What is Echocardiography?
Also known as echo or an ultrasound of the heart, echocardiography is a test that utilizes sound waves in order to create moving pictures of a person’s heart. These pictures can tell the shape and size of your heart, as well as pinpoint how well your heart’s valves and chambers are doing.

An echo can show the structure, the movement, and the size of different parts of your heart, including the septum (the wall which separates the left and right heart chambers), the walls of the heart chambers, and the heart valves.

An echo can locate areas in the heart that aren’t contracting well either because of an injury from a previous heart attack or poor blood flow. Doppler ultrasound, a type of echo, can show how well blood flows through the heart.

An echo can also pinpoint possible blood clots in your heart, problems with the aorta (the main artery), or any fluid buildup in the pericardium (a sac around the heart).

What are the Different Types of Echocardiography?
There are a few types of echocardiography, but they all use sound waves to generate moving pictures of your heart. This is the same technology used to see a baby inside a pregnant woman.

    Transthoracic Echocardiography
    This is the most common type of test. It’s noninvasive, meaning that no surgery is performed on your body.

    This type of echocardiography places a device in your chest called a transducer. This device sends sound wavesfrom your chest wall to your heart. When the ultrasound waves bounce around your heart, the echo machine converts them into pictures on a screen.

    Stress Echocardiography
    This is done as part of a stress test. You may be asked to exercise or take medicine to make your heart beat fast. A technician will utilize echo before and after increasing your heart rate to evaluate your heart's response to stress.

    Transesophageal Echocardiography
    Also called a TEE, the test involves a transducer being attached to the end of a flexible tube. It is then guided down into your esophagus through your throat to get a more detailed picture of your heart structure and function. The transesophageal echo is used when we have a difficult time seeing the aorta or other parts of your heart using a transthoracic echo.
When Do We Need Echocardiography?
You might be asked to get an echo if you have any symptoms or signs of heart problems. Examples would include swelling in the legs or shortness of breath, as they may be signs of heart failure.

Dr. Khorrami might also want to determine:
  • Any heart valve problems; an echo can show if your heart valves open or close appropriately.
  • Your heart’s size; an enlarged heart might be from leaky heart valves, high blood presusure, or heart failure.
  • If your heart muscles are weak, particularly if you have had damage from a heart attack. A weak heart can be due coronary artery disease, which means you’re not getting enough blood supply.
  • Any blood clots or tumors, particularly if you’ve had a stroke.
  • How your heart responds to different heart treatments, to guide next steps in treatment.
  • Any problems with the structure of your heart, such as congenital heart defects, which have been present since birth.
What Can I Expect Before My Echocardiograph?
You don’t need any type of special preparation for most types of echo. That means you can eat or take your medicines normally.

What Can I Expect During My Echocardiograph?
An echo normally takes less than an hour to perform and is painless. Depending on what type of echo you do, Dr. Golshani might also order injection of a special dye or saline into one of your veins. It will help to make your heart show up more clearly in the pictures.

You will need to take off your clothing from the waist up. Your privacy will be respected, as women will wear a gown during the test. You lie either on your left side or back on an exam table.

Electrodes will be attached to your chest so an electrocardiogram (a test that records the heart’s activity) can be performed. The echo technician will then apply gel to your chest. A transducer will be moved on your chest. The transducer will transmit ultrasound waves into your chest, and a computer will convert the echoes into pictures. We will record these pictures and put them on a file for a heart specialist to review.

During the test, you might need to hold your breath for a short while or change positions. The light might also be dimmed. They may also apply light pressure on your chest with the inducer. This is to help the sonographer get a better picture of your heart. If you feel uncomfortable, let the doctor or sonographer know.

There are some variations to the procedure mentioned above. They are detailed below:

    Transesophageal Echocardiography
    The technology is a bit different as the transducer is attached to the end of a flexible tube. The cardiologist will guide the tube into your esophagus down from your throat so that the major blood vessels leading to and from the heart can be seen.

    You will get medicine to help you relax for the duration of the test. An anesthesiologist will inject it in to one of your veins. You will need to remove dentures or partials if you wear them.

    Before the tube is guided down the back of your mouth will be numbed with gel or sprayThe tube will then be guided down until it is right behind your heart. Throughout the procedure, your vital signs such as the oxygen content or your blood and blood pressured will be monitored. You will also be given oxygen via a tube in your nose.

    Pictures will be recorded as the cardiologist positions the transducer around in your stomach and esophagus. As this happens, you shouldn’t feel any discomfort.

    Even though the whole process takes less than an hour, you might be monitored for a few hours in the procedure center afterwards. Stress Echocardiography

    A stress echo is basically an exercise or pharmacological stress test combined a transthoracic echo. If you’re doing a pharmacological stress test, you will be given medicine to speed up your heart rate. If you are doing an exercise stress test, you’ll either pedal a stationary bike or walk or run on a treadmill to force your heart to work hard and beat quickly. Pictures of your heart will be taken before you start exercising and as soon as you finish.
What Can I Expect After My Echocardiograph?
Usually, you can resume your normal activities after getting an echocardiograph. You might be monitored for a few hours afterwards only if you’ve had a transesophageal echo (TEE). Your throat might also be sore for several hours after the test. You might not be able to drive after having a TEE so you might need to arrange a ride home.

Are There Any Risks?
A stress echo might have some risks, but it’s more from the medicine used to raise your heart rate, or related to the exercise. It is very rare to have serious complications from a stress test.

There might be some risks with the medicine administered to help you relax for a TEE. Potential risks include having trouble breathing, nausea, or having a bad reaction to the medicine. There is a rare chance that the tube used for TEE might cause a minor throat injury.

Discuss Your Options with Dr. Khorrami
Dr. Khorrami has been in practice since 1996 as a double-board certified gastroenterologist, has experienced a variety of patient cases, and is well trained to solve your digestive problems. Get in touch to learn more about the benefits of getting an echocardiography


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About Dr. Khorrami

Dr. Payman Khorrami is a UCLA graduate, has been in practice since 1996, and is double board certified. Undergraduate Education at University of California, Berkeley, Medical School at University of California, San Francisco, Internal Medicine Training at University of California, San Diego Read Full Bio