Echocardiogram at Cardiff and Vale Hospitals

What is an echocardiogram?

An echocardiogram, sometimes called an echo, is an ultrasound scan of your heart. It uses sound waves to build up moving pictures of your heart as it beats, showing its structure and how well it's pumping blood. It's different from an ECG (electrocardiogram), which records your heart's rhythm and electrical activity rather than its structure.

Why might I need one?

You might need an echocardiogram to find the cause of symptoms that could be linked to your heart, to confirm a diagnosis, or to monitor a condition you already have.

It's also used to check your heart before or after surgery, and to help diagnose conditions such as heart failure, congenital heart disease, cardiomyopathy (a condition affecting your heart muscle) and heart valve problems.

What are the benefits of having one?

An echocardiogram gives your doctor detailed, moving pictures of your heart's structure and how well it's pumping, including blood flow through each of its valves. This can help confirm a diagnosis and decide on the right treatment, and because it uses sound waves rather than X-rays, it doesn't involve any radiation.

Are there different types of echocardiogram?

There are several types, and which one you have depends on what your doctor needs to find out:

• Transthoracic echocardiogram (TTE): The standard, most common type, uses a small device on your chest
• Transoesophageal echocardiogram (TOE or TEE): This is where a small device is guided down your throat while you're sedated, giving more detailed pictures of the back of your heart
• Stress echocardiogram: This is done while your heart is working harder than usual, either through exercise on a treadmill or bike, or using a medicine that has a similar effect if you're not able to exercise
• Contrast echocardiogram: This is where a dye is injected into a vein to highlight extra detail.

How do I prepare for an echocardiogram?

Preparation depends on the type of echo you're having, so your doctor will give you specific instructions. You may be asked to avoid caffeine, alcohol, tobacco or food for a while beforehand, or to wear comfortable clothes and shoes if you'll be exercising during the test. Never stop taking any of your medicines unless your doctor tells you to.

If you'll be sedated, arrange for someone to drive you home afterwards. For most types of echo, you'll need to undress from the waist up and change into a hospital gown. You can also ask for a chaperone, such as a nurse, to be in the room with you.

What happens during the test?

For a standard (transthoracic) echocardiogram:

1. you'll undress from the waist up and change into a gown, then lie down on a couch or bed
2. small sticky patches (electrodes) are placed on your chest to monitor your heart rate and rhythm throughout the test
3. a cold gel is applied to your chest, which helps the sound waves travel to your heart
4. the sonographer moves a probe over different areas of your chest, which may make a swishing sound, and might ask you to move position or hold your breath at times to get clearer pictures
5. you may feel some pressure as the probe presses against your chest, but the scan itself shouldn't be painful.

Appointment times vary depending on the type of echo and where you have it, but a standard scan often takes somewhere between 30 minutes and an hour, and you may be asked to stay a little longer afterwards so you can be monitored.

What happens after the test?

For most types of echo, you can drive yourself home afterwards. If you were sedated for a TOE, you'll need someone to collect you and drive you home, as you shouldn't drive for 24 hours yourself, and your throat may feel sore for a few days.

The sonographer who scanned you will let you know when your results are ready. Sometimes this is discussed with you on the same day, but you'll often be given a separate appointment, or your results will be sent to your GP or a specialist like a cardiologist who had requested the test.

You might see your results appear in an online medical record before you've discussed them with your doctor, but it's best to wait and go through them together, as some things can look more concerning than they are without an explanation.

What are the risks?

A standard transthoracic echocardiogram has no known risks and is painless. Other types carry a small chance of side effects. A stress echocardiogram might cause chest pain or shortness of breath while your heart is working harder, a TOE can leave your throat mildly sore for a few days, and the contrast dye used in some scans can occasionally cause an allergic reaction, such as itching, though a serious reaction is rare.

Your doctor will explain the possible risks for the specific type of echo you're having before the test.