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During an echocardiogram (echo), a high-frequency sound wave from a hand-held wand placed on your chest provides pictures of the heart's valves and chambers. This helps the ultrasound technician evaluate your heart's pumping action. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow moving across the heart's valves.

The test is used to:

  • Assess how well your heart is functioning.

  • Determine if there is any heart disease, such as infective endocarditis, cardiac masses, myocardial disease, pericardial disease, valve disease, and congenital heart disease.

  • See how well you are healing from medical or surgical treatments.

  • Track the progress of your heart disease over time.

The type of echocardiogram you get depends on the information needed.

  • Transthoracic echocardiogram: In this standard echocardiogram, the ultrasound technician aims the ultrasound beam at your chest.

  • Doppler echocardiogram: Sound waves change pitch when they bounce off blood cells moving through your body. These changes can help your doctor measure blood flow.

  • Transesophageal echocardiogram: The ultrasound wand (transducer) is guided down your throat and into your stomach (esophagus). The transducer records the sound waves from your heart.

  • Stress test: Some heart problems—particularly in the arteries—happen during physical activity. In this test, ultrasound images of your heart are taken before and immediately after you exercise.

Who is eligible for an echocardiogram?

Your doctor may suggest an echocardiogram:

  • To detect congenital heart defects before birth (fetal echocardiogram).

  • If you have problems with the valves or chambers of your heart.

  • If you have symptoms such as shortness of breath or chest pain.

What conditions can be diagnosed by an echocardiogram?

Conditions the echocardiogram can show:

  • Valve problems: An echo can show if your heart valves open wide enough for enough blood to flow in or close completely to stop blood from leaking.

  • Damaged heart muscle: An echo can check if the heart wall is properly contributing to your heart's pumping. Weak areas of the heart wall may be damaged from a heart attack or receive too little oxygen.

  • Pumping strength: The echo measures the percentage of blood pumped with each heartbeat and the volume of blood pumped in one minute.

  • Changes in heart size: Damaged or weak heart valves, high blood pressure, or other diseases can cause the heart chambers to get bigger or the walls to thicken.

  • Heart defects: An echo can show problems with the heart structure, abnormal connections between the heart and major blood vessels, and heart defects.

How do I prepare for an echocardiogram?

You don't need to prepare for most echocardiograms.

If you're having a transesophageal echocardiogram, your doctor will ask you not to eat for several hours beforehand. Also, you won't be able to drive after because of the medication you'll likely receive. Make sure you have someone to drive you home.

What should I expect during my echocardiogram?

This is what you should expect:

  • You will put on a hospital gown.

  • The ultrasound technician will ask you to lie on your left side on an exam table. The technician will place a wand (called a transducer) on several areas of your chest. The wand will have a small amount of gel on the end, which will not harm your skin. This gel helps produce clearer pictures.

  • You may or may not hear sounds from the Doppler ultrasound signal.

  • You may be asked to change positions a few times so the ultrasound technician can take pictures of different areas of the heart. You may also be asked to hold your breath at times.

If you have a transesophageal echocardiogram:

  • Your throat will be numbed with a spray or gel.

  • You'll be given a sedative to help you relax.

  • The tube containing the transducer will be guided down your throat and into your esophagus and positioned to obtain images of your heart.

You should feel no major discomfort during the test. Most echocardiograms take less than an hour. Most people can resume their normal daily activities.

Why choose Presbyterian for an echocardiogram?

Presbyterian’s Heart and Vascular team have many different options to help you manage your heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans for your heart health needs. Depending on the type of heart condition you have and its underlying cause, the team can recommend a wide variety of treatment options, including lifestyle modifications, medications, and procedures. Our cardiologists and cardiovascular surgeons work closely together for cases in which surgery is the best treatment option. We also offer a customized cardiac rehabilitation program at our Healthplex, where clinically appropriate, which can improve your endurance and exercise tolerance, as well as improve heart-related symptoms. Your cardiologist will work with the rehabilitation team to create a plan that will be tailored to your individual health needs.