What is an echocardiogram (echo)?

An echocardiogram, or echo, is a type of ultrasound or sonogram imaging test. It uses a transducing device that translates sound wave echoes into moving images of the heart. Your doctor uses an echocardiogram to look at the heart’s size and structure, and to see how well it pumps blood. 

An echocardiogram evaluates many heart problems, including heart murmurs, heart failure, and heart valve disease.

An echocardiogram is only one method used to monitor and diagnose heart conditions. Discuss all of your diagnostic options with your doctor to understand which options are right for you.    

Types of echocardiogram

The types of echocardiogram include:

  • Standard transthoracic echocardiogram (TTE) makes moving pictures of your heart while you are at rest. It uses a painless, wand-like instrument, called a transducer, on your chest. It is the most common type of echocardiogram. Your doctor may also perform an EKG (electrocardiogram) during your echocardiogram to evaluate your heart’s electrical activity during the test.
  • Stress echocardiogram involves performing an echocardiogram during a cardiac stress test. A cardiac stress test shows how exercising on a treadmill affects your heart. If you cannot tolerate walking on a treadmill, the doctor will give you a medication called dobutamine to mimic the effect of exercise on the heart.
  • Transesophageal echocardiogram (TEE) involves passing a special, much smaller transducer down your throat to take moving pictures of your heart. A transesophageal echocardiogram produces clearer pictures than other types of echocardiograms.  
  • Doppler echocardiogram records the flow of blood through the heart.

Why is an echocardiogram (echo) performed? 

Your doctor may recommend an echocardiogram to evaluate your heart health. An echocardiogram by itself cannot diagnose all types of heart conditions or predict future heart problems. It provides important information about your heart health in relation to your age, physical exam, medical history, and other tests.

Doctors use echocardiograms to help diagnose, determine the severity of, or monitor treatment of the following conditions:

  • Cardiac arrhythmias, a heartbeat that is too fast, too slow, or irregular 
  • Cardiomyopathy, thickened or enlarged heart muscle 
  • Congenital heart defects, birth defects of the heart 
  • Coronary artery disease (CAD), a buildup of plaque on the walls of the coronary arteries that supply blood to the heart
  • Heart attack, death of a portion of the heart muscle usually due to coronary artery disease and a blood clot that blocks blood flow to the heart
  • Heart failure, an inability of a weakened heart to pump enough blood to the body
  • Heart murmurs, unusual or abnormal heart sounds heard with a stethoscope
  • Heart valve disease including narrowed valves, leaky valves, and infectious endocarditis (an infection of the heart valves) 
  • Pericarditis, inflammation of the sac that surrounds the heart 
  • Pulmonary hypertension, increased blood pressure in the blood vessels that carry blood from the heart to the lungs

Your doctor may also use an echocardiogram to look for blood clots inside the heart that could travel to the brain and cause a stroke or transient ischemic attack (TIA). 

An echocardiogram can also help your doctor determine if certain symptoms are related to a heart problem. This commonly includes an irregular heartbeat or fluttering sensation in your chest. Other symptoms include chest pain, dizziness, shortness of breath, fatigue, weakness, palpitations, or passing out.

Who performs an echocardiogram (echo)?

A specially trained radiologic technologist, called a sonographer, generally performs an echocardiogram. Radiologic technologists are trained in medical imaging and the care of patients during imaging procedures. A radiologic technologist is supervised by a radiologist or other doctor. 

The following specialists order echocardiograms:

  • Cardiologists are internists or pediatricians who specialize in treating heart conditions. A cardiologist will also evaluate the echocardiogram images and provide your primary doctor with the results.  
  • Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons. 
  • Primary care providers including internists, family practitioners (family medicine doctors), pediatricians, geriatricians, physician assistants (PAs), and nurse practitioners (NPs). Primary care providers offer comprehensive healthcare services and treat a wide range of illnesses and conditions. 
  • Pulmonologists are internists or pediatricians with specialized training in treating diseases and conditions of the chest.
  • Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.