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Echocardiography

Echocardiography (EK-o-kar-de-OG-ra-fee) is a painless test that uses sound waves to create images of your heart. It provides your doctor with information about the size and shape of your heart and how well your heart’s chambers and valves are working.

The test also can identify areas of heart muscle that aren’t contracting normally due to poor blood flow or injury from previous heart attack(s). Echocardiography can detect possible blood clots inside the heart, fluid buildup in the sac around the heart (pericardium), and problems with the aorta (the main artery that carries oxygen-rich blood out of the heart).

Your doctor may recommend echocardiography if you’re suffering from signs and symptoms of heart problems. For example, symptoms such as shortness of breath and swelling in the legs can be due to weakness of the heart (heart failure), which can be seen on an echocardiogram.

Doctors also use echocardiography to provide information on:

  • The size of your heart. An enlarged heart can be the result of high blood pressure, leaky heart valves, or heart failure. 
  • Heart muscles that are weak and aren’t moving (pumping) properly. Weakened areas of heart muscle can be due to damage from a heart attack. Or weakening could mean that the area isn’t getting enough blood supply, which can be due to coronary artery disease.
  • Problems with your heart’s valves. Echocardiography can show whether any of the valves of your heart don’t open normally or don’t form a complete seal when closed. 
  •  Abnormalities in the structure of your heart. Echocardiography can detect a variety of heart abnormalities, such as a hole in the septum (the wall that separates the two chambers on the left side of the heart from the two chambers on the right side) and other congenital heart defects (structural problems present at birth).
  • The aorta. Echocardiography is commonly used to assess and detect problems with the aorta such as aneurysm (abnormal bulge or “ballooning” in the wall of an artery). 
  • Blood clots or tumors. If you have had a stroke, echocardiography might be done to check for blood clots or tumors that may have caused it.

What to expect:

Echocardiography is painless and usually takes less than an hour to perform. For some tests, the doctor will need to inject saline or a special dye into your vein that makes your heart show up more clearly on the test images. This special dye is different from the dye used during an angiogram test.

For most types of echocardiography, you will be asked to remove your clothing from the waist up. Women will be given a gown to wear during the procedure. You will lay on your back or left side on an exam table or stretcher.

EKG electrodes will be attached to your chest to allow an EKG to be done. A doctor or sonographer (a person specially trained to do ultrasounds) will apply a gel to your chest that helps the sound waves reach your heart. A wand-like device called a transducer will then be moved around on your chest.

The transducer transmits ultrasound waves into your chest. Echoes from the sound waves will be converted into pictures of your heart on a computer screen. During the test, the lights in the room are dimmed so the computer screen is easier to see.

The sonographer will make several recordings of the images to show different locations in your heart. The recordings will be put on a computer disc or videotape for the cardiologist (a doctor who specializes in treating people who have heart problems) to review.

During the test, you may be asked to change positions or hold your breath for a short time so that the sonographer can get good pictures of your heart. At times, the sonographer may apply a bit of pressure to your chest with the transducer. This pressure can be a little uncomfortable, but it helps the sonographer get the best picture of your heart. You should let him or her know if you feel too uncomfortable.

How to prepare for an echocardiogram:

No special preparation is necessary. We recommend you refrain from drinking caffeinated beverages for 12 hours prior to your exam.