An echocardiogram is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain x-ray image and involves no radiation exposure.
How the test is performed:
A trained sonographer performs the test, then your heart doctor interprets the results. An instrument called a transducer that transmits high-frequency sound waves is placed on your ribs near the breast bone and directed toward the heart.
Additional images will be taken underneath and slightly to the left of your nipple (at the apex of your heart). The transducer picks up the echoes of the sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of the heart. The Doppler probe records the motion of the blood through the heart.
An echocardiogram allows doctors to see the heart beating, and to see many of the structures of the heart. Occasionally, your lungs, ribs, or body tissue may prevent the sound waves and echoes from providing a clear picture of heart function. If so, the sonographer may inject a small amount of liquid (contrast) through an IV to better see the inside of the heart.
Very rarely, more invasive testing using special echocardiography probes may be necessary.
TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE)
Your health care provider may choose to perform a transesophageal echocardiogram (TEE):
- If the regular or transthoracic echocardiogram is unclear due to a barrel chest, lung disease, or obesity
- If a much clearer picture is needed of a certain area
With TEE, the back of your throat is numbed and a scope is inserted down your throat. On the end of the scope is an ultrasonic device that an experienced technician will guide down to the lower part of the esophagus. It is used to obtain a more clear two-dimensional echocardiogram of your heart.
What abnormal results mean:
An abnormal echocardiogram can mean many things. Some abnormalities are very minor and do not pose significant risks. Other abnormalities are signs of very serious heart disease that will require further evaluation by a specialist. Therefore, it is very important to discuss the results of your echocardiogram in depth with your health care provider.
Connolly HM, Oh JK. Echocardiography. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 14.