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Echocardiogram

An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture is more detailed than a standard x-ray image. An echocardiogram does not expose you to radiation.

Alternative Names

Transthoracic echocardiogram (TTE); Echocardiogram - transthoracic; Doppler ultrasound of the heart; Surface echo

How the Test is Performed

TRANSTHORACIC ECHOCARDIOGRAM (TTE)

TTE is the type of echocardiogram that most people will have.

  • A trained sonographer performs the test. A heart doctor (cardiologist) interprets the results.
  • An instrument called a transducer is placed on your ribs near the breast bone and directed toward the heart. This device releases high-frequency sound waves. Images will be taken at other locations as well, including underneath and slightly to the left of your nipple and in the upper abdomen.
  • The transducer picks up the echoes of sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of the heart. Still pictures are also taken.
  • Pictures can be two-dimensional or three-dimensional. The type of picture will depend on the part of the heart being evaluated and the type of machine.
  • A Doppler echocardiogram records the motion of blood through the heart.

An echocardiogram allows doctors to see the heart beating. It also shows the heart valves and other structures.

In some cases, your lungs, ribs, or body tissue may prevent the sound waves and echoes from providing a clear picture of heart function. If this is a problem, the sonographer may inject a small amount of liquid (contrast) through an IV to better see the inside of the heart.

Rarely, more invasive testing using special echocardiography probes may be needed.

TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE)

The back of your throat is numbed and a scope is inserted down your throat.

On the end of the scope is a device that sends out sound waves. A heart doctor with special training will guide the scope down the esophagus. This method is used to get a clearer echocardiogram of your heart.

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How to Prepare for the Test

No special steps are needed before a TTE test. If you are having a TEE, will not be able to eat or drink for several hours before the test.

How the Test will Feel

  • You will need to take off your clothes from the waist up and lie on an exam table on your back.
  • Electrodes will be placed on your chest to monitor your heart beat.
  • A gel is spread on your chest and the transducer will be moved over your skin. You will feel a slight pressure on your chest from the transducer.
  • You may be asked to breathe in a certain way or to roll over onto your left side. Sometimes a special bed is used to help you stay in the proper position.

Why the Test is Performed

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This test is done to evaluate the valves and chambers of the heart from the outside of your body. The echocardiogram can help detect:

  • Abnormal heart valves
  • Abnormal heart rhythms
  • Congenital heart disease
  • Damage to the heart muscle from a heart attack
  • Heart murmurs
  • Inflammation (pericarditis ) or fluid in the sac around the heart (pericardial effusion)
  • Infection on or around the heart valves (infectious endocarditis)
  • Pulmonary hypertension
  • Ability of the heart to pump (for people with heart failure )
  • Source of a blood clot after a stroke or TIA

Your health care provider may recommend a transesophageal echocardiogram (TEE) if:

  • The regular or transthoracic echocardiogram is unclear. Unclear results may be due to the shape of your chest, lung disease, or excess body fat.
  • An area of the heart needs to be looked at in more detail.

Normal Results

A normal echocardiogram reveals normal heart valves and chambers and normal heart wall movement.

What Abnormal Results Mean

An abnormal echocardiogram can mean many things. Some abnormalities are very minor and do not pose major risks. Other abnormalities are signs of serious heart disease. You will need more tests by a specialist in this case. It is very important to talk about the results of your echocardiogram with your health care provider.

Risks

There are no known risks from an external transthoracic echocardiogram (TTE) test.

There is some risk associated with the transesophageal echocardiogram (TEE) test. Transesophageal echocardiogram (TEE) is an invasive procedure. Talk with your health care provider about risks associated with this test.

Considerations

Abnormal results may indicate:

This test is used to evaluate and monitor many different heart conditions.

References

Connolly HM, Oh JK. Echocardiography. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 15.

Updated: 5/1/2013

Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


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