Echocardiogram: Why and How Is It Done?

Echocardiography or echocardiogram uses sound waves to produce live images of your heart. It helps your doctor to study your heart and the function of its muscles and valves. The images give information about:

• Fluid in the sac around your heart
• Blood clots in your heart chambers
• Issues with the aorta
• Problems with the pumping function or relaxing function of your heart
• Issues with the function of your heart valves

An echocardiogram is painless and a key to determining the health of your heart muscles, especially after a heart attack. Echocardiography can help reveal heart defects in unborn babies.

Types of Echocardiogram

There are different types of echocardiogram, such as:

Transthoracic Echocardiography

It is a common type of echocardiogram in which a healthcare practitioner places a transducer on your chest over your heart. The transducer sends sound waves to your heart through your chest. The monitor attached to the transducer produces live images as the sound waves bounce back to the transducer.

Transesophageal Echocardiogram

Your doctor may recommend a transesophageal echocardiogram when a transthoracic echocardiogram does not produce definitive images or there is a need to visualize the back of the heart better.

In this test, your doctor passes a small transducer down your throat through your mouth. Your doctor will use local anesthesia on your throat to complete this procedure easily and eliminate the gag reflex.

The doctor then passes the transducer through your esophagus to look at the back of your heart. With a transducer connected to a monitor, your doctor can look behind your heart easily and know if there is any problem or issue.

Fetal Echocardiogram

Fetal echocardiography is used on pregnant women sometimes during their pregnancy weeks 18 to 22.

In this test, a healthcare practitioner places a transducer over the abdomen to check for heart problems in the fetus. A fetal echocardiogram is considered safe for an unborn child because it does not use any radiation, unlike an X-ray.

Three-Dimensional (3D) Echocardiography

A 3D echocardiogram uses either transthoracic or transesophageal echocardiography to produce a 3D image of your heart. This test involves multiple images from different angles. 3D echocardiography is used before heart valve surgery. Also, it is used to diagnose heart problems and issues in children.

Stress Echocardiography

A stress echocardiogram uses traditional transthoracic echocardiography. However, this test is done before and after you have used medicines to make your heart beat faster or you have exercised. This helps your doctor to study and understand how your heart performs under stress.

Echocardiogram: Why Is It Done?

Your doctor will recommend an echocardiogram to look at your heart’s structure and how well it is functioning. This test also helps your doctor to find out:

• Blood clots in the chambers of your heart
• Congenital heart disease
• Damages from a heart attack
• The size, thickness, and movement of your heart’s walls
• Heart failure
• If blood is flowing backwards through your heart valves (regurgitation)
• If the heart valves are functioning correctly
• Endocarditis – an infection of the heart valve
• If the heart valves are too narrow (stenosis)
• Issues with the outer lining of your heart (the pericardium)
• Abnormal holes between the chambers of your heart
• The size and shape of your heart
• The pumping strength of your heart
• Problems with the larger blood vessels that enter and exit the heart
• Tumors or infectious growths around your heart valves

Prerequisites

For this test, you don’t need any specific or special preparation. However, your doctor may ask you to stop certain prescription and OTC medications.

Also, tell your doctor if you have a pacemaker.

Your doctor may also give further, more specific instructions if you have any other health condition.

Understanding the Results

Your echocardiogram results may show:

• Heart defects: An echocardiogram can detect problems with your heart chambers, abnormal connections between your heart and major blood vessels, and complex heart defects present at birth.
• Damages to the heart muscle: This test helps your doctor to determine if all the parts of your heart wall are functioning properly. Your doctor will look at your heart wall that has been damaged during a heart attack or receives less oxygen.
• Change in size of your heart: The chambers of your heart can enlarge or the walls of your heart may abnormally thicken due to high blood pressure, weakened or damaged valves, or other diseases. 
• Valve issues and problems: An echocardiogram helps to understand if your heart valves open wide enough to help flow blood normally and close fully to prevent blood leakage.
• Pumping strength: The measurement obtained from the test includes the percentage of blood that is pumped out of a filled ventricle with each heartbeat and the volume pumped in one minute. When your heart does not pump enough blood to meet your body’s needs can lead to symptoms of heart failure.

Your doctor may ask to repeat an echocardiogram to monitor your heart health after recommended medication and treatment. It also helps your doctor to map future treatments.

Echocardiogram: What To Expect

• Before an echocardiogram, your doctor will explain the procedure in detail along with possible complications and side effects.
• Once in the laboratory or diagnostic room, you will then be asked to remove clothes above the waist and wear a hospital gown.
• A cardiac sonographer or doctor will place three small, flat, and sticky patches called electrodes on your chest.
• These electrodes are attached to an electrocardiograph (EKG) monitor that records your heart’s electrical activity during the test.
• The healthcare practitioner will ask you to lie down on an examination table.
• After that, the sonographer places a transducer on several areas of your chest.
• Your doctor will use a special gel that will help the transducer to capture clear images and to move the transducer smoothly on your skin.
• Your sonographer might ask to change positions to get every angle of your heart.
• Also, the sonographer will ask you to hold your breath at times.

This test will not cause any major discomfort. You may feel a slight coolness on the skin due to gel on the transducer and slight pressure on your chest due to the transducer. 

An echocardiogram will take approximately 40 minutes. After the test, you may get dressed and be asked to go home. The sonographer might schedule your appointment for the reading of the test.

Learn more about Heart Disease here.