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Imaging is an important part of diagnosing heart and vascular disorders and help to prevent you from future heart events. Baylor Scott & White The Heart Hospital – Plano ​uses innovative technology to take pictures of your heart and the surrounding area. Through noninvasive imaging your physician can see how effectively your heart is pumping or blood is circulating through your arteries and your body. Preventive screening and heart tests allow us to track how you're doing and make a diagnosis.

What is Echocardiography?

Echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart's chambers and valves are working.

Echo also can pinpoint areas of heart muscle that aren't contracting well because of poor blood flow or injury from a previous heart attack​. A type of echo called Doppler ultrasound shows how well blood flows through your heart's chambers and valves.

Echo can detect possible blood clots inside the heart, fluid buildup in the pericardium (the sac around the heart), and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body.

Doctors also use echo to detect heart problems in infants and children.

What to Expect Before Echocardiography

Echocardiography (echo) is done in a doctor's office or a hospital. No special preparations are needed for most types of echo. You usually can eat, drink, and take any medicines as you normally would.

The exception is if you're having a transesophageal echo. This test usually requires that you don't eat or drink for eight hours prior to the test.

If you're having a stress echo, you may need to take steps to prepare for the stress test. Your doctor will let you know what steps you need to take.

What to Expect During Echocardiography

Echocardiography (echo) is painless; the test usually takes less than an hour to do. For some types of echo, your doctor will need to inject saline or a special dye into one of your veins. The substance makes your heart show up more clearly on the echo pictures.

The dye used for echo is different from the dye used during angiography (a test used to examine the body's blood vessels).

For most types of echo, you will remove your clothing from the waist up. Women will be given a gown to wear during the test. You'll lie on your back or left side on an exam table or stretcher.

Soft, sticky patches called electrodes will be attached to your chest to allow an EKG (electrocardiogram) to be done. An EKG is a test that records the heart's electrical activity.

A doctor or sonographer (a person specially trained to do ultrasounds) will apply gel to your chest. The gel helps the sound waves reach your heart. A wand-like device called a transducer will then be moved around your chest.

The transducer transmits ultrasound waves into your chest. A computer will convert echoes from the sound waves into pictures of your heart on a screen. During the test, the lights in the room will be dimmed so the computer screen is easier to see.

During the test, you may be asked to change positions or hold your breath for a short time. This allows the sonographer to get better pictures of your heart.

At times, the sonographer may apply a bit of pressure to your chest with the transducer. You may find this pressure a little uncomfortable, but it helps get the best picture of your heart. You should let the sonographer know if you feel too uncomfortable.

The process described above is similar to the process for fetal echo. For that test, however, the transducer is placed over the pregnant woman's belly at the location of the baby's heart.

Transesophageal Echocardiography

Transesophageal echo (TEE) is used if your doctor needs a more detailed view of your heart. For example, your doctor may use TEE to look for blood clots in your heart. A doctor, not a sonographer, will perform this type of echo.

TEE uses the same technology as transthoracic echo, but the transducer is attached to the end of a flexible tube.

Your doctor will guide the tube down your throat and into your esophagus (the passage leading from your mouth to your stomach). From this angle, your doctor can get a more detailed image of the heart and major blood vessels leading to and from the heart.

For TEE, you'll likely be given medicine to help you relax during the test. The medicine will be injected into one of your veins.

Your blood pressure, the oxygen content of your blood, and other vital signs will be checked during the test. You'll be given oxygen through a tube in your nose. If you wear dentures or partials, you'll have to remove them.

The back of your mouth will be numbed with gel or spray. Your doctor will gently place the tube with the transducer in your throat and guide it down until it's in place behind your heart.

The pictures of your heart are then recorded as your doctor moves the transducer around in your esophagus and stomach. You shouldn't feel any discomfort as this happens.

Although the imaging usually takes less than an hour, you may be watched for a few hours at the doctor's office or hospital after the test.

Stress Echocardiography

Stress echo is a transthoracic echo combined with either an exercise or pharmacological stress test​.

For an exercise stress test, you'll walk or run on a treadmill or pedal a stationary bike to make your heart work hard and beat fast. For a pharmacological stress test, you'll be given medicine to increase your heart rate.

A technician will take pictures of your heart using echo before you exercise and as soon as you finish. The Health Topics Stress Testing article provides more information about what to expect during a stress test.

What You May See and Hear During Echocardiography

As the doctor or sonographer moves the transducer around, you will see different views of your heart on the screen of the echo machine. The structures of your heart will appear as white objects, while any fluid or blood will appear black on the screen.

Doppler ultrasound often is used during echo tests. Doppler ultrasound is a special ultrasound that shows how blood is flowing through the blood vessels.

This test allows the sonographer to see blood flowing at different speeds and in different directions. The speed and direction of blood flow appear as different colors moving within the black and white images.

The human ear is unable to hear the sound waves used in echo. If you have a Doppler ultrasound, you may be able to hear "whooshing" sounds. Your doctor can use these sounds to learn about blood flow through your heart.

What to Expect After Echocardiography

You usually can go back to your normal activities right after having echocardiography (echo).

If you have a transesophageal echo (TEE), you may be watched for a few hours at the doctor's office or hospital after the test. Your throat might be sore for a few hours after the test.

You also may not be able to drive for a short time after having TEE. Your doctor will let you know whether you need to arrange for a ride home.

Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.

Why The Heart Hospital​​?

Cardiac and vascular imaging specialists on the medical staff of The Heart Hospital Baylor use advanced technologies to diagnose and manage a wide range of cardiac and vascular disorders.

Main phone number: 469.814.3278  469.814.3278 (HEART)

1.877.814.4488  1.877.814.4488 Toll-free

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