Echocardiography

What is echocardiography?

Echocardiography is an ultrasound of the heart. It uses sound waves to create an image of the beating heart.

Using echocardiography, doctors are able to view the heart beating as it happens. This allows them to diagnose a number of serious health problems.

An echocardiograph is sometimes called an echo, for short.

Why is echocardiography done?

An echocardiography is usually ordered if doctors suspect a problem within the heart or nearby blood vessels (cardiovascular system), or a more general problem, such as shock.

An echocardiography is able to show:

• problems with the structure of the heart, such as problems with the heart muscle or the valves
• problems with blood flow
• how much blood is pumped by the heart
• how much blood remains in the heart after a heartbeat.

An echocardiography can help to diagnose:

• heart failure
• heart attack
• cardiomyopathy – a disease of the heart muscle
• cardiac tamponade – when fluid collects in the thin sac-like sheath around the heart
• heart valve problems
• pericarditis –  inflammation of the thin sac-like sheath around the heart
• cardiogenic shock – when the heart is too damaged to supply enough blood to the body’s organs
• pulmonary hypertension –  where the arteries in the lungs become too narrow
• blood clots within the heart
• defects in the heart muscle walls.

How is echocardiography done?

A person can have echocardiography done in their beds or in a special unit set up for this purpose.

Types of echocardiography

The more common type of echo is called transthoracic echocardiography, or TTE. In this type, the person having the echo will be positioned lying down on their left side. Several electrodes applied to the chest and connected to a machine to record their heart rate.

To do the echocardiography, a trained sonographer (an ultrasound specialist) will apply a small probe to the chest wall in several places near the heart. This probe releases high frequency sound waves into the chest wall and records the changes to these sound waves as they return to the probe. A small amount of electrode gel is used to assist this.

Another type is the transoesophageal echocardiography, or TOE. This is similar to TTE, except that the probe is inserted down into the oesophagus (food pipe), rather than pressing the probe against the chest wall. To do a TOE, a very light anaesthetic is given to the person to make them feel more comfortable.

The benefit of doing a TOE is that the ultrasound waves have fewer obstacles to go through (such as tissue, muscle and bone) to get an image of the beating heart. This is because the probe is much closer to the heart, which allows the sonographer to look the heart from different angles and get much better pictures. The disadvantage is that the person having the echo needs a light anaesthetic.

How it works

The echocardiography machine converts the impulses from the probe into a digital image of the moving heart. The whole procedure usually takes around 20 minutes.

What are the risks?

As with any medical procedures, echocardiography has a small risk, even when performed by skilled and experienced staff.

When will the results be back?

Results should be available within a few hours.

Publication details

Version 1.1. First published 2015. Next review 2023.