An echocardiogram (echo) is a test that uses high frequency sound waves (ultrasound) to make pictures of your heart. The test is also called echocardiography or diagnostic cardiac ultrasound.

The type of echocardiogram you have depends on the information your doctor needs.

Transthoracic echocardiogram

In this standard type of echocardiogram:

  • A technician (sonographer) spreads gel on a device (transducer).
  • The sonographer presses the transducer firmly against your skin, aiming an ultrasound beam through your chest to your heart.
  • The transducer records the sound wave echoes from your heart.
  • A computer converts the echoes into moving images on a monitor.

If your lungs or ribs block the view, you may need a small amount of an enhancing agent injected through an intravenous (IV) line. The enhancing agent, which is generally safe and well tolerated, will make your heart’s structures show up more clearly on a monitor.

Transesophageal echocardiogram

If your doctor wants more-detailed images or it’s difficult to get a clear picture of your heart with a standard echocardiogram, your doctor may recommend a transesophageal echocardiogram.

In this procedure:

  • Your throat will be numbed, and you’ll be given medications to help you relax.
  • A flexible tube containing a transducer is guided down your throat and into the tube connecting your mouth to your stomach (esophagus).
  • The transducer records the sound wave echoes from your heart.
  • A computer converts the echoes into detailed moving images of your heart, which your doctor can view on a monitor.

Doppler echocardiogram

Sound waves change pitch when they bounce off blood cells moving through your heart and blood vessels. These changes (Doppler signals) can help your doctor measure the speed and direction of the blood flow in your heart.

Doppler techniques are generally used in transthoracic and transesophageal echocardiograms. Doppler techniques can also be used to check blood flow problems and blood pressure in the arteries of your heart — which traditional ultrasound might not detect.

The blood flow shown on the monitor is colorized to help your doctor pinpoint any problems.

Stress echocardiogram

Some heart problems — particularly those involving the arteries that supply blood to your heart muscle (coronary arteries) — occur only during physical activity. Your doctor might recommend a stress echocardiogram to check for coronary artery problems. However, an echocardiogram can’t provide information about any blockages in the heart’s arteries.

In a stress echocardiogram:

  • Ultrasound images of your heart are taken before and immediately after you walk on a treadmill or ride a stationary bike
  • If you’re unable to exercise, you may get an injection of a medication to make your heart pump as hard as if you were exercising

Quick facts

  • An echo uses sound waves to create pictures of your heart’s chambers, valves, walls and the blood vessels (aorta, arteries, veins) attached to your heart.
  • A probe called a transducer is passed over your chest. The probe produces sound waves that bounce off your heart and “echo” back to the probe. These waves are changed into pictures viewed on a video monitor.
  • An echo can’t harm you.

Why do people need an echo test?

Your doctor may use an echo test to look at your heart’s structure and check how well your heart functions. The test helps your doctor find out:

  • The size and shape of your heart, and the size, thickness and movement of your heart’s walls.
  • How your heart moves.
  • The heart’s pumping strength.
  • If the heart valves are working correctly.
  • If blood is leaking backwards through your heart valves (regurgitation).
  • If the heart valves are too narrow (stenosis).
  • If there is a tumor or infectious growth around your heart valves.

The test also will help your doctor find out if there are:

  • Problems with the outer lining of your heart (the pericardium).
  • Problems with the large blood vessels that enter and leave the heart.
  • Blood clots in the chambers of your heart.
  • Abnormal holes between the chambers of the heart.

How do I prepare for the echo?

You don’t have to do anything special. You can eat and drink before the test like you usually would.