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Echocardiogram

Test Overview

An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen.

Echocardiograms can be done in different ways. The types include transthoracic, transesophageal, and stress echocardiograms. A Doppler echo shows blood flow through the heart and blood vessels. It can be done during any of these types of echocardiograms.

Types of echocardiograms

The different types of echocardiograms are:

  • Transthoracic echocardiogram (TTE). This is the most common type. Views of the heart are obtained by moving the transducer to different locations on your chest or abdominal wall.
  • Stress echocardiogram. During this test, an echocardiogram is done both before and after your heart is stressed either by having you exercise or by injecting a medicine that makes your heart beat harder and faster. This test is usually done to find out if you might have decreased blood flow to your heart (coronary artery disease).
  • Transesophageal echocardiogram (TEE). For this test, the probe is passed down the esophagus instead of being moved over the outside of the chest wall. TEE shows clearer pictures of your heart. That's because the probe is closer to the heart and because the lungs and bones of the chest wall don't block the sound waves produced by the probe. A sedative and an anesthetic applied to the throat are used to make you comfortable during this test.
  • Doppler echocardiogram. This test can be done during a TTE, TEE, or a stress echocardiogram. It is used to look at how blood flows through the heart chambers, heart valves, and blood vessels. The movement of the blood reflects sound waves to a transducer. The ultrasound computer then measures the direction and speed of the blood flowing through your heart and blood vessels. Doppler measurements may be displayed in black and white or in colour.

Why It Is Done

An echocardiogram is done for many reasons. It can measure how well your heart is pumping blood. It can show blood flow through the heart and blood vessels. It may be done to look for problems with your heart size, thickness, shape, and muscle movement. The test can also be used to see how well your heart valves work and if there are blood clots or tumours inside the heart.

Results

Results are usually available within one day. If the test is done by a cardiologist, the results may be available immediately after the test.

Echocardiogram

Normal:

The heart chambers and walls of the heart are of normal size and thickness, and they move normally.

Heart valves are working normally, with no leaks or narrowing. There is no sign of infection.

The amount of blood pumped from the left ventricle with each heartbeat (ejection fraction) is normal.

There is no excess fluid in the sac surrounding the heart, and the lining around the heart is not thickened.

There are no tumours and blood clots in the heart chambers.

Abnormal:

Heart chambers are too big. The walls of the heart are thicker or thinner than normal. A thin heart wall may mean poor blood flow to the heart muscle or an old heart attack. A thin, bulging area of the heart wall may indicate a bulge in the ventricle (ventricular aneurysm). The heart muscle walls do not move normally because of a decreased blood supply from narrowed coronary arteries.

One or more heart valves do not open or close properly (are leaking) or do not look normal. Signs of infection are present.

The amount of blood pumped from the left ventricle with each heartbeat (ejection fraction) is lower than normal.

There is fluid around the heart (pericardial effusion). The lining around the heart is too thick.

A tumour or blood clot may be found in the heart.

Credits

Current as of: September 7, 2022

Author: Healthwise Staff
Medical Review:
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine
George Philippides MD - Cardiology