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Echocardiogram (Transthoracic)

An echocardiogram (often called simply “Echo”) is a non-invasive test that provides an actual image of the heart at work. Sound waves are used to create this image and the test is absolutely pain free. Similar to an x-ray, but without the use of any radiation, high-frequency sound waves (called ultrasound) are bounced off the structures of the heart and returned to a computer that uses the ultrasound data to create a picture of the heart. Heart sounds are also collected during the procedure to aid the physician in making a diagnosis. Many patients are familiar with the technology used during an echocardiogram since it is the same as that used to create an image of babies during pregnancy.

There are actually several different types of echocardiograms, including the following:

  • Transthoracic echos are diagnostic tests that use crystals to generate high-frequency sound waves. As these sound waves are aimed at the valves and tissues of the heart, they are reflected (echoed) back to a machine that analyzes them and generates an image of your heart on a computer monitor.
  • Stress echos that involve echocardiograms performed before and immediately following exercise. Stress echos are useful in identifying problems with coronary artery blood flow to the heart brought on by exertion.
  • Dobutamine stress echocardiograms are stress echos for people unable to exercise. In these procedures, a drug is used to cause the heart to pump as it does during exercise.
  • Transesophageal echocardiograms (TEE) that require a small device to be inserted into the throat and esophagus to provide a clearer image of the heart and to visualize areas not able to be seen on a transthoracic echocardiogram. Below is a detailed overview of what you can expect to occur during a transthoracic echocardiogram/doppler procedure.

For information about the other types of echocardiograms, please see Stress Echo, Dobutamine Stress Echo, and Transesophageal Echo.

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Purpose of the Procedure

An echocardiogram is used to help diagnose certain heart conditions and can be especially useful to determine the cause of heart murmurs, angina (chest pain), shortness of breath, or abnormal electrocardiograms. Heart conditions that echocardiograms may identify include problems with heart valves, heart failure, rheumatic heart disease, bacterial endocarditis, and cardiac ischemia (insufficient blood flow to the heart), and the presence of a blood clot in the heart, among others.

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Before the Procedure

Before the echocardiogram, you should receive an explanation of the procedure and the benefits and risks, and you will be asked to sign medical consent forms to authorize the procedure. Either before or sometimes after an echocardiogram, you will be asked several questions about symptoms you are feeling and about your health history. These questions are simply to assist the doctor and technologist to better interpret the results of the echocardiogram. Be sure to ask any questions you may have about the procedure and why it needs to be performed. The more you understand, the better.

There are no special preparations required before a transthoracic echocardiogram and you may eat and drink normally before your procedure. To help you prepare for your procedure, please use the following checklist:

  • Please wear comfortable clothing to the hospital
  • Please bring your reading glasses for reading and signing forms.
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During the Procedure

Patients will be asked to remove their clothing from the waist up and will wear a hospital gown during the procedure. Patients will be on their back on a bed or stretcher next to an ultrasound machine. The echocardiogram is performed on a machine that is hooked to a television-like video monitor. It has a movable arm that holds a long cord and a small wand called a transducer.

A trained technologist will perform the actual examination. It begins with the technologist placing a gel substance on your chest. This gel helps the transducer to detect the ultrasound waves. After the gel is applied, the technologist may dim the lights in the room to make it easier to see the video monitor. Once preparations are completed, the procedure begins as the technologist places the wand firmly on your chest and moves it around to provide the desired image of your heart. Throughout the procedure, you may be able to see the image that appears on the video monitor and you will be able to hear your heartbeat.

As the technologist moves the transducer around your chest, you may be asked to change positions and to hold your breath for short periods. These steps may help to provide a clearer view of the heart. Most transthoracic echocardiograms will take about 30-45 minutes to complete. Once the examination is complete and all of the necessary images have been collected, the procedure ends with the technologist removing the gel from your chest. You will then be able to sit up, dress, and leave the examination room. Since no medications are used to perform an echocardiogram, you will be able to drive immediately following the procedure.

In addition to an echocardiogram, an electrocardiogram may also be performed at the same time. The electrocardiogram adds information about the electrical activity of the heart that the doctor may use to help make the diagnosis.

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After the Procedure

Since the echocardiogram is a noninvasive test and involves no medications, you will be able to immediately return to your normal activities following the procedure. You will need to return for a visit with your doctor within a few days at which time your doctor will discuss the results of the examination.

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