Echocardiogram (Echo) Test: What It Shows and What to Expect

An echocardiogram, often called an echo, is a scan that shows how your heart is working. It is a common test and is used for many different heart conditions. This article explains what the NHS says about it.

What is an echocardiogram?

The NHS describes an echocardiogram as a scan of the heart that uses ultrasound, which is sound waves, to see how well the heart is working. It is usually done in hospital by a trained sonographer.

Why is it done?

The NHS says an echo may be used to:

• Check whether your symptoms could be caused by a heart condition
• Check heart function in people who have current or past heart problems
• Look at the heart after a heart attack
• Diagnose conditions such as heart failure, heart valve disease or congenital heart disease

Types of echo

The NHS describes three kinds:

• Transthoracic echocardiogram (TTE): the most common type. A device is moved over the chest.
• Exercise or stress echocardiogram: similar to a TTE, but done after exercise on a treadmill or exercise bike, or after medicine with a similar effect. A second scan follows.
• Transoesophageal echocardiogram (TOE): a thin tube with a small ultrasound device is passed through the mouth into the food pipe (oesophagus) to give a more detailed image.

What happens during a standard scan

According to the NHS, for a TTE:

1. You undress from the waist up and wear a gown.
2. You lie on a couch or bed, with sticky patches placed on your chest to monitor your heart rate.
3. A contrast agent may be injected into a vein in your arm to make the heart and blood vessels clearer.
4. Gel is applied to your chest and the sonographer moves the device over it for about 30 to 40 minutes.

You can ask for a chaperone to be present.

Preparing and recovering

For a TTE you can usually eat and drink as normal beforehand. For a TOE you may be asked to stop eating and drinking first, and you will be told if this applies.

If a contrast agent was used, the NHS says you may be asked to wait up to 30 minutes so staff can check for a reaction. If you had sedation, you will recover in a recovery room, someone must take you home, and you should not drive for 24 hours. After a TOE, a sore throat is possible and usually goes within 1 to 2 days. The NHS says a TOE is not painful but people can find it uncomfortable, and the throat is numbed with anaesthetic spray.

Results

The NHS says that sometimes a doctor can discuss results on the same day. Otherwise you will usually have a separate appointment. If you have not heard anything after a few weeks, contact the doctor who referred you. Ask your doctor to explain anything you do not understand, and what the findings mean for your care.

When to see a doctor

See a doctor if you have breathlessness, swelling in your ankles, palpitations, dizziness or chest discomfort, so they can decide whether an echo or other tests are needed. If you have already had an echo and your symptoms get worse, tell your care team.

Call emergency services at once for chest pain that is tight or squeezing, pain spreading to the arms, neck or jaw, severe breathing difficulty, or pale, blue or grey skin. The NHS says not to drive yourself to hospital.

In an emergency, call your local emergency number (112 in India, 911 in the United States).