Getting a Heart Ultrasound Scan? What to Know About an Echocardiogram

Getting a heart ultrasound may seem intimidating, but it is a useful and low-risk imaging technique. This guide covers the reasons for heart ultrasounds, the different types of echocardiograms, how to prepare for your scan and what to expect regarding obtaining your results.

Your doctor will discuss the final report and any next steps with you. For those who prefer an early preview, PocketHealth offers secure, instant access to your results as soon as they’re uploaded. This allows you to review your results ahead of time, so you can go prepared with questions and make the most of your follow-up appointment.

 

 

What is an echocardiogram?

An echocardiogram, commonly known as an echo, is an ultrasound of the heart. This imaging technique uses high-frequency sound waves to create detailed, digitized images of your heart’s movement, structure, and size. A technician uses a hand-held device called a transducer to send high-frequency sound waves through your body, creating digitized images as the waves bounce back through your internal structures. This imaging technique evaluates your heart’s function, including its movement, structure and size.

What is the difference between an echocardiogram and an electrocardiogram?

An electrocardiogram is another type of test used to assess heart health. Though they sound similar, they serve two different functions.

• An echocardiogram creates images of your heart’s structures and internal workings.
• An electrocardiogram (ECG or EKG) examines your heart’s rhythm and electrical activity.

These two non-invasive tests are often used together. An EKG is the most common heart screening test and is often performed first to assess any irregularities that could be associated with heart disease. However, an EKG cannot assess the heart’s pumping ability, an echocardiogram is often recommended next if more detail is required.

 

Why would a doctor order an ultrasound of the heart?

Your heart health is vitally important. An echocardiogram can help your physician detect, diagnose or eliminate many cardiac ailments and conditions. You might be referred for a heart ultrasound for any of the following reasons:

• Arrhythmia from an abnormally fast or slow heartbeat
• To assess your heart after a cardiac incident
• Breathlessness with no other apparent cause
• Chest pain or persistent discomfort
• Cyanosis which causes blue fingernails, lips and/or skin
• Dizziness or faintness
• Edema due to sudden swelling from excessive fluid build-up
• Fatigue or exhaustion with no explanation

You also might have an echocardiogram to check your heart health as part of a larger overall healthcare routine.

 

What does an electrocardiogram show?

Depending on your circumstances and symptoms, a heart ultrasound might show signs that you have had a cardiac event, or evidence of other cardiac conditions, including:

• Atherosclerosis: gradual blockage of the arteries
• Aneurysm: weak spot in the heart or coronary arteries
• Congenital heart disease: structural defects from fetal development
• Heart muscle issues: includes heart failure, cardiomyopathy (thick or weak muscle), muscle impairment from heart attacks
• Heart attack damage: specifically where blood supply was suddenly blocked to the heart
• Heart valve issues: includes weakness, damage, or irregularity
• Heart murmur: extra sound heard during a heartbeat
• Endocarditis: infection in the inner lining of the heart
• Pericarditis: swelling or irritation of the heart membrane
• Tumors: in heart chambers, muscle, or on its surface

 

Understanding the types of echocardiograms

There are several types of echocardiograms, depending on your particular health situation and needs:

Transthoracic echocardiogram (TTE)

This is the most common type of heart ultrasound, in which the sonographer runs the transducer through a conductive gel spread on the skin above where your heart is located. The technician will be able to assess the parts of your heart (such as valves and chambers) as well as adjacent blood vessels. It is also one of the least invasive of the echocardiogram types.

Why you may need one:

TTEs have several diagnostic uses. Here are some common reasons to have this type of echo:

• Assess the heart for function
• Measures the shape and size of your heart
• Detecting blood clots or aortic aneurysms
• Identify congenital heart issues
• Investigate heart-related symptoms, such as difficulty breathing or heart murmurs

Stress echocardiogram

This is also a TTE, but it happens after you have had a period of intense exercise or an injection of a heart rate-increasing medication. This is to determine how your heart functions when it is beating at a faster rate and is particularly useful for evaluating patients who have heart disease symptoms.

