Echocardiogram: Definition, Types, Procedure and Risks of the Test

It is a common ultrasound test that examines your heart and shows its movements.

The echocardiogram is a painless and non-invasive treatment. The procedure is helpful in identifying any abnormalities in the heart and heart valves.

During the test, sound waves are used to produce images of the heart.

Types of echocardiograms

Transthoracic Echocardiogram – This is the standard non-invasive echocardiogram. The transducer is moved across your chest to see an image of the patient’s heart.

Transesophageal echocardiogram: During a transesophageal echocardiogram, the patient’s throat is numbed and an endoscopic probe is swallowed, providing a close-up image of the heart; patients remain conscious but are sedated for comfort during the procedure.

Doppler echocardiogram: This procedure helps determine the speed and direction of blood flow in the heart. It is used to measure and evaluate the flow of blood through the chambers and valves of the heart.

The amount of blood that is pumped in each heartbeat is indicative of a problem with one or more of the four heart valves, or with the walls of the heart.

Echocardiogram stress : during this procedure, ultrasound images of the heart before and after walking taken, running in a band or ride a stationary bike. A stress echocardiogram is done to assess the heart’s response to stress or exercise.

Effort is also monitored while the patient exercises. If you are unable to exercise, you may receive an injection of a medication that increases your heart rate to simulate the effects of exercise.

Intracardiac echocardiogram: This is performed under local anesthesia, an intracardiac echocardiogram is performed by passing a thin, flexible tube with a small transducer through an artery through a small opening in the arm, wrist, or groin.

The doctor places the catheter so that ultrasound images of the heart and its valves can be recorded and interpreted to detect possible problems or diseases.

The procedure produces a more direct visualization of the structures of the heart than most other tests and allows physicians to develop a precise treatment plan tailored to the needs of the patient.

This procedure helps to identify any problem with the coronary arteries, through a detailed visualization of the cardiac structures , hemodynamic information, allows the positioning of catheters, the monitoring of acute complications such as thrombus formation, pericardial effusion, cardiac tamponade, among others.


During most echocardiograms, the patient will be asked to lie on an exam table.

The electrodes will be placed on the chest, and a clear gel will be applied to the chest, in the area of ​​the chest where the heart is.

This lubricating gel allows the device, called an ultrasound transducer, to detect ultrasound signals and glide easily over the skin, and information will be collected through the recordings of the sound wave echoes produced by the heart.

These images are recorded on videotape and can then be viewed by your doctor at any time.

Transthoracic echocardiogram

When the transducer is placed against the skin, an image of the area is displayed on a video screen. Depending on how the transducer is positioned, the heart can be viewed from several different angles.

Due to the blood flowing through the heart, a sound similar to that of the heart will be heard.

A dye, called stirred saline, can be injected to find any leaks between the chambers of the heart.

The images, stored as a 15-minute recording, will be recorded and can be viewed by the physician at any time.

This procedure takes approximately 45 minutes to perform.

Transesophageal echocardiogram

Unlike a transthoracic echocardiogram, it requires preparation before the test can be performed.

The patient will be asked not to eat or drink anything except water for eight hours prior to the test.

You also shouldn’t smoke for six hours before taking the test.

Make sure to adjust your daily medications, such as insulin if you are diabetic.

During the actual procedure, the patient is sedated intravenously to make it less uncomfortable.

Your doctor will ask you to swallow a thin, flexible tube with a special tip (called a catheter).

You may be asked to gargle with an anesthetic that will numb your throat and tongue so you can swallow the tube more easily.

The test takes 60 to 90 minutes to complete, but may need to stay in for an hour or two until the sedative wears off.

Ultrasonic waves pass through the skin and other tissues of the body to the tissues of the heart, from there the waves echo the structures of the heart.

These are passed to a computer that is capable of creating moving images of the walls and valves of the heart with this information, and the following can be observed:

  • Heart size: The chambers or muscular walls of your heart may be enlarged due to damaged heart valves, high blood pressure, or other conditions.
  • Heart valves: The test shows if your valves are the normal shape, if they open and close properly, and if they are leaking.
  • Damage to the heart muscle: If you’ve had a heart attack, coronary artery disease, or other conditions, the walls of your heart may be damaged.
  • Heart defects: problems seen in the chambers of the heart, abnormalities in the connections between the heart and major blood vessels, and some congenital heart defects.
  • The heart’s pumping ability: When the heart cannot pump enough blood to meet the body’s demands, heart failure can be a concern.
  • Determine the percentage of ejection of blood pumped from a filled ventricle with each heart beat.
  • Determine the cardiac output or volume of blood that the heart is capable of pumping in one minute.
  • The presence of blood clots, tumors, and infectious growths can be seen through an echocardiogram.

Risks of the echocardiogram

Since the transthoracic echocardiogram is done without entering the body and does not use dyes, there is no risk or pain.

In the transesophageal echocardiogram, swallowing the tube may cause some discomfort or pain.

However, anesthetics are generally administered to make the procedure less uncomfortable.