Real-time imaging of the heart's structure, valve motion, and pumping strength using sound waves. It is radiation-free and most often performed through the chest wall (transthoracic).
Indication
- Suspected heart failure presenting with shortness of breath, easy fatigue, or leg swelling
- Evaluation of a heart murmur or valve disease (stenosis, regurgitation)
- Follow-up of pumping strength (ejection fraction) after a heart attack
- Assessment of cardiac involvement in hypertension, diabetes, or chronic lung disease
- Investigation of palpitations, fainting, or unexplained chest pain
- Evaluation and follow-up of suspected congenital (present at birth) heart disease
- Investigation of intracardiac thrombus, septal defects, or infective endocarditis (valve infection)
Preparation
- Standard (transthoracic) echocardiography does not require fasting
- Wear a comfortable upper garment that is easy to remove; you may be asked to remove jewelry
- Continue your regular medications unless otherwise instructed
- If a transesophageal echocardiogram is planned, do not eat or drink for 6 hours before the procedure; sedation is used and you should bring a companion
- Bringing previous ECGs, echocardiogram reports, and imaging studies helps with comparison
How it's performed
- You lie on your left side; ECG electrodes and conductive gel for the probe are applied to your chest
- The physician sends sound waves to your heart through different points on your chest using a small probe (transducer)
- Live images of the heart chambers, walls, and valves, along with blood flow velocities, are displayed on the screen
- You may be asked to briefly hold your breath or change position during certain segments
- If a transesophageal evaluation is needed, the throat is numbed, sedation is given, and a thin probe is advanced through the esophagus to obtain images close to the heart
- The procedure typically takes 20-45 minutes; the transthoracic study is painless
Post-procedure
- Results and images are reported by the cardiologist; they are usually shared the same day or within a few days
- Depending on the findings, treatment adjustments, medication changes, or further tests (stress test, coronary imaging) may be recommended
- In chronic conditions, follow-up evaluations are scheduled at intervals determined by your physician (e.g. yearly, more often for valve disease)
- After a transesophageal procedure, the throat may remain numb for 1-2 hours; do not eat or drink during this period
- If sedation was used, do not drive on the same day and postpone important decisions to the next day
Risks
- Transthoracic echocardiography is considered painless and risk-free; it does not involve radiation
- There may be a temporary mild pressure sensation where the probe is pressed
- In transesophageal studies, throat irritation, temporary hoarseness, and rare nausea may occur
- With sedation during transesophageal studies, respiratory depression, blood-pressure drops, or allergic reactions are rarely seen
- Esophageal injury is very rare; pre-existing esophageal conditions may increase the risk
FAQ
What is the difference between echocardiography and ECG?
An ECG records the electrical activity of the heart as a tracing. Echocardiography uses ultrasound to display the heart's structure, valves, and pumping function in real time. The two tests complement each other and answer different questions.
What is the difference between transthoracic and transesophageal echocardiography?
Transthoracic echocardiography is performed through the chest wall, is painless, and requires no preparation. In transesophageal studies, a thin probe is advanced through the esophagus to view the heart more closely; it provides more detailed information in conditions such as valve infection, thrombus, or congenital septal defects, and requires sedation.
Does echocardiography use radiation? Can it be performed during pregnancy?
No, echocardiography uses sound waves and does not involve radiation. It is safely performed during pregnancy and is often used to evaluate the heart in cases of pregnancy-related high blood pressure, shortness of breath, or palpitations.
Are results available immediately?
Images are evaluated during the procedure and important findings are shared with your physician right away. The detailed written report is usually delivered the same day or within a few days.
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