Echo Test

What is an Echo test?

An echo test, also known as an echocardiogram or echocardiography, is a safe, non-invasive medical diagnostic tool that uses high-frequency sound waves (ultrasound) to create a visual image of the movements of the heart (its valves and chambers) to help the doctor assess the heart’s pumping action.

A transducer or wand (hand-held) is positioned on the chest and moved around to take the images of your heart that can be visualised on a monitor. This helps the doctors identify any cardiac condition present.

The echo test can be performed in a hospital setting or a clinic by a cardiologist or a skilled technician called a cardiac sonographer.

Even though they may sound similar, an ECG is different from an echo. This is because an ECG is performed to assess the rhythm and electrical activity of your heart, while an echocardiogram test is performed to evaluate the functioning and structure of the heart.
Additionally, there is no radiation used in echocardiogram. This sets apart an echo from other examinations that involve modest quantities of radiation, such as X-rays and CT scans.

Why would I require an echo test?

An echo test allows your doctor to examine the structure of your heart and determine how well it is functioning. The test assists your healthcare provider in determining:

• The shape and size of your heart as well as the thickness, size, and movement of the heart walls
• The pumping strength of the heart
• Whether your heart’s valves are properly functioning
• How is the heart moving during heartbeats
• If your heart valves are leaking blood backward (regurgitation)
• If your heart valves are clogged (stenosis)
• If you have a tumour or an infectious growth near your heart valves

The echocardiogram will also assist your doctor in determining whether you have:

• Problems with your heart’s outer lining (the pericardium)
• Issues with large blood vessels that flow into and out of the heart
• Blood clots in the heart chambers
• Abnormal holes that are present in between the chambers of the heart.

What are the different types of echo tests?

There are multiple types of echocardiograms. Each one provides distinct advantages in the diagnosis and management of heart disease. These include:

• Transthoracic echocardiography
• Exercise-stress echocardiography
• Transoesophageal echocardiography

The type of echo test you undergo is determined by the heart issue being evaluated and the level of detail required in the images.

Stress echocardiography, for example, may be indicated if your heart issue is triggered by physical exertion, whereas the detailed pictures provided by a transoesophageal test may be valuable in assisting with heart surgery planning.

Transthoracic echocardiography

An echocardiogram can be performed in a number of ways; however, the majority of individuals will undergo transthoracic echocardiography (TTE).
You will not be required to prepare in any specific way in order to prepare for this test. In general,

• Continue to take your medicines as normal
• Wear anything you want
• Anything valuable should be left at home. During the exam, you will be provided with a place to store your belongings

For a transthoracic echocardiogram:

• You will be asked to take off any clothes covering your top half prior to lying down on the exam bed. You may be given a gown from the hospital to wear during the exam.
• If a contrast medium is needed in your case, the technician will infuse or inject the dye at this stage. This material shows up distinctly on the scan and can assist in generating a better picture of the heart.
• When you lie down, a technician will attach numerous little sticking sensors known as electrodes to your chest area. During the exam, these will be linked to a device that will measure your heart rhythm.
• Once the electrodes are positioned, the technician will apply lubricant gel to your chest or use the ultrasound probe directly. Then, they will start moving this probe around your chest as you lie on your left side.
• This ultrasound probe is connected to a device that will show and record the pictures generated.
• During the scan, you won’t be able to hear the probe’s sound waves, but you might notice a swishing sound. This sound is completely normal and is simply the sound of blood flowing through the heart that is being detected by the probe.
• The entire procedure should take from 15 to 60 minutes, and you should be able to return home soon after.

Stress echocardiography

Also known as a stress echo, this test is done to check how your heart performs after physical exertion or stress.
This test is more or less similar to the ‘exercise stress test’, wherein your blood pressure, heart rhythm, and heart rate are monitored by a technician. In a stress echo test, the technician additionally employs echo imaging.

This test reveals the extent to which your heart can endure stress. Your technician takes images both prior to you begin exercising as well as again after you finish.
You may not need to exercise in some instances. Instead, your doctor might give you medicines that make your heart work harder as if you were actually exercising. The idea is to make your heart require more oxygen.

When your heart is stressed, your technician can notice details that they would not be able to observe if you were lying down on the exam table. These include issues with the coronary arteries or the heart lining.

