What is an Echocardiogram (Echo)?
An echo uses ultrasound waves to evaluate the structure and function of the heart muscle and valves. The test is performed by a registered cardiac sonographer and read by our trained cardiologists.
We offer three kinds:
- Transthoracic echocardiogram (TTE) — This echo looks for abnormalities in the physical structures of the heart, including the heart chambers and valves. It can be used to:
- Look for the cause of an abnormal heart sound (heart murmur)
- Check the size of the heart chambers
- Inspect the pumping capability of the heart muscle
- Stress echocardiogram — An exercise stress echo uses a TTE to produce and compare images from your heart at rest to your heart immediately after exercise.
- Transesophageal echocardiogram (TEE) — This variation of TTE uses ultrasound to evaluate the small detailed structures of the heart and vessels. A narrow swallowing tube is inserted into the esophagus.
What Should I Expect?
Upon your arrival, you will be led to the ultrasound exam room where the ultrasound machine and other monitoring devices are located. You will be asked to remove clothing from the waist up — women will be given a gown to wear during the procedure.
ECG lead wires are attached to electrodes on your chest using basic medical tape. Your blood pressure and oxygen levels are monitored during TEE and stress echoes.
How Does a TTE Work?
During the procedure, the sonographer applies gel to a wand-like device and moves it around on your chest, stomach and neck. The gel allows ultrasound waves to go through your chest wall and take recordings of your heart at different locations.
You may be asked to change your position or hold your breath. You may feel pressure on your skin, but the procedure is not uncomfortable. Imaging takes about 45 to 60 minutes.
How to prepare for a TTE: Before your appointment, eat and drink as you do normally.
How Does a Stress Echo Work?
A stress echo combines a stress test with a TTE and compares images of the heart at rest to images of the heart during and/or after exercise to evaluate how the heart responds to exertion.
A TTE is performed first to take images of your heart at rest. You will then exercise on a treadmill. The speed and incline increases every few minutes. Exercise continues until your target heart rate is reached, immediately followed by more images being taken of your heart. We then compare before and after images.
A pharmacologic stress echo may be suggested to patients who can’t exercise. Medication is used to replicate the effects of the treadmill on your heart.
How to prepare for a stress echo: Refrain from eating and drinking for a few hours before the test — no caffeinated drinks after midnight the night before your test. Don’t take blood pressure medication 24 hours prior to your test, unless otherwise directed by your physician. Wear comfortable walking shoes and suitable, loose-fitting clothes.
How Does a TEE Work?
TEEs are performed while you’re asleep or under general anesthesia. During the procedure, a cardiologist places a flexible endoscope tube in your mouth. When you swallow, the tube enters your esophagus. The tube contains an ultrasound transducer that sends and receives ultrasound waves.
Various recordings are taken in different locations inside your esophagus. The movement of the tube is not uncomfortable. Imaging takes no longer than 20 minutes.
How to prepare for a TEE: You should not eat and drink fluids for at least four hours before the test. You will need someone to drive you home.
25 Years of Excellence
UVA Health received the Intersocietal Accreditation Commission 25 Year Silver Milestone award. It recognizes facilities that have maintained accreditation in adult echocardiography for more than a quarter century. An accredited echocardiography facility requires the interpreting physicians and practicing sonographers to be adequately trained and experienced to interpret and perform echocardiograms, which requires considerable training and expertise.