Echocardiograms: What to Know About a Heart Ultrasound

An echocardiogram, often called an “echo” or heart ultrasound, uses sound waves to produce moving images of your heart. It helps healthcare providers assess your heart’s size, structure, valves and pumping function.

The most common type uses a probe placed on the chest. It is noninvasive and does not expose you to radiation. Other types involve exercise or medication, or a probe passed into the esophagus.

Why Might You Need an Echocardiogram?

Your provider may recommend an echo to investigate a heart murmur, unexplained shortness of breath, leg swelling, or other signs of a heart condition. It can also help monitor an existing condition or assess how well treatment is working.

Depending on the type of exam, an echocardiogram can help assess:

• The size of the heart’s chambers and thickness of its walls.
• How effectively the heart pumps blood.
• Narrowed or leaking heart valves.
• Heart muscle disorders, including cardiomyopathy.
• Certain heart defects present at birth.
• Fluid buildup around the heart.

Results are interpreted alongside your symptoms, medical history and other tests.

Types of Echocardiograms 

Transthoracic Echocardiogram (TTE)

A TTE is the standard chest-based echocardiogram. A trained sonographer applies gel and moves a handheld probe, called a transducer, over your chest to capture images.

You may be asked to change position or briefly hold your breath. Some exams use an ultrasound-enhancing agent administered through an IV to improve image clarity.

Transthoracic  Echocardiogram (TTE)

A TEE provides detailed images using a small ultrasound probe guided through your mouth and into your esophagus, which lies close to the heart. Your throat is numbed, and sedation is typically provided.

Unlike a TTE, this procedure is invasive. Tell your care team about swallowing difficulties or esophageal conditions before the exam.

Stress Echocardiogram 

A stress echo evaluates your heart while it is working harder. Images are taken at rest and during or immediately after stress induced by exercise or medication.

A standard resting echo does not directly show coronary artery blockages. A stress echo can help identify reduced blood flow by showing changes in heart muscle movement; additional testing may be needed.

Transesophageal Echocardiogram (TEE)

The main aim of a transesophageal echocardiogram (TEE) test is to get clear images of the heart's structures. During a TEE, a small, flexible tube with a transducer on end is passed through the mouth and down the esophagus, providing a close-up view of the heart. TEE is often used to diagnose various things, such as:

• heart valve disorders
• infections in the heart
•  blood clots

Three-Dimensional Echocardiogram

Providers may use 3D imaging during a TTE or TEE to provide additional views of heart structures, including the valves. It is an imaging technique rather than a separate method for performing the exam.

‍

What Does an Echocardiogram Show?

An echocardiogramis a noninvasive test that uses sound waves to create images of the heart. Thistest provides valuable information about the heart. Here are some of the thingsan echocardiogram may show:

• Septal wall defects 
• Pericarditis 
• Cardiomyopathy 
• The movement of the heart muscle
• Congenital heart disease 
• Atherosclerosis 
• Cardiac tumor 
• Atrial wall defects 
• Pericardial effusion 
• The thickness of the heart muscle
• Heart failure 
• The flow of blood through the heart
• Aneurysm 
• Heart valve disease 
• The size and shape of the heart's chambers

How to Prepare

Preparation depends on the test:

• Standard TTE: Usually requires no fasting or special preparation.
• Stress echo: Follow instructions about food, caffeine, activity and medications.
• TEE: Follow fasting instructions and arrange for someone to drive you home after sedation.

Wear comfortable clothing and bring an updated medication list. Do not stop prescribed medication unless your care team tells you to.

Risk and Recovery

A standard TTE has no known risks from the ultrasound itself, though probe pressure may cause mild discomfort.

TEE carries additional risks, including reactions to sedation and esophageal injury. Afterward, wait until your care team says it is safe to eat or drink. Stress testing also requires monitoring because exercise or medication increases the heart’s workload.

Your provider will explain the results and whether follow-up testing or treatment is required.

Discuss Your Heart Health

It's vital to follow the instructions from your healthcare provider before going for the test. Have questions about an echocardiogram or a recommended heart evaluation? Schedule a visit with tru Primary & Urgent Care to discuss your concerns and the appropriate next steps.