Echocardiograms are carried out in hospital by a cardiologist (a doctor specialising in conditions of the heart) or a sonographer (a technician trained in the procedure).
Your doctor will explain how to prepare for your procedure. For example, if you're having a stress echocardiogram you may be asked not to take beta-blockers or calcium-channel blockers for 48 hours and not to eat for two hours before the test.
Alternatives to an echocardiogram include the following.
- Transoesophageal echocardiogram. This is also an echocardiogram, but involves a doctor passing the ultrasound sensor into your oesophagus (the pipe that goes from your mouth to your stomach).
- Cardiac MRI scan. MRI is a special technique that uses powerful magnets, radio waves and computers to produce detailed images (or scans) of the inside of your heart.
- Radionuclide test. In this test, a doctor injects a harmless, radioactive substance into your body. He or she then uses a special camera to take pictures of your heart. The radioactive substance shows up as it travels through your heart and your doctor uses this to assess your heart function and blood flow.
Your doctor will advise you which procedure is most suitable.
An echocardiogram can take 30 to 45 minutes. You will be asked to undress to your waist and lie on your left-hand side. Your doctor or technician will place a clear gel over the left side of your chest. This is to make sure there will be a good, airtight contact between your skin and the sensor.
The sensor is held firmly against your skin and, as it moves across your chest, sends out sound waves and picks up the returning echoes. Pictures of the inside of your heart will be displayed on a screen. These pictures are constantly updated, so the scan can show movement. The test is painless but may feel uncomfortable when the sensor is being moved over your skin.
During the echocardiogram, you may be able to hear loud whooshing sounds. This is the sound of your blood flow and can be heard whether or not there are any abnormalities in your heart.
Your heart rhythm will be also monitored throughout your echocardiogram.
This is when the echocardiogram is done while your heart is under stress. This helps your doctor find out how well your heart copes when it has to work harder. You may be asked to do some exercise (such as walking on a treadmill or riding an exercise bike), or take medicines to make your heart beat faster and harder.
If you have an exercise stress echocardiogram, the exercise will be gentle at first but will get progressively more strenuous. Your doctor may take pictures of your heart while you are exercising or immediately afterwards.
If medicines are used to increase your heart rate, you may be asked to rest for 20 minutes after the test to make sure the effects have completely worn off.
This is when a special dye (contrast agent) is injected into your vein during the echocardiogram. The dye helps show your heart more clearly. A contrast echocardiogram can help diagnose any holes in your heart.
The results of your echocardiogram may be discussed with you immediately after the examination. Alternatively, your results may be sent to your doctor who will discuss them with you at your next appointment.
If you have an echocardiogram as an out-patient procedure, you will be able to return home after the test is completed. You will be able to continue with your day-to-day activities as usual.
As with every procedure, there are some risks associated with an echocardiogram. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Medicines for stress echocardiograms can sometimes make you feel sick or dizzy.
Complications are when problems occur during or after the procedure.
- A standard echocardiogram is a safe procedure. There are no known complications associated with having it.
- A stress echocardiogram can occasionally cause heart rhythm problems, headache or chest pains.
- If contrast agent or medicines are used during the echo, there is a small risk of having an allergic reaction.
Speak to your doctor or technician for more information.
How will the doctor know if there is a problem with my heart?
An echocardiogram produces detailed pictures of the structures inside your heart, helping your doctor to identify any problems.
An echocardiogram produces very detailed pictures of the structures inside your heart and your doctor will look at these pictures to identify any problems.
For example, to check how well your heart is pumping blood, your doctor will look at the size, thickness and function of your left ventricle. This is one of the lower chambers of your heart, which pumps blood that contains oxygen around your body. Looking at the size of your left ventricle and how well it’s working can show your doctor whether there is a problem with your heart’s pumping ability.
To check for heart valve disease, your doctor will look at the shape of the valves, how they are moving and for signs of calcium deposits. Measuring how fast your blood is flowing, which makes a whooshing sound, will help your doctor to assess whether the valves have become narrowed or whether they are leaking.
What will happen after I get the results of my echocardiogram?
Your doctor will help you to choose the best course of action or treatment, based on the results of your echocardiogram together with any other tests you have had done.
An echocardiogram is just one test that doctors use to assess how your heart is working. You may have other tests such as an electrocardiogram (ECG), a chest X-ray and blood and urine tests.
Your doctor may diagnose a problem with your heart using the results of all these tests. However, your echocardiogram may also rule out a problem with your heart, or show that you need further tests before a diagnosis can be made.
If tests do show up a problem with your heart, your doctor will discuss your treatment options with you. Depending on the problem identified, you may be advised to take medicine or have surgery.
Why do I need a fetal echocardiogram?
A fetal echocardiogram is used to get a very detailed picture of your developing baby's heart, before he or she is born. It's used to check whether your developing baby has a heart problem.
In the UK, around 5,000 babies are born with congenital heart disease (heart disease from birth) each year. Half of these babies will have major heart disease, requiring surgery or intervention in the first year of life.
It’s very important that you attend your routine ultrasound scans during pregnancy. If there's a problem with your baby's heart, it's often first noticed when you have your routine 20-week ultrasound scan.
You will be asked to have a fetal echocardiogram if a routine 20-week scan shows up a problem, or if you have a family history of congenital heart disease, or you already have a child with heart problems.
A fetal echocardiogram can show up abnormalities in the structure or function of the heart and problems with heart rhythm. The scan is often performed by a sonographer (or midwife) and sometimes by an obstetrician or cardiologist.
- Echocardiogram. British Heart Foundation. www.bhf.org.uk, accessed 17 February 2012
- Clinical indications for echocardiography. British Society of Echocardiography. www.bsecho.org, published 2009
- Guidelines, protocols and patient information. British Society of Echocardiography. www.bsecho.org, accessed 17 February 2012
- Chaubal NG, Chaubal J. Fetal echocardiography. Indian J Radiol Imaging 2009; 19(1):60–68. doi: 10.4103/0971-3026.44524
- Screening. Tiny Tickers. www.tinytickers.org, accessed 17 February 2012
- Heart failure – chronic. Prodigy. www.prodigy.clarity.co.uk, published November 2010
- Heart failure. British Heart Foundation. www.bhf.org.uk, accessed 18 February 2012
- Ejection fraction heart failure measurement. American Heart Association. www.heart.org, published June 2011
- Aortic stenosis assessment. Stanford University. www.stanford.edu, published July 2009
- Radionuclide tests. British Heart Foundation. www.bhf.org.uk, accessed 20 February 2012
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