Echocardiogram

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What is an echocardiogram?

An echocardiogram, also known as an echo, is a scan of the heart. It is similar to ultrasound scanning used in pregnancy because it uses sound waves to build up a picture of your heart.

An echo is not the same as an electrocardiogram, also known as an ECG, which is a simple and useful test that records the rhythm, rate and electrical activity of your heart.

What does an echocardiogram show?

An echo looks at the structures of your heart, such as your heart valves. It also looks at how the blood flows through the main arteries and veins of the heart and gives information on how well your heart is pumping.

An echo is often done to diagnose and assess the following conditions:  

• heart attack
• heart failure
• heart valve problems
• congenital heart disease
• inherited heart conditions
• heart rhythm problems.

What happens when you have an echocardiogram?

• You will be given a hospital gown to wear as you will need to remove all clothing from your top half when the echo is done. Your privacy will be maintained as you will be behind curtains or in a hospital clinic room in the outpatients department.

• With a standard echo, sometimes called a transthoracic echo or TTE, you’ll be asked to lie on a couch or bed. A gel used especially for scanning will be used to help the sound waves reach your heart. It feels cold and sticky, but is otherwise harmless.

• The healthcare professional (called a sonographer) doing the procedure will move the probe in different areas of your chest around your heart. The probe gives off pulses of high frequency sound waves which pass through your skin to your heart. This may sound like a "swishing" noise as the ultrasound waves "echo" against the structures of your heart, as well as the sound of the blood flow through the chambers of the heart. The probe picks up these reflections and shows them as images on a screen. 

• Different parts of the heart are seen as the probe is moved around on your chest.

How long will an echocardiogram take?

It varies from person to person and can take from 15 minutes up to an hour. It’s a very common, safe test, and most people find it’s not uncomfortable, although you may feel a bit of pressure as the technician presses the probe onto your chest to obtain the best images. Electrodes (small sticky dots) will normally be attached to your chest to monitor your heart rate and rhythm during the test.

In some cases the results of the scan maybe discussed with you in a clinic appointment with your heart doctor after the scan otherwise the results will be sent to your GP. Most people go home after the scan is finished.

There are no risks or side effects from having a standard echo. Your doctor will discuss any risks or side effects if you need a different type of echo.

Other types of echocardiogram

The type of echo that you will have will depend on the condition that the doctor is trying to diagnose and treat.

Transoesophageal echocardiogram (TOE)

A transoesophageal echocardiography, or TOE, takes detailed pictures of your heart from your oesophagus (the tube that connects your throat to your stomach) which lies behind your heart. This test is used to get closer and more defined images of the heart as it can detect areas of the heart that are not as easy to see with a standard echo.

You will be asked to lie on your side and ‘swallow’ a small probe which is mounted at the end of a flexible tube. A local anaesthetic that numbs the area will be sprayed onto the back of your throat and you will be offered a short-acting light sedative to help you relax. The procedure usually takes about 30 minutes. You may need to avoid eating for several hours before this test.

The technician will obtain the images they need and remove the tube as soon as the procedure is done.

Watch the film below to see Dave's experience of a TOE:

Stress echocardiogram

An echocardiogram may be done while the heart is beating faster – a stress echo is performed while deliberately increasing the heart rate with either exercise on a treadmill or stationary bike, or with medication given through a vein. This test can help to diagnose coronary heart disease as it shows the coronary arteries in the heart aren’t getting as much oxygen rich blood as they should.

Contrast echo

To create a better image on a scan, a contrast or dye is injected into your vein.

Foetal echocardiogram

Foetal echocardiograms are used to help identify heart defects before a child is born. 

Bubble echo

This is sometimes called a bubble study. 

A bubble echo involves performing an echo in the usual way whilst a small amount of salt water (saline) is injected into your bloodstream, through a vein in your arm. The salt water contains tiny bubbles which show up clearly on the scan pictures, and can be a useful way to identify a hole in the heart. It may be carried out after a stroke or TIA, or after complex heart surgery. 

The test is quick and painless, and the bubbles are harmless.

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