Echocardiogram

Key points

1. An echocardiogram (also called ECHO) is a test used to assess heart conditions.
2. It is a type of ultrasound test that uses high frequency sound waves to examine the structure and functioning of the heart. 
3. The ultrasound waves are turned into moving pictures of your heart that can be seen on a video screen and are recorded on a film that your doctor can watch.
4. There are a few different types of ECHO. The most common type is the transthoracic echocardiogram (also called a standard echocardiogram). More specialised types of ECHO are exercise stress echocardiogram, dobutamine stress echocardiogram and transoesophageal echocardiogram.     

What is an echocardiogram (ECHO)

An echocardiogram (ECHO) is a type of ultrasound test that uses high frequency sound waves to examine the structure and functioning of the heart. 

• The ultrasound waves are turned into moving pictures of your heart that can be seen on a video screen and are recorded on a film that your doctor can watch.
• An echo gives your doctor information about how well the heart pumps and whether your heart valves are working properly.  

When is an ECHO done?

An ECHO can be carried out for many different reasons, such as to:

• check how well your heart is working after a heart attack
• look at how well the valves are moving inside the heart
• see how well an artificial heart valve is working
• check if there is any fluid that may have collected around the heart
• check the thickness and movement of the heart wall
• measure the size and shape of the heart's chambers
• look for blood clots and tumours inside the heart
• identify the specific cause of heart failure.

How to prepare for a transthoracic or standard ECHO

For the most part, no special preparations are necessary for a transthoracic or standard ECHO.

• You may eat or drink as you normally would before the test.
• Take your medicine as you normally would. This will not affect the test. 
• You will need to undress to the waist in a private space and a hospital gown will be provided.

For specialised echocardiograms, specific requirements may be necessary to prepare for the test. You doctor will provide you with more detailed information.

Guide to an ECHO (echocardiogram)

(British Heart Foundation, UK, 2014)

How is a transthoracic or standard ECHO done

• An ECHO is usually done by a trained technician, in an ECHO lab.
• During the ECHO test, the technician will place a small amount of a cool gel on your chest and a small, hand-held transducer, or wand will be placed on the gel, and moved back and forth over the surface of your chest.   
• The wand sends sound waves to your heart that bounce off your heart and make pictures on the video screen and is recorded on a film that your doctor can watch.
• If the technician turns on the sound, you may hear a whooshing noise as your heart beats.
• The technician may ask you to breathe in and out slowly, or to briefly hold your breath during some parts of the test. You may have to turn on to your side during the test so that the technician can scan the heart from different angles.
• The test will take about 45 minutes.

Specialised ECHO tests

Sometimes the transthoracic or standard ECHO does not provide enough information and your doctor may request a more specialised ECHO test, such as:

Exercise stress echocardiogram

During this type of ECHO you will be asked to walk on a treadmill or ride an exercise bike whilst pictures are taken of your heart. This allows your doctor to understand how the heart copes when it is made to work harder, and is helpful to diagnose whether you have angina or not. It can also give your doctor information about the severity of a heart-valve problem.

Dobutamine stress echocardiogram

This type of ECHO also allows your doctor to understand how the heart copes when it is made to work harder. If you are unable to exercise, you may be given medication called dobutamine to make your heart react as if you were exercising. A drip will be put in the vein in your arm, and dobutamine will be infused into the drip, causing your heart to work harder. Whilst this is happening the technician will take pictures of your heart using an ultrasound probe gently placed on your chest.

Transoesophageal echocardiogram

In this type of ECHO pictures of your heart are taken by inserting a probe into your throat (oesophagus). These pictures are clearer to see than those produced using a probe on your chest (as in a standard echo) because the oesophagus is close to your heart and there is no chest wall in the way.

Learn more

The following links provide further information on echocardiograms. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Heart tests  Heart Foundation NZ
Transthoracic (standard) echocardiogram Heart Foundation NZ
Dobutamine stress echocardiogram Heart Foundation NZ
Transoesophageal echocardiogram Heart Foundation NZ
Echocardiogram Patient Info, UK