What is an Echocardiogram?

Using ultrasound to examine the heart’s size, shape and motion, this test is used to detect possible abnormal rhythms (arrhythmias) or defects that could cause a stroke. There are several types of echocardiograms:

Transthoracic Echocardiogram

TTE is a completely noninvasive test that uses reflected sound waves (echoes) to create images of the beating heart. During the test, a device called a transducer will be placed on the surface of your chest. The transducer sends sound waves through the chest wall to the heart, which reflects the sound waves back to the transducer, creating echoes that are converted into 2D or 3D images. You will be able to watch your heart beating on a computer screen as the test is being done.

TTE provides a wealth of information about the size and shape of the heart, the functioning of the heart muscle and valves, as well as information about the blood flow through the heart. This bedside test represents the easiest way to diagnose valve narrowing (stenosis) or backflow (regurgitation). Occasionally, TTE is performed in conjunction with a stress test (typically treadmill exercise). This combination is known as a stress echocardiogram and helps your physician understand your symptoms better and choose between major treatment options.

By creating an image of the heart that is more detailed than an X-ray, this noninvasive test is used as a baseline to:

• Evaluate the size of the heart
• Evaluate the heart’s valves and chambers
• Detect abnormalities or presence of heart disease
• Evaluate cardiac function after a heart attack

Dobutamine Echocardiogram

Patients who are unable to exercise are given dobutamine, an intravenous medication that causes the heart to beat faster, mimicking the effects of exercise.

Transesophageal Echocardiogram

This more invasive test requires a device called a transducer be inserted down the throat into the esophagus. Because there is no interference from the lungs and chest, these images are clearer than those obtained with the transthoracic echocardiogram (TEE).

During TEE, a very small transducer is attached to the end of a thin, flexible tube, which is gently and painlessly guided down the throat and into the esophagus and stomach. A mild sedative is given intravenously, which requires a short recovery time at the end of the 15-minute procedure.

TEE is complementary to TTE and produces high-resolution images of the smallest heart structures. This test can be performed at the bedside, or during cardiac catheterization or surgery, guiding the procedures of interventional cardiologists or surgeons aiming to repair structural heart disease.

Stress Echocardiogram

During this test, an echocardiogram is performed while the patient uses a treadmill or stationary bike. Performed both before and immediately after exercise, the test can assess how the heart performs under stress. It can reveal parts of the heart that may not be receiving adequate blood or oxygen because of blocked arteries.