Why you may need one:

Besides investigating heart attack symptoms, some reasons include:

• Diagnosing coronary artery disease
• Investigate signs of heart failure
• Pulmonary hypertension concerns
• Assessing congenital heart conditions

Transesophageal echocardiogram (TEE)

This is an internal ultrasound, in which a small tube is sent down your throat and the ultrasound is taken from inside the body. This allows significantly clearer images of the heart, as the esophagus is located close to this organ. TOEs are used when particularly detailed images are required.

Why you may need one:

Much of the same heart functions, symptoms and conditions already discussed in other echo types are also assessed with the TEE. Some specific reasons to have a TEE include:

• To assess heart valves to see if they are blocked, narrowed or stiff
• To assess if your blood is going backward through your valves (called regurgitation)
• To provide detailed data during various heart surgeries, meaning the patient is undergoing the scan during their surgery

Fetal echocardiogram

You may require a fetal echocardiogram while pregnant, to ensure the fetus has no cardiac abnormalities. Often performed transabdominally (on the surface of the stomach), the scan might also be taken transvaginally, in which the transducer is coated in gel and then inserted into the vagina. This can provide better angles for imaging, when needed.

Why you may need one:

If there is a family history of congenital heart defects in either parent, a fetal echo is routinely recommended, so try not to get too anxious. This allows for early intervention or a referral to specialists, if needed. They can also be used to monitor existing fetal heart conditions, helping to plan the next steps.

Echocardiograms with contrast

Your specific circumstances may also require the use of a contrast agent in your echocardiogram. The contrast, which is injected into your blood, shows up very clearly in the scan and can help generate better, sharper images of your heart.

Why you may need one:

When standard echos don’t provide enough details for assessment or diagnosis, the contrast agent can greatly improve visibility.

 

Echocardiogram methods

There are various techniques used to capture images of your heart, each suited to different conditions and diagnostic needs. The most appropriate technique will depend on your specific situation and what your healthcare provider needs to examine. These methods include:

• M-mode: This provides a very simple, monodimensional view of the heart, displayed along a single line. M-mode is sometimes used to view or measure heart structures.
• 2D/3D: 2D ultrasounds show both the structures of your heart (chambers, valves, walls, major blood vessels, etc.) and also their motion in real-time. Some imaging clinics offer 3D echocardiograms, which can provide more detail.
• Doppler: A Doppler ultrasound measures how blood flows through your arteries as well as your heart’s chambers and valves. The amount of blood pumped with each heartbeat can indicate whether or not there is any abnormality.
• Color flow imaging: An embellished form of a Doppler ultrasound, color flow imaging assigns different colors to each direction of blood flow. It makes the Doppler results simpler to see.

 

How to prepare for an echocardiogram: What to do and what not to do

Heart ultrasound appointments generally take between 30-60 minutes. There are a few things you can do to prepare:

• Check with the imaging clinic ahead of time in case you need to fast for several hours before your scan. Other possible things they may have you avoid include tobacco products, caffeine and certain medications.
• Bring your requisition with you, as it has valuable information for the clinic staff about what type of echocardiogram you need.
• Wear clothing you can easily get in and out of. You’ll need to remove all clothing from your upper body. However, if you’re having a stress echocardiogram, wear clothes you can comfortably exercise in such as a sports bra.
• If you’re having a TOE scan, it’s recommended to inform your doctor in advance about any known conditions, such as esophageal issues (e.g., hiatal hernias), swallowing difficulties or sleep apnea. This will allow your medical provider to prepare for any necessary accommodations.

 

What to expect during an echocardiogram appointment

The heart ultrasound process will differ a little depending on the type you have. For each type, you’ll have to remove the top half of your clothing, and several electrodes may be attached to the skin of your chest. You’ll be asked to lie on your left side.

• For a TTE, the technician will spread the gel on your skin, and then run the transducer through it. You won’t hear the high-frequency sound waves, and the procedure is painless.
• If you’re having a stress echocardiogram, your electrodes will be hooked up to a monitor and you’ll be asked to exercise vigorously on a treadmill or exercise bike before your scan. If you can’t exercise, you’ll be injected with a medication that will make your heart work harder, which sometimes causes a sensation of internal warmth.
• If you’re having a TOE, you’ll be asked not to eat or drink for several hours before your scan, and you might be given sedative medication to help you relax.