For a stress echocardiogram:

• You may have to refrain from drinking or eating anything for several hours prior to the test.
• You should not consume caffeinated drinks for at least 24 hours before the echo test. These may include coffees, teas, decaf beverages, or even medicines containing caffeine.
• You may have to skip certain medications on the day of the test. Talk to your doctor about this and inquire whether you should take your medications as usual or whether they need some modifications.

On the day of the stress echo:

• You may be given a hospital gown to put on.
• You will be asked to lie on the exam bed, and multiple electrodes (small sticker-like sensors) will be attached to your chest. These electrodes are linked to the monitor in order to record your heart rhythm and heart rate while performing the test.
• Before you start, your physician will check your blood pressure, heart rate, and rhythm.
• While you are still lying on the exam bed, the technician will move an ultrasound probe on the chest area to take images of the heart.
• Once this is done, you will be asked to start exercising on an exercise bike or a treadmill. The intensity of the exercise will progressively go up. You will have to keep going until you are completely exhausted. This normally takes between 7 and 12 minutes. At this step, some people may be given medicine that causes their hearts to work faster without having to do the exercise.
• While you are exercising, the technician may inquire about how you are feeling and use an EKG monitor to observe your heart.
• After you come to a halt, another echo test will be performed.
• You may have to do some slow cycling or walking till your vitals are back to normal.

Transoesophageal echocardiogram

A transoesophageal echocardiography may be recommended by your doctor for detailed imaging.

In this test, a small probe passes through your throat and is advanced into your oesophagus (food pipe), and at times it is further advanced into the stomach. With the probe behind the heart, the doctor can get a better picture of any issues and visualise some heart chambers that the transthoracic echocardiography does not show.

This type of echo might be used under some conditions:

• When your doctor requires an in-depth evaluation of the aorta or the back of the heart (particularly the left ventricle or left atrium)
• To assess your aortic valve or mitral valve
• If you suffer from lung disease or obesity
• To detect blood clots
• When a transthoracic echo isn’t possible due to a number of different factors.

For this procedure:

• You may have to refrain from eating or drinking anything for about 8 hours prior to the test.
• You may require the use of local anaesthetic spray or gel to numb your throat to avoid the discomfort of the probe.
• A sedative medication may also be given that will help you relax while performing the procedure.

You should feel no discomfort or trouble breathing throughout the process. The procedure normally takes between 20 and 40 minutes.

Following the procedure, you will likely experience the following:

• You might have to remain in the hospital for a few hours while your physician monitors your vital signs.
• For some time after the procedure, your throat might feel painful.
• You may have to refrain from eating or drinking anything for about 30 to 60 minutes

following the procedure, and you should not consume hot drinks for a few hours.

• After 24 hours, you will be able to resume your normal activities.

Are there any risks associated with the echo test?

Echocardiograms are regarded as quite safe procedures. Echocardiograms, unlike other imaging procedures such as X-rays, do not employ radiation.

Electrodes patches and contrast dyes

There is a minor risk of problems such as an allergic response to the contrast dye if a scan requires a contrast medium injection.

While taking out the electrodes from your skin, you may experience some discomfort. This may feel similar to removing a band-aid.

Transoesophageal echocardiography

The probe used during transoesophageal echocardiography has a small probability of scraping the oesophagus and causing irritation. In extremely rare circumstances, it can rupture the oesophagus and cause oesophageal perforation, a potentially fatal consequence.

The most commonly seen side effect is a sore throat caused by irritation of the throat. Due to the sedative used during the procedure, you may feel a little drowsy.

Stress echocardiogram

The drug or physical activity used to raise your heart rate during a stress echocardiogram might result in a temporary irregular heartbeat or even a heart attack. This procedure will be supervised by medical personnel in order to lower the possibility of a serious reaction that includes an arrhythmia or heart attack.

Takeaway

Echocardiograms can indicate whether your heart is functioning properly and highlight the areas of concern. Most procedures involving echo are safe and non-invasive; however, your doctor might inject a contrast material to obtain an image with greater clarity.
A transoesophageal echocardiography involves numbing the throat and passing a probe down through it to obtain a more detailed view.

Unless your doctor instructs otherwise, you should arrive at a stress echo test prepared to exercise.

Echocardiograms are the reliable methods used for obtaining precise details about the heart. They can assist a doctor in diagnosing heart and cardiovascular issues and determining the best therapy if any issues come up.