Cardiology Services Education

Echocardiogram & Vacular Ultrasound

Ultrasound or echocardiogram techniques are available to diagnose heart muscle and valve abnormalities, circulatory abnormalities of the legs, abdominal aorta, kidneys and the neck arteries that bring blood flow to the brain. Similarly this technique can be used to evaluate venous problems of the legs.

What is an Echocardiogram?

Echocardiogram (EK-o-kar-de-OG-ra-fee), or echo, is a painless test that uses sound waves to create pictures of your heart.

The test gives your doctor information about the size and shape of your heart and how well your heart’s chambers and valves are working. Echo also can be done to detect heart problems in infants and children.

The test also can identify areas of heart muscle that aren’t contracting normally due to poor blood flow or injury from a previous heart attack. In addition, a type of echo called Doppler ultrasound shows how well blood flows through the chambers and valves of your heart.

Echo can detect possible blood clots inside the heart, fluid buildup in the pericardium (the sac around the heart), and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body.

Who Needs Echocardiography?

Your doctor may recommend echocardiography (echo) if you have signs and symptoms of heart problems. For example, shortness of breath and swelling in the legs can be due to weakness of the heart (heart failure), which can be seen on an echocardiogram.

Your doctor may also use echo to learn about:

  • The size of your heart. An enlarged heart can be the result of high blood pressure, leaky heart valves, or heart failure.
  • Heart muscles that are weak and aren’t moving (pumping) properly. Weakened areas of heart muscle can be due to damage from a heart attack. Weakening also can mean that the area isn’t getting enough blood supply, which may be due o coronary heart disease (also called coronary artery disease).
  • Problems with your heart valves. Echo can show whether any of your heart valves don’t open normally or don’t form a complete seal when closed.
  • Problems with your heart’s structure. Echo can detect many structural problems, such as a hole in the septum and other congenital heart defects. The septum is the wall that separates the two chambers on the left side of the heart from the two chambers on the right side. Congenital heart defects are structural problems present at birth. Infants and children may have echo to detect these heart defects.
  • Blood clots or tumors. If you’ve had a stroke, echo might be done to check for blood clots or tumors that may have caused it.

Your doctor also may use echo to see how well your heart responds to certain heart treatment, such as those used for heart failure.

What to Expect Before Echocardiography

Echocardiography (echo) is done in a doctor’s office or a hospital. No special preparations are needed for most types of echo. Usually you can eat, drink, and take any medicines as you normally would.

The exception is if you’re having a transesophageal echo. This test usually requires that you don’t eat or drink for 8 hours prior to the test.

If you’re having a stress echo, there may be special preparations. Your doctor will let you know how to prepare for your echo test.

What to Expect During Echocardiography

Echocardiography (echo) is painless and usually takes less than an hour to do. For some types of echo, your doctor will need to inject saline or a special dye into one of your veins to make your heart show up more clearly on the test images. This special dye is different from the dye used during angiography (a test used to examine the body’s blood vessels).

For most types of echo, you’ll be asked to remove your clothing from the waist up. Women will be given a gown to wear during the test. You’ll lay on your back or left side on an exam table or stretcher.

Soft, sticky patches called electrodes will be attached to your chest to allow an EKG (electrocardiogram) to be done. An EKG is a test that records the heart’s electrical activity.

A doctor or sonographer (a person specially trained to do ultrasounds) will apply gel to your chest. The gel helps the sound waves reach your heart. A wand-like device called a transducer will then be moved around on your chest.

The transducer transmits ultrasound waves into your chest. Echoes from the sound waves will be converted into pictures of your heart on a computer screen. During the test, the lights in the room will be dimmed so the computer screen is easier to see.

Other Types of Echocardiography

Transthoracic Echocardiography - This type of echo involves placing a device called a transducer on your chest. The device sends special sound waves, called ultrasound, through your chest wall to your heart. The human ear can’t hear ultrasound waves.

Stress Echocardiography - Stress echo is done as part of a stress test. During a stress test, you exercise or take medicine (given by your doctor) to make your heart work hard and beat fast. A technician will take pictures of your heart using echo before you exercise and as soon as you finish.

Transesophageal Echocardiography - With standard transthoracic echo, it can be hard to see the aorta and other parts of your heart. If your doctor needs a better look at these areas, he or she may recommend transesophageal. During this test, the transducer is attached to the end of a flexible tube. The tube is guided down your throat and into your esophagus (the passage leading from your mouth to your stomach). This allows your doctor to get more detailed pictures of your heart.

Three-Dimensional Echocardiography - A three-dimensional (3D) echo creates 3D images of your heart. These images provide more information about how your heart looks and works.

Information provided by National Heart Lung and Blood Institute