• Echocardiogram

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    An echocardiogram - also called a Doppler, heart ultrasound or “echo,” - is a noninvasive test that uses sound waves to create a moving picture of the heart. Just as a baby in the mother’s uterus can be visualized with ultrasound, pictures of the heart can help doctors evaluate the heart’s structures, including the muscles and valves. Doctors may be able to see a hole in the wall that divides the left and right sides of the heart or a deformity of a heart valve, for example, as well as the following:

    • The motion of the muscular walls in the heart’s lower chambers (ventricles) provides insight into the heart’s pumping power.
    • The flow of blood within the heart, which can be seen on a color Doppler echocardiogram, helps doctors identify and assess such abnormalities as a leaky heart valve.
    • Pressure differences between one part of the heart and another can help detect heart muscle or valve problems.   

    There are three types of echocardiography:  echocardiogram, transesophageal echocardiogram (TEE), and intracardiac echocardiogram (ICE). An echocardiogram takes images within the body from the skin’s surface, without devices entering the body. For TEE, images are taken from within the esophagus (food pipe), and ICE involves taking images from within the heart. TEE and ICE can provide more detailed images than traditional echocardiography. Keep reading to learn more about echocardiograms and TEE tests. More information about ICE is available alongside a description for angiograms – the test with which ICE is typically performed.

    How Does It Work? 

    Echocardiography uses ultrasound waves to make a picture of structures moving inside the heart. These harmless sound waves travel from an instrument, called a transducer, placed on the chest and left rib cage. As the sound waves reflect back from structures in the heart to the transducer, the echocardiogram machine receives and interprets them - and creates a picture of the heart’s internal structures. As the transducer continuously emits ultrasound waves, it also receives continuous feedback from the heart. The result is a picture of the heart muscles, valves and blood vessels in motion.    

    How Is It Performed? 

    A slippery gel is applied to the outside of the chest of the patient as he or she lies on a table. A trained ultrasound technician moves a transducer over the patient’s chest to collect different “views” of the heart. The test takes 30 to 60 minutes to complete.

    Is It Safe?

    There are no known risks associated with echocardiography. Some mild soreness of the rib cage may occur.

    Transesophageal Echocardiogram (TEE)

    A transesophageal echocardiogram (TEE) is a variation of the echocardiogram that is performed in patients where a traditional echocardiogram may not have provided enough information. The echo transducer, a device that produces high- frequency sound waves, is passed down the esophagus (food pipe) to look closely at the heart valves and chambers to check for abnormalities. The TEE is performed while using a topical spray to numb the throat and heavy sedation to avoid discomfort during the test.

    Prior to the procedure it is important to avoid eating for six hours; daily medications are usually taken with sips of water. Since heavy sedation is used for this test, patients are restricted from driving for the remainder of the day and should take it easy at home. Patients are required to have a responsible person accompany them home.

    Most commonly after the procedure people feel a bit groggy for a few hours and have a sore throat that can be treated with lozenges. There are small risks associated with this test, including reaction to the sedative, or rarely, loss of a tooth, damage to the throat or esophagus, or difficulty breathing.

    Questions to Ask Your Doctor About Echocardiograms and Transesophageal Echocardiograms

    The following questions can help you talk to your physician about echocardiograms, transesophageal echocardiograms, and intracardiac echocardiograms. Print out or write down these questions and take them with you to your appointment. Taking notes can help you remember your physician’s response when you get home.


    • What can an echocardiogram tell us about my heart?
    • What happens next if the echocardiogram reveals a potential problem?

    Transesophageal echocardiogram (TEE)

    • What can a transesophageal echocardiogram tell us about my heart?
    • What are the possible benefits for me of TEE?
    • Do I need to have an empty stomach before the procedure? Should I withhold any of my medications? Are there any medications that I will need to take?
    • What happens next if TEE reveals a potential problem?
    • What are my individual risks associated with having a TEE test?

    Please print this list of questions here. Take them with you to the doctor and share them with friends and loved ones when you are encouraging them to see their doctors.

    Learn from Other Patients’ Stories

    Anna Grace Bundros

    In 2000, Anna Grace Bundros was a happy and healthy newborn, a bundle of joy to her parents Lara and Tom. Throughout the next six years Anna Grace met every milestone and proved to be an active, vibrant little girl who was a very enthusiastic learner. Despite this, Anna Grace was small for her age and often a little lethargic, lacking the energy to play for hours like other kids her age. Learn how a variety of tests helped diagnose Anna’s congenital heart defect - and how TEE supported minimally invasive treatment.

    Harper O’Bomsawin

    Nine days after Harper was born, an echocardiogram revealed that she had a coarctation of the aorta (CoA), a condition where the arch of the aorta (the main vessel in the heart) is narrowed, limiting blood flow from the heart to the lower part of the body. If left untreated, CoA causes the heart to overwork, leading to heart failure, possible kidney failure, and in some cases, death. Read about how quick diagnosis helped Harper get the treatment she needed.