Robert Wood Johnson University Hospital

Echocardiography (Echo)

Echocardiography (Echo)

What is an echocardiogram?

An echocardiogram (also called echo, transthoracic echocardiogram or TTE, exercise or stress echocardiogram, dobutamine stress echocardiogram or DSE, or transesophageal echocardiogram or TEE) is a noninvasive (the skin is not pierced) procedure used to assess the heart's function and structures. A transducer (like a microphone) sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on your chest at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or echo off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer interprets the echoes into images of the heart walls and valves.

Anatomy of the heart, interior view
Click Image to Enlarge

An echocardiogram may utilize one or more of several special techniques:

Why is an echo done?

There are many diseases of the heart that may be detected by echocardiography, including the following:

An echocardiogram may be done to further evaluate signs or symptoms of these and other conditions. The echo can detect problems with the heart, such as enlargement, abnormalities in motion of the heart wall, blood clots, and heart valve abnormalities. It also measures the strength of the heart muscle (ejection fraction).The echo is more accurate than an ECG, but also more expensive.

How is an echocardiogram done?

A basic echocardiogram may be done in the doctor's office, a clinic, or in the hospital. For the procedure, you will remove your clothing from the waist up. Privacy will be ensured by using drapes across the chest and limiting access into the procedure room during the test. You will lie on your left side on a table or bed, but may be asked to change position during the procedure. EKG leads may be attached to your chest, so that the echo images can be compared to the EKG tracing during and after the procedure. The echocardiography technician will apply warmed gel to your chest. Then he or she will position the transducer on your chest and use a small amount of pressure to obtain the desired image. The technician will move the transducer around on your chest so that all areas and structures of your heart can be observed. During the test, the different echo techniques described above (M-mode, 2-D, 3-D, Doppler, and color Doppler) may be used. You will not be aware of the different techniques except that during the Doppler or color Doppler, you may hear a "whoosh-whoosh" sound. This whooshing sound is your blood moving through the heart.

Once all the images have been taken, the technician will wipe the gel from your chest, remove the EKG electrode pads, and provide you with privacy to dress. Once the procedure has been completed, you will be able to leave and return to your previous activities, unless your doctor instructs you differently. The procedure usually takes about 30-45 minutes to perform. However, factors such as schedule delays, emergencies, and other factors may delay the start of your procedure or prolong the length of it.

There are other types of echo procedures beyond the basic exam. These procedures are described below:

Click here to view the
Online Resources of Cardiovascular Disease


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