Echocardiogram

An echocardiogram (also sometimes called a heart echo, echogram or echo test) is a special ultrasound scan used to help diagnose and monitor heart problems. It is different from an electrocardiogram (ECG).

During a standard echocardiogram (also called a transthoracic echocardiogram), an ultrasound probe is moved across your chest. The probe uses high frequency sound waves to create moving images, so your doctor can look at the structure and function of your heart and surrounding blood vessels.

Other types of echocardiogram include:

• Contrast echocardiogram — a harmless contrast agent (a special dye that shows up on an ultrasound scan) is injected into your bloodstream, which helps create a clearer image
• Stress echocardiograms — this includes:
• Dobutamine stress echocardiogram — a standard echocardiogram is carried out after you have been given a drug called dobutamine, which increases your heart rate
• Exercise stress echocardiogram — a standard echocardiogram is carried out after you’ve exercised on a treadmill 
• Transoesophageal echocardiogram (TOE) — a small probe is passed down your throat into your oesophagus (gullet) to perform the echocardiogram

An echocardiogram is often performed alongside a Doppler ultrasound or a colour Doppler ultrasound, which assess blood flow through your heart valves.

A referral letter from a consultant or GP is required before booking any diagnostic investigation.

Your GP or a doctor who specialises in treating the heart (a cardiologist) may refer you for an echocardiogram if they think there is a problem with your heart. An echocardiogram can help detect, monitor and plan treatment for the following heart conditions:

• Cardiomyopathy — thickening of your heart wall
• Congenital heart disease — birth defects in your heart
• Endocarditis — infection of your heart
• Heart attack damage
• Heart failure
• Heart valve problems

An echocardiogram can also check how well medical or surgical treatments of the heart are working.

Transthoracic echocardiograms

This is the standard type of echocardiogram performed. A cardiologist or a technician called a sonographer will press a device called a transducer against the skin of your chest, over your heart. The transducer will have a gel on it, which may feel cool and sticky. It will pass high frequency ultrasound waves through your chest towards your heart. These waves will echo back to the transducer as they bounce off your heart. The transducer will then record these echoes and send this information to a computer. The computer will convert these echoes into images, which will be displayed on a monitor.

If your lungs or ribs are blocking the passage of sound waves, you may need to have an injection into a vein of a harmless contrast agent. This will help create clearer images of your heart.

Foetal echocardiograms

A foetal echocardiogram is used to examine the structure and function of an unborn baby's heart. It is usually performed between weeks 18 to 24 of pregnancy to check the development of your baby's heart.

You may need to have further foetal echocardiograms if you have previously given birth to a baby with a heart condition, have a family history of heart disease or have other medical conditions, such as rubella, type 1 diabetes, lupus or phenylketonuria.

Further foetal echocardiograms may also be needed if:

• You have used drugs or alcohol during your pregnancy
• You have taken medications or been exposed to medications that may cause heart defects e.g. certain epilepsy drugs, prescription acne drugs
• Your unborn baby is at risk of a heart condition or other disorder

Bubble echocardiograms

Also known as a bubble study, a bubble echocardiogram is performed in the same way as a standard (transthoracic) echocardiogram except a small amount of salt water (saline) is injected into your bloodstream via a vein in your arm.

The saline contains tiny, harmless bubbles that appear on the images collected and can help identify a hole in your heart. Bubble echocardiograms may be performed after complex heart surgery, a stroke or transient ischaemic attack (TIA or mini stroke).

A cardiologist or a technician called a sonographer will perform your scan using a device called a transducer, which sends out high frequency ultrasound waves. These waves will bounce off internal structures in your body, including your heart, creating echoes. The transducer will detect these echoes and send them to a computer, which will convert them into live images of your heart and its surrounding blood vessels.

For a standard echocardiogram, also known as a transthoracic echocardiogram, you will be asked to lie down. A cold, sticky gel will be applied to the transducer before it is then pressed against the skin of your chest, over your heart. This gel helps the ultrasound waves reach your heart.

The procedure is safe and although you may feel a slight pressure as the transducer is pressed against your skin, it is usually not uncomfortable.

An echocardiogram takes no more than an hour and you’ll be able to go home on the same day.

Your doctor may be able to explain your echocardiogram results during or immediately after the test. If they’re able to make a diagnosis, they can recommend the next steps in your personal treatment plan.

Sometimes, your doctor may need more time to assess your results. If so, you’ll be asked to come back for a follow-up appointment to discuss the echocardiogram results or they’ll be sent to the doctor who requested your test. We try to get your results back to you as soon as possible as less waiting means less worrying.

A standard (transthoracic) echocardiogram is a safe procedure with no known side effects as it doesn’t use any radiation, unlike CT scans and X-rays, but instead uses ultrasound waves.

In a contrast echocardiogram, some people have a mild reaction to the contrast agent, such as itching. In rare cases, a serious allergic reaction can occur.

In a transoesophageal echocardiogram, you may feel some discomfort during and after the procedure. There is a small chance that the probe may damage your throat. If you had a sedative during the test, you can’t drive for 24 hours afterwards.

During a stress echocardiogram (using exercise or dobutamine), you may experience symptoms such as nausea, dizziness or chest pain. In very rare cases, the test can trigger an arrhythmia (irregular heartbeat) or a heart attack, however, you’ll be monitored carefully to prevent this from happening.

At Spire Healthcare, we’re careful to weigh up the benefits and risks of any test or scan and discuss it with you if you have any concerns.