An echocardiogram is a test that, much like an ultrasound, uses sound waves to create a moving image of the heart. The most common type of echocardiogram is performed transthoracic, meaning the image is taken through a probe against the chest. A TTE does not involve radiation and is a very safe procedure. A cardiac sonographer will put a gel on the patient’s chest and move the transducer around different areas, including directly anterior to the breastbone, inferior and lateral to the right nipple, and over to the right side. The echocardiography machine will pick up the sound waves as electrical impulses and convert them into images that a doctor will later review. The test is fairly common in that it allows doctors to view the heart chambers and valves noninvasively, as well as monitor patient condition.

A less common procedure to obtain similar pictures of the heart is a transesophageal echocardiogram, which is when a scope is inserted down the patient’s throat. The transducer is at the end of the scope and allows the images to be gathered from directly posterior to the heart. Lung disease and obesity are two conditions in which a TEE would be indicated. Another type of echocardiogram is a stress test. This is performed to see if a patient’s chest pain or related symptoms is due to heart disease. Images will be taken when the patient is still and the heart is at rest. Then the patient will walk on a treadmill until a target heart rate is reached and the heart is said to be under stress. The stress test can monitor heart wall movement, but it cannot see the coronary arteries.

Doppler ultrasounds can be used with echocardiograms to allow the doctor to see blood flowing through the heart. This can be particularly helpful in conditions where arteries or valves are leaking, and miscommunication between the left and right sides of the heart.

Echocardiograms are indicted in patients that present with any range of cardiac symptoms and diagnoses that are new or changing, including but not limited to: atrial fibrillation, atrial flutter, murmurs, chest pain NOS, arrhythmias, congenital heart disease or failure, pericarditis, mitral regurgitation, aortic dissection or stenosis, transposition of the great vessels, atrial/ventricular septal defects, cardiomyopathy, strokes, and heart attacks.

Image Caption: This is an ultrasound picture of the heart, an echocardiogram. It depicts a ventricular septal defect. Credit: Kjetil Lenes/Wikipedia