put on a hospital gown, then lie down and electrodes are stuck on to monitor the heartbeat. You may be given a contrast agent through a vein in the arm. The sonographer applies conducting gel then moves the probe across the chest, and the test takes about 30 to 40 minutes.

According to MedlinePlus: you will feel slight pressure on the chest when the probe is moved, and you may be asked to change your body position during imaging.

The transoesophageal echo according to the NHS: a thin tube carrying a small ultrasound device is passed from the mouth down into the oesophagus for more detailed images, and it is not painful but may be uncomfortable. According to MedlinePlus the throat is numbed and sedatives are given, and the probe is guided by a cardiologist.

Stress echo according to the NHS: combines a transthoracic echo with exercise on a treadmill or bicycle, or the use of a medicine that mimics the effect of exercise, with imaging afterwards.

Understanding the result

According to MedlinePlus: a normal echo shows normal valves and chambers and normal movement of the heart wall.

According to MedlinePlus: an abnormal echo may mean many things; some differences are minor and pose no great risk, and some are a sign of serious heart disease. Examples include valve diseases, cardiomyopathy and pericardial effusion.

According to the NHS the doctor may discuss the results straight after the test or at a later appointment. Laboratories, guidelines and machines differ, so what applies is the test report and the doctor's interpretation.

Risks and side effects

According to MedlinePlus: there are no known risks for the transthoracic echo.

The transoesophageal echo is more invasive. According to MedlinePlus its risks include a reaction to the sedatives and injury to the oesophagus, which are more likely for someone with an oesophageal problem.

According to the NHS: a sore throat may remain for one to two days after an oesophageal echo. You may be asked to stay for about 30 minutes for observation after the contrast injection. After sedation driving is prohibited for 24 hours.

Limits of the test

The sources that were read do not list specific limits of the test; according to MedlinePlus tissue obstruction may prevent a clear image, so a contrast agent is injected.

After the test

According to the NHS the doctor may explain the result immediately or at a follow-up appointment. What is needed after the result is decided by your doctor.

Common questions