What is an Echocardiogram?

An echocardiogram, also called an echo, is a type of ultrasound test that evaluates the heart, the heart's valve function, and the blood flow in both. It also evaluates the motion of the heart’s walls and the amount of blood the heart pumps with each stroke.

Technically, echocardiograms use high-pitched sound waves sent through a device called a transducer. The device picks up the echoes of these sound waves as they bounce back off your heart. These echoes are turned into real-time, moving pictures of your heart that can be seen on a monitor. Echo is often combined with Doppler ultrasound and color Doppler to better see or identify blood flow across the heart's valves.

Doctors often suggest an echocardiogram when they suspect problems with the valves or chambers of a patient’s heart or it’s ability to pump. However, an echocardiogram is also able to be used to detect congenital heart defects in unborn babies. Besides the ability to assess the overall function of your heart, an echo can help determine the presence of many types of heart disease, follow the progress of heart valve diseases over time or evaluate the effectiveness of medical or surgical treatments.

Depending on what information a doctor needs, they may request one of the following kinds of echocardiograms:

Transthoracic echocardiogram (TTE). This is the most common type. Views of the heart are obtained by moving a transducer over different locations on your chest or abdominal wall. If any lungs or ribs block the view, a small amount of intravenous dye may be used to improve the images. It is a painless test similar to X-ray, but without the radiation.

Stress echocardiogram. Some heart problems, like those involving the coronary arteries, occur only during physical activity. During a stress echocardiogram, ultrasound images of a heart are taken before and immediately after the patient has been on a treadmill or rode a stationary bike. A stress echocardiogram is usually done to find out if there is a decreased blood flow to the heart (coronary artery disease, or CAD). It may reveal a lack of blood flow that isn't always apparent on other heart tests.

Dobutamine or adenosine/sestamibi stress echocardiogram: This is another form of stress echocardiogram. The test is given to evaluate heart and valve functions when a patient is unable to exercise on a treadmill or stationary bike. The stress is then obtained by giving a drug that stimulates the same effect. Like a stress echo, it is also used to determine how well a heart can tolerate activity and the likelihood of having coronary artery disease (blocked arteries), as well as evaluating the effectiveness of most cardiac treatment plans.

Intravascular ultrasound: This is a form of echocardiography performed during cardiac catheterization. During this procedure, instead of using a handheld transducer, a special, tiny transducer is threaded into the heart blood vessels via a catheter in the groin. It is often used to provide detailed information about the atherosclerosis (blockage) inside the blood vessels and can provide a more detailed view than some of the other echo procedures.

Doppler echocardiogram. When sound waves bounce off blood cells moving through your heart and blood vessels, they change pitch. These changes, called Doppler signals, can help a qualified doctor and ultrasound machine measure the speed and direction of the blood flowing in and out of heart chambers, heart valves, and blood vessels. Doppler measurements may be displayed in black and white or in color. Doppler techniques are used in most transthoracic and transesophageal echos, and can check blood flow problems that traditional ultrasounds might not detect.

Transesophageal echocardiogram (TEE). If it's difficult to get a clear picture of your heart with a standard echocardiogram, a transesophageal echocardiogram may be performed. In this procedure, instead of moving a transducer over the outside of a chest, a flexible tube containing a smaller-sized transducer is guided down your throat and into your esophagus. From there, the transducer can obtain more detailed images of the heart. The patient’s throat will be numbed, and medications are available to ease the procedure. But the benefits are the ability to show clearer pictures of the heart since the probe is located closer to it and the lungs and the chest wall bones do not block the sound waves.

To find a list of qualified doctors or facilities for any of these procedures near you, click here.