An echocardiogram, also known as an "echo," is a noninvasive test that uses sound waves to create detailed images of the heart. It helps doctors assess the heart's structure and function, providing key insights into heart health. It’s not to be confused with an electrocardiogram, which displays electrical signals from your heart in wavy lines on a screen.
What Is an Echocardiogram?
An echocardiogram is an ultrasound test to evaluate the heart. It uses high-frequency sound waves (ultrasound) to produce live images, or "echos," of the heart and its components, including the heart chambers, valves, and blood flow.
“It’s exactly the same as an ultrasound that women who are pregnant get to see the size and movement of the baby,” says Gaurav Upadhyay, MD, a cardiologist and a cardiac electrophysiologist at University of Chicago Medicine.
When it’s applied to your chest, it allows your doctor to check for various heart conditions, such as heart murmurs, valve issues, or heart muscle damage.
“Echocardiogram provides a black-and-white image that lets us evaluate the size and movement of the heart,” says Dr. Upadhyay.
The test is typically performed in a doctor's office or hospital, and it offers vital information about the heart’s pumping ability, any structural abnormalities, and how well blood flows through the heart.
“It is safe, painless, and doesn't involve radiation, making it a go-to diagnostic tool for evaluating the strength of the heart,” says Upadhyay.
Types of Echocardiograms
Transthoracic Echocardiogram (TTE) This is the most common type, in which a transducer (a handheld device) is placed on your chest to send and receive sound waves that create images of your heart.
Transesophageal Echocardiogram (TEE) In this type, a flexible tube with a transducer is passed down your throat and into your esophagus to get a closer look at the heart. This is usually done when more detailed images are needed.
Stress Echocardiogram This type is done while your heart is under stress, either through exercise or with medication that mimics exercise, to see how your heart works when it’s pumping harder.
Doppler Echocardiogram This test evaluates the speed and direction of blood flow through the heart’s valves and chambers.
An echocardiogram is typically done to diagnose or monitor heart problems. It's used to investigate chest pain, shortness of breath, irregular heartbeats, or a heart murmur. It helps detect various conditions, such as:
Heart valve disease: To check if your valves are opening and closing properly, or if they are damaged.
Heart failure: To evaluate how well your heart is pumping blood; poor pumping efficiency can indicate heart failure.
Congenital heart defects: To spot heart problems present since birth.
Pericarditis or cardiomyopathy: To assess inflammation or damage to the heart muscle or lining (pericardium).
Post–heart attack assessment: To see if your heart muscle has been damaged by a heart attack.
“Looking at an echocardiogram can tell us the size of an attack,” says Upadhyay.
Your doctor might recommend an echocardiogram if you have symptoms of heart disease, or if you’re undergoing treatment for an existing heart condition.
During a transthoracic echocardiogram (TTE), a technician or cardiologist applies gel to your chest to help transmit sound waves. A transducer is then moved across your chest, which sends high-frequency sound waves through your skin and into your heart. These waves bounce back, creating images on a monitor that the doctor can interpret.
A transesophageal echocardiogram (TEE) is performed by numbing your throat and guiding a tube into your esophagus, which allows the doctor to get clearer, more detailed images of your heart. This procedure is typically performed in a hospital setting and may require mild sedation.
Both types of echocardiograms are noninvasive (except for the tube insertion in a TEE) and usually take about 30 to 60 minutes.
For a standard TTE, no special preparation is needed. You can eat, drink, and take medications as usual. But if you’re scheduled for a transesophageal echocardiogram (TEE), you may be asked to fast for a few hours before the procedure since sedation is typically used. Make sure to follow your healthcare provider’s instructions regarding fasting, and make arrangements for someone to drive you home.
During a TTE, you will lie on a table while a technician applies gel to your chest and uses a transducer across the area. You might be asked to lie in different positions or briefly hold your breath to help capture clear images. The procedure is painless and usually takes 30 to 60 minutes.
For a TEE, your throat will be numbed with local anesthesia, and you will likely receive a sedative to help you relax. A flexible tube with a transducer is inserted down your throat and into your esophagus, and the test takes about 60 minutes. You may experience a sore throat afterward but can typically resume normal activities after a few hours of rest.
Echocardiograms are generally considered safe. A TTE carries no significant risks since it is noninvasive. But with a TEE, you might experience throat irritation or injury, such as bleeding or a tear in the esophagus, and the sedation may cause drowsiness. Some people may experience discomfort due to the insertion of the probe during a TEE.
For a standard TTE, no follow-up care is required. You can resume your normal activities immediately after the test. If you’ve had a TEE, you may need to rest for a few hours because of the sedative, and someone should drive you home after the procedure. You might also experience a sore throat, which usually resolves within a day.
Your doctor will discuss the results with you at a follow-up appointment, especially if any abnormalities are found.
Complications from an echocardiogram are rare. In some cases, a TEE can cause temporary throat irritation or discomfort. There is also a small risk of esophageal injury during a TEE. You may also feel groggy or disoriented from the sedative given for the TEE.
After your echocardiogram, your doctor will analyze the images and discuss the results with you. If any heart problems are detected, they may recommend further tests or treatments, such as medications or lifestyle changes. In some cases, additional echocardiograms may be needed to monitor your heart over time.
An echocardiogram is a test that provides detailed images of your heart, helping doctors diagnose and monitor heart conditions.
It’s typically painless and involves minimal risks, with no special care required afterward for most patients.
If you have concerns about your heart health, this test offers a valuable way to gain insights and guide treatment decisions.
