An echocardiogram is a test in which ultrasound (high frequency wave) is used to examine the heart. The transducer transmits ultrasound and constantly receives waves reflected back every time the beam travels from one density to another. The reflected ultrasound waves are collected and analyzed by the machine which allows doctors to determine the heart size, shape, function and the state of the heart valves and major vessels.

An echocardiogram can be obtained in a physician’s office or in a hospital. No special preparation is required especially for the resting echocardiogram. Clothing is removed from the upper body and is replaced by a sheet of cloth or hospital gown. Comfort and privacy is always maintained. The patient then lies on the examination table or hospital bed.

Electrodes which are connected to electrode wires are then attached to the chest and shoulders. These help to record the electrocardiogram (EKG or ECG) during the echocardiography test. The EKG helps time various cardiac events (filling and emptying of heart chambers). A colorless gel is then applied to the chest and an echo transducer is placed atop of it. The echo-technologist or doctor then makes recordings from different parts of the chest to obtain several views of the heart. The patient may be asked to move, breathe slowly or even hold his/her breath. This helps in obtaining higher picture qualities. The incoming images are constantly viewed on the monitor.

What Information Does an Echocardiograph Provide?

Echocardiography is an invaluable tool in providing doctors with important information about the following:

• Size of heart chambers, including the dimension or volume of the cavity and the thickness of the walls of the heart. The appearance of the walls may also help to identify certain types of heart diseases that predominantly involve the heart muscle. In patients with long standing hypertension or high blood pressure, the test can determine the thickness and rigidity of the LV walls. When the LV pump function is reduced in patients with heart failure, the LV and RV tend to dilate or enlarge. Echocardiography is able to measure this enlargement. Serial studies performed annually can gauge the response of this treatment.
• Heart pumping function: Doctors can assess via echocardiography if the heart is pumping normally or reduced to a mild or even severe degree. This measurement is known as ejection fraction or EF. A normal EF is around 55-65%. Echocardiography can also identify if the heart is pumping poorly due to a previous heart attack by focusing on the movement of each visualized wall.
• Valves function: Echocardiography identifies the structure, thickness and movement of each heart valve. It can identify if the valve is normal, scarred from an infection like rheumatic fever, if it’s thickened, calcified or torn. It can also assess the function of prosthetic or artificial heart valves. The additional use of Doppler helps to identify abnormal leakage across the heart valves, valve stenosis (narrowing) and determine their severity.
• Other uses: Echocardiography is useful in the diagnosis of fluid in the pericardium (the sac that surrounds the heart). It can also determine when the problem is severe or potentially life threatening. It can also to diagnose congenital heart diseases, blood clots from tumors within the heart, active infection of the heart valves as well as abnormal elevation of pressure within the lungs.

How Safe is Echocardiography?

Echocardiography is extremely safe. There are no known risks from the clinical use of ultrasound during this type of testing.

How Long Does Echocardiography Take?

A brief examination in an uncomplicated case may be done within 15-20 minutes. The additional use of Doppler may add an additional 10-20 minutes. However, it may take up to an hour when there are multiple problems or when there are technical difficulties (patients with lung disease, obesity, restlessness or significant shortness of breath) then it may be more problematic to image.