Echocardiogram

What is an Echocardiogram?

An echocardiogram is a test that uses ultrasound waves to examine the heart. Because it is a non-invasive test, it is a safe and painless way to help doctors diagnose a number of abnormalities of the heart.

Is the Echocardiogram Safe?

The echocardiogram is very safe. It is a non-invasive procedure using ultrasound waves. There are no known risks from the ultrasound waves.

The echocardiogram is also painless, although you may feel slight discomfort when the transducer is held firmly against the chest.

What Does It Show?

Doctors can see how well your heart functions during exertion by studying what happens during the exercise test.

• Size and shape of the heart. The images may be used to measure the size of the heart chambers and thickness of the heart muscle.
• Pumping efficiency of the heart. The images show the efficiency with which the heart pumps blood, as well as whether the heart is pumping at full strength or is weakened. The scans may also show whether the various parts of the heart pump equally.
• Valve abnormalities. An echocardiogram shows the shape and motion of the heart valves. It can reveal if a heart valve is narrowed or leaking and show how severe the problem is.
• Other uses. The test may also detect the presence of fluid around the heart; blood clots, or masses inside the heart; and abnormal holes between heart chambers.

Preparing For A Test

• Do not eat or drink 3 hours prior to the test. This will prevent the possibility of nausea, which may accompany vigorous exercise after eating. If you are diabetic and take medications for diabetes, get special instructions from your doctor.
• If you are currently taking any heart medications, check with your doctor. You may be asked to stop certain medications a day or two before the test. This can help get more accurate test results.
• Wear loose, comfortable clothing that is suitable for exercise. Men usually don't wear a shirt during the test, and women generally wear a bra and a lightweight blouse or a hospital gown. You should also wear comfortable walking shoes or sneakers.
• Several areas on your chest and shoulders will be cleansed with alcohol and an abrasive lotion, to prepare the skin for the electrodes. Men may need to have areas of their chest shaved, to ensure that the electrodes stay in place.

What Happens During the Test?

The echocardiogram can be performed in the doctor's office or at the hospital. No special preparation is necessary for this test. If you are scheduled for an exercise echocardiogram, however, you will be given special instructions.

You will be asked to remove clothing above the waist, and put on a hospital gown or a sheet to help keep you warm and comfortable. You will then lie on an examination table.

Electrodes (small sticky patches) and wires will be attached to your chest and shoulders to record your electrocardiogram (ECG or EKG). The ECG shows your heart's electrical activity during the test.

Next, you will lie on your back or on your left side. To improve the quality of the pictures, a colorless gel is applied to the area of the chest where the transducer will be placed.

A technician moves the transducer over the chest, to obtain different views of the heart. He or she may ask you to change positions. You may also be asked to breathe slowly or hold your breath, in order to get a better picture. A thorough examination usually takes from 20 minutes to an hour, depending on the number of views and whether the Doppler echo is used.

How Does An Echocardiogram Work?

An echocardiogram works very much like sonar. Ultrasound waves are transmitted into the chest and the reflection of these waves off the various parts of the heart is analyzed by sophisticated equipment.

A transducer, which is a small microphone-like device, is held against the chest. The transducer sends and receives the ultrasound waves. By moving the transducer to various positions on the chest, different structures of the heart may be analyzed.

A computer assembles the reflected ultrasound waves to create an image of the heart. These images appear on a television screen. The images may be recorded on videotape or printed on paper for review by the cardiologist.

An echocardiogram study typically involves three different techniques. The most basic technique, called M-mode echo, produces an image that appears as a tracing than an actual heart. The exact size of the heart chambers may be measured using the M-mode echo technique.

Two-dimensional (2-D) echo shows the actual shape and motion of the different heart structures. This advanced technique provides images that represent "slices" of the heart in motion.

Doppler echo is a third technique that portrays the flow of blood through the heart. The images representing the flow of blood through the heart may be displayed as a series of black-and-white tracings or as color images on the television screen.

During a Doppler echo procedure, you will hear some unusual sounds. These whooshing or pulsating sounds are computer-generated to provide the technologist with audio feedback. They are not the sounds of your heart.

The Benefits

A Major benefit of the echocardiogram is that it gives information about the heart's structures and blood flow without anything other than sound waves entering the body. The information gained from the echocardiogram allows your doctor make an accurate diagnosis and develop a treatment plan that is best for you. The major limitation is that it is often difficult to obtain good quality images from persons who have broad chests, are obese, or are suffering from chronic lung disease.

The Results

Typically, the doctor will review the images at a later time and prepare a report detailing his findings.