An echocardiogram is a non-invasive ultrasound test that uses sound waves to create real-time images of the heart. It allows doctors to see how the heart moves, pumps blood, and how the heart valves function. Because it provides direct information about heart structure and function, the echocardiogram is one of the most important tests in cardiology.
The test is painless, safe, and does not involve radiation.
What Does an Echocardiogram Show?
An echocardiogram provides detailed information about the heart that cannot be obtained from an ECG alone. It allows doctors to assess:
- The size and shape of the heart chambers
- How well the heart muscle contracts and relaxes
- Heart valve structure and function
- Blood flow through the heart
- The presence of fluid around the heart
- Pressure estimates inside the heart
Because the images are obtained in real time, doctors can observe how the heart works beat by beat.
Why Is an Echocardiogram Performed?
An echocardiogram is ordered when symptoms or other tests suggest a heart problem, or to monitor known heart disease. Common reasons include shortness of breath, chest discomfort, leg swelling, heart murmurs, palpitations, fainting, or abnormal ECG findings.
It is also used to evaluate conditions such as heart failure, valve disease, cardiomyopathy, congenital heart disease, pulmonary hypertension, and pericardial disease.
How Is an Echocardiogram Performed?
The most common type is a transthoracic echocardiogram. You lie on an examination table while a technician places a small probe on the chest with gel. The probe sends and receives sound waves, which are converted into heart images on a screen.
You may be asked to change position or briefly hold your breath to improve image quality. The test usually takes 20 to 40 minutes.
What Will I Feel During the Test?
An echocardiogram is painless. You may feel light pressure from the probe on the chest, but there is no discomfort from the ultrasound itself.
Doppler and Color Echocardiography
Modern echocardiograms include Doppler imaging, which shows how blood flows through the heart. Color Doppler highlights blood flow direction and speed, helping detect valve leaks, narrowing, or abnormal connections.
This information is essential for diagnosing and grading valve disease and assessing pressure inside the heart.
Different Types of Echocardiograms
Although many people think of echocardiography as a single test, there are several different types of echocardiograms. Each one is designed to answer a specific clinical question. Your doctor chooses the most appropriate type based on your symptoms, medical history, and what needs to be evaluated.
Transthoracic Echocardiogram (TTE)
The transthoracic echocardiogram is the most common and widely used form of echocardiography. It is performed by placing an ultrasound probe on the chest wall to obtain images of the heart.
This test provides essential information about heart size, pumping strength, valve function, and overall heart structure. For most patients, this standard echocardiogram is sufficient to diagnose or rule out many heart conditions, including heart failure, valve disease, and cardiomyopathies.
Because it is completely non-invasive, painless, and does not require sedation, it is usually the first-line echocardiographic test.
Transesophageal Echocardiogram (TEE)
A transesophageal echocardiogram is used when more detailed images are needed than those obtained through the chest wall. In this test, a specialized ultrasound probe is gently passed into the esophagus, which lies directly behind the heart.
Because the probe is much closer to the heart, TEE provides highly detailed images of heart valves, chambers, and blood clots, especially in areas that may be difficult to visualize from the chest.
TEE is commonly used to:
- Evaluate heart valve infections or severe valve disease
- Look for blood clots in the heart, particularly in atrial fibrillation
- Guide certain procedures such as cardioversion or valve interventions
Sedation is used to ensure comfort during the test, and patients typically recover quickly afterward.
Stress Echocardiogram
A stress echocardiogram evaluates how the heart functions when it is working harder. Images of the heart are taken at rest and then repeated during physical exercise or after medication that simulates exercise.
This type of echocardiogram helps determine whether parts of the heart muscle are not receiving enough blood during exertion. It is particularly useful for assessing suspected coronary artery disease, unexplained shortness of breath during activity, or reduced exercise tolerance.
Stress echocardiography can also assess how well the heart responds to increased workload and help guide treatment decisions.
Choosing the Right Type of Echocardiogram
Each echocardiogram serves a specific purpose. A standard transthoracic study is usually enough for routine evaluation, while transesophageal or stress echocardiography is reserved for situations where additional detail or functional information is required.
Your doctor will explain why a particular type of echocardiogram is recommended and what information it is expected to provide.
What an Echocardiogram Cannot Show
Although very powerful, an echocardiogram does not directly visualize the coronary arteries. It cannot always detect early coronary artery disease unless it affects heart muscle function.
In such cases, additional tests may be needed.
Is an Echocardiogram Safe?
Yes. Echocardiography is extremely safe. It uses sound waves, not radiation, and can be repeated as often as necessary, including during pregnancy.
After the Echocardiogram
You can resume normal activities immediately after the test. The images are reviewed by a cardiologist, and the results are discussed with you in the context of your symptoms and other findings.
In Summary
An echocardiogram is a cornerstone test in cardiology that provides detailed, real-time information about heart structure, pumping function, valves, and blood flow. It is painless, safe, and essential for diagnosing and monitoring many heart conditions. When combined with clinical evaluation and other tests, echocardiography plays a central role in guiding accurate and effective heart care.
Reference: Echocardiogram
