Echocardiography or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart’s chambers and valves are working. Echo also can pinpoint areas of heart muscle that aren’t contracting well because of poor blood flow or injury from a previous heart attack. A type of echo called Doppler ultrasound shows how well blood flows through your heart’s chambers and valves.
Echo can detect possible blood clots inside the heart, fluid buildup in the pericardium (the sac around the heart), and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body. Doctors also use echo to detect heart problems in infants and children.
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Your doctor may recommend echocardiography (echo) if you have signs or symptoms of heart problems.For example, shortness of breath and swelling in the legs are possible signs of heart failure. Heart failure is a condition in which your heart can’t pump enough oxygen-rich blood to meet your body’s needs. Echo can show how well your heart is pumping blood. Echo also can help your doctor find the cause of abnormal heart sounds, such as heart murmurs. Heart murmurs are extra or unusual sounds heard during the heartbeat. Some heart murmurs are harmless, while others are signs of heart problems.
Your doctor also may use echo to learn about:
- The size of your heart. An enlarged heart might be the result of high blood pressure, leaky heart valves, or heart failure. Echo also can detect increased thickness of the ventricles (the heart’s lower chambers). Increased thickness may be due to high blood pressure, heart valve disease, or congenital heart defects.
- Heart muscles that are weak and aren’t pumping well. Damage from a heart attack may cause weak areas of heart muscle. Weakening also might mean that the area isn’t getting enough blood supply, a sign of coronary heart disease.
- Heart valve problems. Echo can show whether any of your heart valves don’t open normally or close tightly.
- Problems with your heart’s structure. Echo can detect congenital heart defects, such as holes in the heart. Congenital heart defects are structural problems present at birth. Infants and children may have echo to detect these heart defects.
- Blood clots or tumors. If you’ve had a stroke, you may have echo to check for blood clots or tumors that could have caused the stroke.
Your doctor also might recommend echo to see how well your heart responds to certain heart treatments, such as those used for heart failure.
Types of echocardiography
There are several types of echocardiography (echo)—all use sound waves to create moving pictures of your heart. This is the same technology that allows doctors to see an unborn baby inside a pregnant woman. Unlike x rays and some other tests, echo doesn’t involve radiation.
Transthoracic echo is the most common type of echocardiogram test. It’s painless and noninvasive. “Noninvasive” means that no surgery is done and no instruments are inserted into your body. This type of echo involves placing a device called a transducer on your chest. The device sends special sound waves, called ultrasound, through your chest wall to your heart. The human ear can’t hear ultrasound waves. As the ultrasound waves bounce off the structures of your heart, a computer in the echo machine converts them into pictures on a screen.
Stress echo is done as part of a stress test. During a stress test, you exercise or take medicine (given by your doctor) to make your heart work hard and beat fast. A technician will use echo to create pictures of your heart before you exercise and as soon as you finish. Some heart problems, such as coronary heart disease, are easier to diagnose when the heart is working hard and beating fast.
Your doctor may have a hard time seeing the aorta and other parts of your heart using a standard transthoracic echo. Thus, he or she may recommend transesophageal echo, or TEE. During this test, the transducer is attached to the end of a flexible tube. The tube is guided down your throat and into your esophagus (the passage leading from your mouth to your stomach). This allows your doctor to get more detailed pictures of your heart.
Fetal echo is used to look at an unborn baby’s heart. A doctor may recommend this test to check a baby for heart problems. When recommended, the test is commonly done at about 18 to 22 weeks of pregnancy. For this test, the transducer is moved over the pregnant woman’s belly.
A three-dimensional (3D) echo creates 3D images of your heart. These detailed images show how your heart looks and works. During transthoracic echo or TEE, 3D images can be taken as part of the process used to do these types of echo. (See above for more information about how transthoracic echo and TEE are done.) Doctors may use 3D echo to diagnose heart problems in children. They also may use 3D echo for planning and overseeing heart valve surgery. Researchers continue to study new ways to use 3D echo.