Echocardiography uses ultrasound
waves to produce an image of the heart’s
structure and function, to measure the blood
pressure inside the heart, and to measure
the direction and speed of blood flow.
Standard echocardiography produces a twodimensional
image of a cross section, or
slice, of the heart, its chambers and valves,
and the large blood vessels of the heart.
Doppler echocardiography bounces sound
waves off the blood cells within the heart or
blood vessels, and measures the speed and
direction of flow.
The test is painless, does not use radiation,
and has few known risks.

Echocardiography is a diagnostic test that uses ultrasound, or high-frequency sound waves,
to create images of the heart. A transducer, or modified microphone, turns electrical energy
into sound waves, which bounce off tissues in the heart and are recorded onto videotape or
computer for later analysis.
Echocardiography is primarily used to detect and
assess the following:

  • Blocked coronary arteries;
  • Heart Failure or cardiomyopathy (enlargement
    of the heart);
  • Congenital (present at birth) heart defects;
  • Damage from hypertension (high blood
  • Heart attack damage or scarring;
  • Pericardial disease (the membrane that
    surrounds the heart); and
  • The function of the heart muscle, blood
    vessels, and valves.

Several echocardiographic techniques can be used,

  • Transthoracic echocardiography
  • Echocardiographic stress testing: This test evaluates how well the heart works during exercise, or stress. People who cannot exercise are given medications that simulate exercise.

Pre-Test Guidelines

The physician will give the patient specific pre-test directions to follow, but patients are often given common guidelines, such as:

  • Patients should not eat, drink, or use tobacco products for two hours before stress echocardiography, but should take any medications as usual unless otherwise directed.
Risk Factors

No known risks are associated with transthoracic echocardiography. Stress echocardiography carries a very small risk of heart attack or arrhythmia (unusual heart rhythm or rate).

What to Expect

Echocardiography is performed by a trained sonographer or technician at an echocardiography lab, a clinic, or in the patient’s hospital room. Throughout the test, an electrocardiogram, or ECG, which record’s the heart’s electrical activity, is performed to monitor the heartbeat and blood pressure is monitored. For transthoracic and stress echocardiography, a gel is used on the chest to improve conduction and reception; it may feel cold and moist.

For transthoracic echocardiography, the transducer is moved across the chest to gather data and the patient may feel slight pressure or vibration surrounding the area being examined. The patient may hear a “whooshing” sound, which is the amplified sound of the blood flowing. For stress echocardiography, the patient exercises on a treadmill or stationary bicycle until reaching a pre-determined target heart rate, then stops exercising and the transthoracic echocardiographic technique is used.

Occasionally, the patient may be asked remain silent or hold his or her breath so that the heart may be seen more clearly.

The procedure lasts approximately 30 to 60 minutes.

Post-Test Guidelines

There are no post-test restrictions for transthoracic echocardiography or stress echocardiography.


Medical Review Date: June 30, 2008