Echocardiography: How the Test Evaluates the Heart

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

What is echocardiography and how does it examine the heart?

Echocardiography uses high-frequency sound waves from a handheld transducer to produce images of the heart. The typical transthoracic echocardiogram (TTE) places the transducer on the chest wall; other forms like transesophageal echocardiography (TEE) position the probe in the esophagus for clearer images of certain structures. Doppler techniques measure blood flow and pressure differences, revealing valve leaks, stenosis, and intracardiac shunting. Because it captures real-time motion, echocardiography is well suited to evaluate cardiac pumping function and wall motion abnormalities after suspected heart injury.

When might a doctor recommend an echocardiogram?

Doctors may order an echocardiogram for a range of clinical reasons: new or worsening shortness of breath, chest pain suggestive of cardiac origin, suspected heart murmurs, abnormal electrocardiogram (ECG) results, or to evaluate heart function in patients with known coronary disease or cardiomyopathy. It’s also commonly used pre-operatively for medical risk assessment and to monitor disease progression or response to treatments such as medications or device therapy. The test is useful across ages, from newborns with congenital concerns to older adults with valve disease.

What should a patient expect during the echocardiography test?

A standard transthoracic echocardiogram usually takes 30–60 minutes. The patient lies on an exam table while a sonographer applies gel to the chest and moves the transducer to capture multiple views. The procedure is painless for most people, though some may feel mild pressure. For TEE or stress echocardiography, additional preparation or monitoring is required: TEE often involves light sedation and a throat numbing agent, and stress echocardiography assesses heart response to exercise or pharmacologic stress. After imaging, a cardiologist reviews and interprets the results before discussing findings with the patient.

Where is echocardiography performed in a hospital or local services setting?

Echocardiography is available in hospitals, cardiology clinics, and many outpatient imaging centers offering local services. In acute settings such as an emergency department or inpatient ward, portable echocardiography can provide rapid bedside assessment. Larger hospitals may offer advanced modalities—three-dimensional echoes, contrast-enhanced studies, or strain imaging—while community clinics commonly perform standard TTE and Doppler exams. Coordination between the imaging team, referring doctor, and hospital staff ensures that results are integrated into the patient’s overall care plan.

Types of echocardiography and common medical uses

Common types include transthoracic (TTE), transesophageal (TEE), stress echocardiography, contrast echocardiography, and cardiac ultrasound with strain imaging. TTE is a first-line exam, TEE provides higher-resolution views for valve assessment and intraoperative guidance, and stress echocardiography evaluates ischemia or functional capacity. Contrast agents may be used to improve visualization in technically difficult studies. Clinically, echocardiography helps with diagnosing valvular disease, heart failure, congenital anomalies, pericardial disease, and assessing cardiac function after myocardial infarction or in systemic conditions that affect the heart.

Conclusion

Echocardiography is a widely used, noninvasive medical imaging tool that gives doctors real-time information about heart anatomy and function. It supports diagnosis, treatment planning, and monitoring across many cardiac conditions and can be performed in hospitals or outpatient settings depending on the needed level of detail. For patients, understanding the basic types of echocardiographic exams and what to expect can make the experience less stressful and improve communication with the medical team regarding results and next steps.