Questions to ask during a heart ultrasound scan

The sonographer won’t answer questions about the content or results of your heart ultrasound, but you can ask questions about the procedure and process, such as:

• How long will this appointment take?
• How do you share my results?
• When will my doctor receive the images and report?
• How can I access the images and report?

Seeing your final results may raise questions, especially with complex medical terminology. PocketHealth Report Reader simplifies this by providing instant, easy-to-understand definitions for the technical terms in your report. Just tap or click the underlined terms to gain clarity and better understand your imaging results.

 

 

What to expect during an echocardiogram as a woman?

For female patients or those assigned female at birth (AFAB), getting an echocardiogram can raise additional questions. Here is some information to help you know what to expect:

• Do I have to take my bra off for an echocardiogram? It depends on the type of echocardiogram you are having. Fetal and stress test echos typically do not require you to remove your bra, but many other types do. You will be provided with a medical gown to ensure privacy. If you have any preferences or concerns, such as requesting a female technician, make sure to discuss them with your doctor in advance.
• Will I be asked to remove my clothing? You may be asked to undress from the waist up and will be provided with a medical gown that allows access to your chest while maintaining privacy. Discuss any concerns with your doctor in advance so that accommodations can be made.
• Can I bring a support person with me? Most facilities allow a support person during your scan. You may want to consider confirming this beforehand, in case there is a particular restriction or other factor to prepare for.

 

Getting your echocardiogram results

You may feel anxious waiting for your results, but try not to stress. Here are some common questions patients have regarding their echo results.

When will I get my results?

Turnaround times for echocardiogram results depend on the schedule of the imaging facility and the radiologist who interprets the report. It may also vary based on the availability of the doctor who will follow up with you. Many patients receive their results during their next medical appointment or over the phone from their physician.

For those seeking faster access, PocketHealth notifies you as soon as your final report is uploaded. You can view your results securely and easily, and even share them with your medical provider or family members if desired. This early access empowers you to be more informed and prepared for your follow-up appointment. By reviewing your results ahead of time, you can better understand your condition, formulate questions for your healthcare provider, and play an active role in your health journey.

 

 

Talking with the doctor about my results

If you have online access to your report, you might see your results before your follow-up appointment with your doctor. Reviewing your results in advance can help you prepare any questions you might have. MyCare Navigator offers personalized questions based on your report, giving you a head start in preparing for your discussion. Additionally, the follow-up detector function assesses whether you need to take specific next steps based on your records. You can discuss these recommendations with your doctor to ensure you understand the appropriate actions to take next.

Is it bad to see colors on an echocardiogram?

If you see colors on your echocardiogram, it is likely that your scan included a color Doppler ultrasound or color flow imaging. These techniques use color to represent blood flow, with different colors indicating the direction of movement. Typically, blood flowing away from the transducer is shown in blue, while blood moving toward the transducer is shown in red. Lighter shades of these colors can indicate higher velocities. Additionally, colors like yellow or green may represent high flow turbulence, which helps doctors assess various health conditions. Note that the color scheme may vary by imaging facility, so it’s recommended to confirm the color key with your provider to avoid confusion.

 

Take control of your heart health

Taking care of your heart is the utmost priority. An echocardiogram can help your doctor detect and diagnose heart ailments and conditions. Having early access to your heart ultrasound results gives you the information you need to have better, more focused conversations with your whole healthcare team.

PocketHealth gives you rapid and secure access to your medical images and information, so you can be prepared and fully in control of your own health. That was the case for Ruth, who was able to review her ultrasound records and other imaging when she developed cancer. With Report Reader, she could understand her evolving condition and stay actively involved in her health journey, always prepared for her follow-up discussions in advance. Having your records on hand not only keeps you better informed but also allows you to share them with other physicians, ensuring you are empowered no matter where you go.