Free Guide to Preparing for Your Echocardiogram

What Is an Echocardiogram and Why Your Doctor Might Order One

An echocardiogram is a test that uses sound waves to create pictures of your heart. The test is sometimes called an "echo" for short. Sound waves bounce off your heart and return to create moving images that doctors can see on a screen. Unlike X-rays, echocardiograms do not use radiation, which makes them very safe for most people.

Doctors order echocardiograms for many reasons. They might want to check how well your heart is pumping blood throughout your body. They may also want to look at your heart valves—the structures that open and close to keep blood flowing in the right direction. An echocardiogram can show if your heart chambers are too thick, if there is damage from a heart attack, or if there are signs of heart disease. Some people get this test because they have shortness of breath, chest pain, or irregular heartbeats. Others might have high blood pressure or a family history of heart problems.

According to the American Heart Association, millions of echocardiograms are performed each year in the United States. The test typically takes 20 to 40 minutes, though some variations may take longer. Most people can resume their normal activities right after the test because it is non-invasive—nothing enters your body.

Understanding why your doctor ordered the test and what it shows can help you feel more confident when you arrive for your appointment. Your doctor's office should be able to explain what they are looking for and what they plan to do with the results.

Practical takeaway: Write down any questions you have about why your echo was ordered before your appointment, and don't hesitate to ask your doctor or the scheduling staff to explain the reason in more detail.

Preparing Your Body and Mind Before Your Appointment

Most echocardiograms require little to no special preparation compared to other medical tests. In many cases, you can eat and drink normally before your echo and take all your regular medicines as scheduled. However, you should always check with your doctor's office about any specific instructions for your particular appointment, since some situations may be different.

Before you go to your appointment, wear comfortable clothing that you can easily remove from the waist up. You will need to expose your chest so the technician can place the ultrasound probe against your skin. Some people wear a two-piece outfit or a button-up shirt to make this easier. Women may want to avoid wearing a dress that cannot be easily opened in the front. Leave jewelry and metal objects at home, as they are not usually needed and can get in the way.

Arrive at your appointment about 15 minutes early so you have time to check in and fill out any paperwork. Bring your insurance card and a photo ID with you. If this is your first time at the facility, you may be asked to complete a medical history form. Write down any current medicines you take, including over-the-counter drugs and supplements, in case the office asks about them.

Mentally preparing yourself can make the test go more smoothly. Understanding what will happen during the echo can reduce anxiety. The test is painless, and the room is typically dark and quiet during the procedure. Some people find it relaxing. If you have ever had an ultrasound before—such as during pregnancy or to look at another body part—an echocardiogram works in a similar way, though the images are of your heart instead.

Practical takeaway: Call your doctor's office a few days before your appointment to confirm any specific preparation instructions and ask if there are any items you should bring with you.

What Happens During Your Echocardiogram Procedure

When you arrive at the ultrasound room for your echocardiogram, a technician trained in cardiac ultrasound will greet you and explain what will happen. You will be asked to remove your shirt and lie on a padded table. A small pillow may be placed under your head, and a blanket or sheet will cover the parts of your body that are not being scanned. The technician will position you on your left side for part of the test so they can get the best images of your heart.

The technician will apply a clear, water-based gel to your chest. This gel helps the ultrasound probe, called a transducer, make good contact with your skin. The gel is usually cool and may feel a bit slippery. The technician will then move the transducer slowly across your chest in different directions and angles. You may feel mild pressure but should not feel any pain. The transducer sends out sound waves and picks up the echoes as they bounce back from your heart structures.

As the technician moves the transducer, you will see images appearing on a monitor nearby. The pictures show your heart chambers, valves, and blood flow. The technician may ask you to take a deep breath or change positions to get clearer images. Some people are asked to hold their breath for a few seconds at a time. Throughout the test, you can hear a swooshing sound, which is the sound of blood flowing through your heart picked up by the machine.

A cardiologist, who is a heart specialist doctor, is often present during the test or reviews the images afterward. The entire procedure typically lasts between 20 and 40 minutes. Afterward, you can wipe off the gel with a towel and get dressed. You should have no soreness or marks on your skin after the test.

Practical takeaway: Let the technician know if you need to adjust your position or if anything feels uncomfortable during the test. Technicians are used to helping patients feel at ease and will work with you to complete the scan.

Different Types of Echocardiograms You May Encounter

There are several different types of echocardiograms, and your doctor may order one type or ask that you have multiple types to get a complete picture of your heart. The most common type is a transthoracic echocardiogram, often called a "TTE." During this test, the transducer is placed on the outside of your chest, which is the standard procedure described in the previous section. This type of echo works well for most people and is often the first test a doctor orders.

A transesophageal echocardiogram, or "TEE," is a different approach. In this test, the transducer is attached to a thin tube and is gently guided down your throat into your esophagus, which is the tube that carries food to your stomach. Because the esophagus is closer to the heart than the chest wall, the transducer can get clearer, more detailed images. However, this test requires sedation to keep you comfortable, and you cannot eat or drink for several hours beforehand. Recovery takes longer, and someone must drive you home. TEE is typically used when a TTE doesn't provide enough information or when the doctor needs to look closely at specific heart structures.

A stress echocardiogram combines an echo with exercise or medication that makes your heart work harder. You may walk on a treadmill or ride a stationary bike while your heart rate increases, or you may receive medicine through an IV that increases your heart rate. The doctor takes echo images while your heart is working harder to see how it responds to stress. This test can show if there are problems with blood flow to the heart muscle.

A fetal echocardiogram is performed on pregnant women to look at the developing baby's heart. A three-dimensional, or "3D," echocardiogram creates detailed three-dimensional images instead of flat, two-dimensional ones. These newer technologies allow doctors to see heart structures from different angles and may help with diagnosis in complex cases.

Practical takeaway: Ask your doctor which type of echocardiogram you will have and why that particular type was chosen for your situation. Understanding the difference can help you know what to expect.

Understanding Your Results and What They May Mean

After your echocardiogram is complete, the images and measurements are sent to a cardiologist for review. Within a few days, your doctor will typically call you or send you a written report explaining the results. The report contains measurements and observations about different parts of your heart. Learning what these terms mean can help you understand the information your doctor is sharing with you.

One important measurement is the ejection fraction, sometimes called "EF." This number describes what percentage of blood is pumped out of your left ventric