Also called echocardiography or echo test, an echocardiogram is a type of ultrasound that doctors may suggest when they suspect issues with heart chambers or valves. In other words, an echocardiogram is an ultrasound for examining the heart. The test results usually throw light on the heart’s size, pumping strength, muscle strength and condition, and valve issues. The test usually takes 15 to 20 minutes in case of uncomplicated cases. However, patients with obesity, lung disease, significant breath shortness and restlessness could be tested for close to an hour.

A graphical illustration of the echocardiogram procedure. Image credit: National Heart Lung and Blood Institute (NIH)
A graphical illustration of the echocardiogram procedure. Image credit: National Heart Lung and Blood Institute (NIH)

There are different types of echocardiograms: transthoracic echocardiogram, transesophageal echocardiogram, Doppler echocardiogram, stress echocardiogram, fetal echocardiogram and three-dimensional echocardiogram. The classification primarily being based on the technique and actual results.

Test Outcome

As aforementioned, an echocardiogram reveals pertinent heart information. Let’s look at them in greater detail.

Heart Chamber Size

The test gives information on the size of heart chambers, including the cavity volume or dimensions and the walls’ thickness. The walls’ appearance could also help detect specific heart disease types that primarily entail the heart muscle.

Pumping Function

An echocardiography tells if the heart’s pumping power is regular or decreased to a severe or mild degree, which is measured as ejection fraction (EF). An EF in the 55 to 65 percent range is considered normal. A 45 percent or lower EF means some decline in the heart’s pumping strength. A number below 30 or 35 percent represents a major issue. The test also discloses if the poor heart pumping is courtesy a condition called cardiomyopathy.

Valve Function

An echocardiogram identifies each heart valve’s structure, movement and thickness. It helps ascertain if the valve’s normal, scarred due to rheumatic fever or an infection, torn, calcified, etc. The test also assesses artificial or prosthetic heart valves’ function.

Volume Status

The test reveals if there has been any reduction in the circulating blood’s volume – usually the case with blood loss, dehydration, diuretics or water pill usage.

If the doctor is present during the test, the results usually are delivered to the patient before he/she leaves the test center. However, the results may take a few days if the physician is not around for immediate review.

Test Preparation

There are no special preparations needed prior to the test. The patient can drink, eat and administer other medications like before. However, in case of a stress or transesophageal echocardiogram, the doctor may suggest not eating anything a couple of hours before the test. Since the transesophageal echocardiogram involves sedating medication, self-driving post the test is not advisable. Proper arrangements to get back home should therefore be in place.

Actual Procedure

Right before the test, upper body clothing is generally removed. Women and even some men are provided a cover sheet or gown to maintain privacy. Electrodes or sticky patches are appended to the shoulders and chest. A transparent gel is later spread on the chest and the transducer placed over the gelled area. The transducer is set to motion or moved over the chest to capture different views or images of the heart.

The patient could be asked to move sideways during the procedure, and also hold breath or breathe slowly. This supposedly helps capture higher quality images. The physician or operator sees real-time images on the computer screen – the images are also simultaneously recorded on videotape and photographic paper. These recordings serve as permanent exam record and are looked into by the physician before preparing the final report.

Risks/ Side Effects

Generally, echocardiograms are safe and don’t use radiation, unlike an X-ray. However, during removal of the patches, some patients could feel minor discomfort, which is similar to the feeling when a bandage is pulled off. Some irritation and esophagus scraping is possible during a transesophageal echocardiogram. A sore throat is often its side effect.