Why it's done

Your doctor may suggest an echocardiogram to:

• Check for problems with the valves or chambers of your heart
• Check if heart problems are the cause of symptoms such as shortness of breath or chest pain
• Detect congenital heart defects before birth (fetal echocardiogram)

The type of echocardiogram you have depends on the information your doctor needs.

Transthoracic echocardiogram

In this standard type of echocardiogram:

• A technician (sonographer) spreads gel on a device (transducer).
• The sonographer presses the transducer firmly against your skin, aiming an ultrasound beam through your chest to your heart.
• The transducer records the sound wave echoes from your heart.
• A computer converts the echoes into moving images on a monitor.

If your lungs or ribs block the view, you may need a small amount of an enhancing agent injected through an intravenous (IV) line. The enhancing agent, which is generally safe and well tolerated, will make your heart's structures show up more clearly on a monitor.

Transesophageal echocardiogram

If your doctor wants more-detailed images or it's difficult to get a clear picture of your heart with a standard echocardiogram, your doctor may recommend a transesophageal echocardiogram.

In this procedure:

• Your throat will be numbed, and you'll be given medications to help you relax.
• A flexible tube containing a transducer is guided down your throat and into the tube connecting your mouth to your stomach (esophagus).
• The transducer records the sound wave echoes from your heart.
• A computer converts the echoes into detailed moving images of your heart, which your doctor can view on a monitor.

Doppler echocardiogram

Sound waves change pitch when they bounce off blood cells moving through your heart and blood vessels. These changes (Doppler signals) can help your doctor measure the speed and direction of the blood flow in your heart.

Doppler techniques are generally used in transthoracic and transesophageal echocardiograms. Doppler techniques can also be used to check blood flow problems and blood pressure in the arteries of your heart — which traditional ultrasound might not detect.

The blood flow shown on the monitor is colorized to help your doctor pinpoint any problems.

Stress echocardiogram

Some heart problems — particularly those involving the arteries that supply blood to your heart muscle (coronary arteries) — occur only during physical activity. Your doctor might recommend a stress echocardiogram to check for coronary artery problems. However, an echocardiogram can't provide information about any blockages in the heart's arteries.

In a stress echocardiogram:

• Ultrasound images of your heart are taken before and immediately after you walk on a treadmill or ride a stationary bike
• If you're unable to exercise, you may get an injection of a medication to make your heart pump as hard as if you were exercising