What happens in an echocardiogram?

What Happens in an Echocardiogram: A Complete Guide

An echocardiogram, which is also called an echo, is an ultrasound scan of the heart and the main blood vessels. It is a safe, painless imaging procedure that checks the structure and blood flow through the heart.

A hand-held ultrasound probe is used to send sound waves through your chest to create pictures of your heart, which are displayed on a monitor. These will then be sent to a physiologist who will interpret them and the reports are then overseen with comments from our Consultant Cardiologist. It’s different to an electrocardiogram (ECG), which checks the electrical activity of the heart.

At Vista Health, we offer transthoracic echocardiograms (TTE), the most common type of echocardiogram.

Here, we will explore what to expect during your echocardiogram test, how to prepare for an echocardiogram (sometimes referred to as an echo test) and what it can help diagnose.

Understanding Echocardiogram Basics

Echocardiograms use ultrasound technology. This technology captures detailed pictures of the inside of the human body. It uses high-frequency sound waves, called ultrasound.

The ultrasound waves are produced by a small handheld device called an ultrasound probe. As the ultrasound waves pass through your body, they bounce off the tissues. This creates echoes that are detected by the ultrasound probe in real-time. With an echocardiogram, the echoes create live images of your heart and its main blood vessels.

Different tissues bounce or reflect ultrasound waves to varying extents. This allows ultrasound imaging to clearly detect the boundaries between different body tissues. When imaging the heart, clear images of its chambers, valves and main blood vessels can be captured. It can also show how thick the heart wall is and how blood flows through the heart.

Unlike X-rays and CT scans, ultrasound scans, including echocardiograms, do not use ionising radiation. There is no radiation risk, so these scans are safe to perform on children^*1 and pregnant women.

Different techniques used in echocardiograms

The images captured during an echocardiogram vary depending on what imaging technique is being used. Imaging techniques used during an echocardiogram include:

● 2D imaging – images captured appear as flat slices through the heart

● 3D imaging – images captured appear in 3D and can be viewed from different angles

● Doppler imaging – this measures the speed and direction of blood flow through the heart

● Colour Doppler imaging – this also measures the speed and direction of blood flow through the heart but uses different colours depending on the direction of blood flow

● Strain imaging – this measures the length of your heart muscle as it contracts and relaxes to check how well your heart muscle moves

Common myths and misconceptions about echocardiograms

Echocardiograms (echo tests) are often confused with electrocardiograms. Both of these tests check the health of your heart. Echocardiograms capture images of the structure of your heart, while electrocardiograms capture electrical signals of your heart’s activity.

Another common misconception about echocardiograms is that they use radiation, similar to CT scans and X-rays. However, echocardiograms do not use any radiation and instead rely on ultrasound waves.

Finally, echocardiograms are sometimes mistakenly thought to be painful procedures. A transthoracic echocardiogram is non-invasive and usually painless. However, sometimes when imaging is challenging, additional pressure may need to be applied using the probe and this may feel uncomfortable.

What can an echocardiogram detect?

An echocardiogram can help diagnose a range of heart conditions, including;

● Heart failure – where the heart muscle may not be functioning optimally

● Cardiomyopathy – thickening or enlargement of the heart wall or pumping chambers

● Coronary heart disease - this is sometimes referred to as coronary artery disease; an echo can assess how the heart walls contract to help detect this condition

● Endocarditis – infection of the inner lining of the heart that causes damage to the heart valves

● Heart valve defects – leaky or narrowing of the heart valves

● Pericardial disease – medical conditions that affect the fibrous sac that covers the heart (pericardium)

● Damage following a heart attack

Echocardiograms also use a simple ECG to assist with measurements and timing of the cardiac cycle.

The echocardiogram procedure explained

A transthoracic echocardiogram (commonly abbreviated as TTE) takes 20–40 minutes. You will need to remove the clothes from your upper body. You will lie down on an examination table and will have 3 sticky sensors called electrodes placed on your chest.

These electrodes are connected to wires that provide a simple ECG as part of the echo. This allows accurate timings of measurements made of the structure and function of your heart.

An ECG measures the electrical activity of your heart. A simple version is performed alongside an echocardiogram to aid in the assessment of the heart (this does not replace the need for a 12-lead ECG).

After the ECG electrodes are attached, you will usually lie on your left side for the echocardiogram to be carried out. A gel will be applied to your chest to ensure that the ultrasound waves produced by the ultrasound probe pass easily into your body. If any air comes between the probe and your body, it can reflect the sound waves and interfere with the scan.

The ultrasound probe will be passed across your chest. The ultrasound waves emitted by the probe are beyond the human range of hearing, so you will not be able to hear them. At times, a swishing noise may be heard as the ultrasound machine picks up blood flowing through your heart.

The ultrasound waves will bounce off the tissues in your body and these echoes will be detected by the ultrasound probe. This information will be converted into real-time images of your heart, which will be displayed on a computer screen.

Preparing for your standard echocardiogram

You can eat and drink as usual, and take any medications you have been prescribed.

Make sure you wear comfortable clothing that is easy to take off. You’ll need to undress to expose your upper body. It is also advisable not to wear any jewellery as this may also need to be removed before your scan.

After your echocardiogram

Following a standard echo you can return to your usual activities; this includes driving.

In most cases, you will need to wait until the results have been sent to your referrer.

At Vista Health, we aim to provide a report with your echocardiogram results within 3 working days. These results will also be sent to your NHS GP. Alternatively, you can arrange a private GP appointment with one of our experienced GPs. They will discuss your results and their significance in your particular case, as well as any next steps such as treatment, if needed.

Prioritise your heart health today

If you have a family history of acquired heart disease or you want reassurance that your heart is in good shape, book your private echocardiogram with Vista Health today. With our advanced echocardiography and expert insights, you can take steps to protect your heart for a healthier future.