Echocardiogram: types, what happens and results

What is an echocardiogram?

An echocardiogram is a scan that uses ultrasound, high-frequency sound waves, to produce moving pictures of the heart. An ultrasound probe covered in gel is placed on the chest in the standard test.

What are the types of echocardiogram?

The most common type is the transthoracic echocardiogram, in which the probe is placed over the chest. A transoesophageal echocardiogram uses a probe that passes down the throat and gives more detailed pictures of the heart than the standard test. Doctors may use it when the standard test has not shown enough detail. A stress echocardiogram is a transthoracic scan done during exercise on a treadmill or exercise bike, or after a medicine that has a similar effect on the heart. For some echocardiograms, saline or a special dye is injected into a vein to help show the heart more clearly. A stress echocardiogram may be recommended if a heart problem is triggered by physical activity.

What happens in the throat version?

For the transoesophageal test, the back of the throat is numbed with an anaesthetic spray. A sedative may be given to help the person relax. Avoiding food for several hours beforehand may be needed for this version. Afterwards the throat may be sore, and this should pass within one or two days.

What can an echocardiogram show?

An NHS trust says a transoesophageal echocardiogram can look at the heart valves and heart muscle, and check for blood clots and tears in the aorta. An NHS trust says it can help guide surgeons during some heart procedures.

What does it check, and how long does it take?

The British Heart Foundation says an echocardiogram uses sound waves to build up a picture of the heart and its structures, such as the valves. It describes the test as an important investigation for anyone with suspected heart failure, heart valve problems or cardiomyopathy, a disease of the heart muscle. Like other ultrasound scans, which the NHS says do not use radiation, an echocardiogram uses sound waves.

Is any preparation needed?

For a standard echocardiogram people usually need to do nothing to prepare. The exception is the throat version, which may require avoiding eating for several hours.

What happens in a standard scan?

For a standard echocardiogram no preparation is needed, and NHS trust leaflets say people can eat and drink as normal before and afterwards. The person lies on their left side while a cardiac physiologist, a specially trained technician, scans the chest after putting gel on it. The physiologist may ask the person to change position or to hold their breath briefly so that the pictures are clearer. One trust leaflet describes a standard echocardiogram as painless, with no side effects and no radiation.

What is a stress echocardiogram like?

A stress echocardiogram checks how the heart copes with a greater workload, by taking pictures at rest and again under stress. The stress usually comes from walking on a treadmill or, in a dobutamine stress echocardiogram, from a medicine called dobutamine that raises the heart rate. A cardiologist or a specially trained cardiac physiologist supervises the test. Some trust leaflets ask people to avoid certain heart medicines, such as beta blockers, before a dobutamine stress echocardiogram unless the doctor advises otherwise, and each hospital gives its own instructions. Leaflets describe rare complications such as an abnormal heart rhythm and quote different figures, for example around 1 in 1,000 patients in one leaflet and around 1 in 500 in another.

How are the results given?

A cardiac physiologist analyses the recorded images and writes a report for the doctor who requested the test. The doctor who requested the test then receives the report and passes on the results, for example at a clinic appointment or by letter, depending on the trust. One trust leaflet says the letter about stress echocardiogram results, sent to the GP with a copy to the patient, can take about two to four weeks.