Echocardiography

About the Procedure

Echocardiography, commonly known as an echocardiogram, is a non-invasive procedure which utilizes ultrasound technology to view the heart in motion to diagnose cardiovascular diseases. The test involves sending sound waves through the chest wall and, as the waves reflect off of obstacles they encounter, a two-dimensional picture is formed on a monitor. It is one of the mostly commonly used diagnostic tests in cardiology for identifying heart murmurs, abnormal or poor functioning heart valves, damage to the heart muscles, as well as others. A software program takes data reflected back for analysis and measures the size and shape of the heart and its pumping capacity. The moving picture can indicate where heart damage has occurred, its severity, and the presence of coronary artery disease.

There are three types of echocardiograms performed. A standard test, called a transthoracic echo, in which the device emitting and receiving sound waves is on the chest. In a transesophageal echocardiogram (TTE), the device is put down into the esophagus. A stress echocardiogram is recorded as the patient exercises or is given medication to simulate the stress of exercise. The results of the procedure can be recorded as a video or still film, or a digital version can be made. Technological advances have perfected a 3-D echocardiogram which offers better results for viewing valves, congenital defects, and in obtaining a biopsy.

The procedure, which lasts 15 to 40 minutes depending on the instruments used, is done in a physician's office, a hospital, or a cardiac lab. It is performed by a sonographer or cardiologist. Electrocardiogram pads are applied to the patient's chest and are used to aid in the testing. After a gel is squeezed on the patient's skin, the transducer is placed on top, and spreads it over the chest as the exam proceeds. The patient may be asked to move their body or to hold their breath. Moving images, which look like a moving X-ray, are viewed on a monitor and, if a Doppler ultrasound is also involved, swishing or pulsating sounds can be heard and show on the monitor in color. Occasionally, the lungs, ribs, or other tissue prevent getting a clear picture, so a small amount of contrast material is put in an intravenous line to help create more distinction between tissues. When a transesophageal echocardiogram is performed, a sedative is given and the back of the throat is numbed. A scope with an ultrasound device at the end is guided into the lower esophagus permitting a close, clear picture of the heart.

What to Know Before the Procedure

There are no known risks or side effects to an echocardiogram. Professional echocardiography organizations in the U.S., U.K., and throughout Europe have established guidelines for the operation of laboratories and training of sonographers to assure the safety and accuracy of the procedure.

For standard echocardiograms, no preparation is required. Patients should anticipate the unlikely possibility of a contrast IV being utilized and plan for someone to drive them upon discharge. When a TTE and Doppler procedure or a stress echocardiogram are performed, specific preparation is required and the doctor will instruct the patient.

What to Know After the Procedure

Immediately after the procedure, there are no restrictions for patients who've had a standard echocardiogram. With a TEE, patients will have a sore throat for a few hours and will be observed. Driving is not permitted for twelve hours in these instances. After a stress echocardiogram, patients are monitored for a time before being discharged.

Results of the procedure are available from the referring physician within a few days, at which time he or she will discuss future treatment plans with the patient.

If you Need to Travel Outside of your Local Hospital

Professional sonographers, physicians, and facilities with accreditation from medical oversight organizations are available domestically and internationally. The rarity of complications makes travelling for this procedure a viable option in cases where there is a cost savings. The main priorities when deciding on where to have this procedure done are the overall cost and experience of the sonographer or cardiologist.