Echocardiogram

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What is an echocardiogram?

An echocardiogram is an ultrasound scan of the heart. It is sometimes just called an 'ECHO'. Ultrasound is a very high frequency sound that you cannot hear, but it can be emitted and detected by special machines. The scan can give accurate pictures of the heart muscle, the heart chambers, and structures within the heart such as the valves.

What happens during the test?

You will need to undress to the waist and lie on the couch. A probe is placed on your chest (it is a bit like a very thick blunt pen). Also, lubricating jelly is put on your chest so the probe makes good contact with the skin. The probe is connected by a wire to the ultrasound machine and monitor. Pulses of ultrasound are sent from the probe through the skin towards your heart. The ultrasound waves then echo ('bounce back') from the heart and various structures in the heart.

The amount of ultrasound that echoes back depends on the density of the tissue the sound has hit. Therefore, the different structures send back different echoes. For example, ultrasound travels freely through fluid so there is little echo from blood in heart chambers. But, heart valves are dense tissues so ultrasound waves hitting a valve will echo back clearly.

The echoes are detected by the probe and are sent to the echocardiogram machine. They are displayed as a picture on the monitor. The picture is constantly updated so the scan can show movement as well as structure. (For example, the valves of a heart opening and closing.) The operator moves the probe around over the skin surface to get views from different angles. Some abnormalities can be seen quite clearly. For example, damaged heart valves, thickened heart muscle, some congenital heart defects, etc.

The test is painless and takes about 30-45 minutes. You may have to turn on your side during the test so the operator can scan the heart from different angles.

You do not need any special preparation before the test. You eat and drink normally before and after the test. Continue to take your usual medication.

Other forms of echocardiography

Doppler echocardiography. This can measure variations in blood flow in different parts of the heart. For example, if can detect turbulent flow next to a damaged valve. It can assess how well the heart valves are working.

Transoesophageal echocardiography. In this test you swallow a probe that is attached to a thin wire connecting it to the ultrasound machine. This views the heart from within the oesophagus (gullet) which lies just behind the heart. This can give a clearer view of the heart than normal echocardiography. It is done in situations where a very detailed picture is needed. For example, to assess valves before surgery is done to repair damaged valves, or to assess the extent of infection of a heart valve. The probe is gently pulled out again at the end of the test.

© EMIS and PIP 2006   Updated: February 2006

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

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