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An echocardiogram , often referred to as a cardiac echo or simply an echo , is a sonogram of the heart. It is not abbreviated as ECG, because that is an abbreviation for an electrocardiogram. Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart.

Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic tests in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart internal chamber size quantification , pumping capacity, and the location and extent of any tissue damage.

An echocardiogram can also give physicians other estimates of heart function, such as a calculation of the cardiac output , ejection fraction , and diastolic function how well the heart relaxes. Echocardiography is an important tool in assessing Wall motion abnormality in suspected patients of cardiac disease. It is an early tool which helps in reaching a diagnosis of Myocardial infarction showing regional wall motion abnormality of the heart.

Also, its important in treatment and followup in patients of Heart failure by assessing Ejection fraction. Echocardiography can help detect cardiomyopathies , such as hypertrophic cardiomyopathy , dilated cardiomyopathy, and many others. The use of stress echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease.

Echocardiography for beginners - the best

The biggest advantage to echocardiography is that it is not invasive does not involve breaking the skin or entering body cavities and has no known risks or side effects. Not only can an echocardiogram create ultrasound images of heart structures, but it can also produce accurate assessment of the blood flowing through the heart by Doppler echocardiography, using pulsed- or continuous-wave Doppler ultrasound. This allows assessment of both normal and abnormal blood flow through the heart. Color Doppler, as well as spectral Doppler, is used to visualize any abnormal communications between the left and right sides of the heart, any leaking of blood through the valves valvular regurgitation , and estimate how well the valves open or do not open in the case of valvular stenosis.

How the Test is Performed

The Doppler technique can also be used for tissue motion and velocity measurement, by tissue Doppler echocardiography. Echocardiography was also the first ultrasound subspecialty to use intravenous contrast. Echocardiography is performed by cardiac sonographers , cardiac physiologists UK , or physicians trained in echocardiography. In fact, Dr. Edler in produced the first echocardiographs using an industrial Firestone-Sperry Ultrasonic Reflectoscope. Health societies recommend the use of echocardiography for initial diagnosis when a change in the patient's clinical status occurs and when new data from an echocardiogram would result in the physician changing the patient's care.

A common example of overuse of echocardiography when not indicated is the use of routine testing in response to a patient diagnosis of mild valvular heart disease. Echocardiography now has vast role in Pediatrics diagnosing patient of Valvular heart disease and other congenital abnormalities. Now an emerging branch of Echo is also seen as Fetal echocardiography which involves Echocardiography of unborn fetus by the use of Ultrasonic Waves with no known side effects to mother and fetus. A standard echocardiogram is also known as a transthoracic echocardiogram, or cardiac ultrasound.

In this case, the echocardiography transducer or probe is placed on the chest wall or thorax of the subject, and images are taken through the chest wall. This is a noninvasive, highly accurate, and quick assessment of the overall health of the heart. This is an alternative way to perform an echocardiogram.


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  • Echocardiogram (Echo).

A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus. This allows image and Doppler evaluation from a location directly behind the heart. This is known as a transesophageal echocardiogram. Transesophageal echocardiograms are most often used when transthoracic images are suboptimal and when a more clear and precise image is needed for assessment. This test is performed in the presence of a cardiologist, registered nurse, and ultrasound technician. A stress echocardiogram, also known as a stress echo, uses ultrasound imaging of the heart to assess the wall motion in response to physical stress.

First, images of the heart are taken "at rest" to acquire a baseline of the patient's wall motion at a resting heart rate.

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Finally, images of the heart are taken "at stress" to assess wall motion at the peak heart rate. A stress echo assesses wall motion of the heart; it does not, however, create an image of the coronary arteries directly. Ischemia of one or more coronary arteries could cause a wall motion abnormality, which could indicate coronary artery disease. The gold standard test to directly create an image of the coronary arteries and directly assess for stenosis or occlusion is a cardiac catheterization.

A stress echo is not invasive and is performed in the presence of a licensed medical professional, such as a cardiologist, and a cardiac sonographer. Intracardiac echocardiography ICE is specialized form of echocardiography that uses catheters to insert the ultrasound probe inside the heart to view 2D structures from within.


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Intravascular ultrasound IVUS is a specialized form of echocardiography that uses a catheter to insert the ultrasound probe inside blood vessels. This is commonly used to measure the size of blood vessels and to measure the internal diameter of the blood vessel. For example, this can be used in a coronary angiogram to assess the narrowing of the coronary artery. If the catheter is retraced in a controlled manner, then an internal map can be generated to see the contour of the vessel and its branches. Strain rate imaging is an ultrasound method for imaging regional differences in contraction dyssynergy in for instance iscemic heart disease or dyssynchrony due to Bundle branch block.

Strain rate imaging measures either regional systolic deformation strain or the rate of regional deformation strain rate.

Stress Echocardiography

The methods used are either tissue Doppler or Speckle tracking echocardiography. Three-dimensional echocardiography also known as four-dimensional echocardiography when the picture is moving is now possible, using a matrix array ultrasound probe and an appropriate processing system. This enables detailed anatomical assessment of cardiac pathology, particularly valvular defects, [7] and cardiomyopathies.

Three-dimensional echocardiography technology may feature anatomical intelligence, or the use of organ-modeling technology, to automatically identify anatomy based on generic models. All generic models refer to a dataset of anatomical information that uniquely adapts to variability in patient anatomy to perform specific tasks. Built on feature recognition and segmentation algorithms, this technology can provide patient-specific three-dimensional modeling of the heart and other aspects of the anatomy, including the brain, lungs, liver, kidneys, rib cage, and vertebral column.

Contrast echocardiography, or contrast-enhanced ultrasound is the addition of an ultrasound contrast medium, or imaging agent, to traditional ultrasonography. The ultrasound contrast is made up of tiny microbubbles filled with a gas core and protein shell. This allows the microbubbles to circulate through the cardiovascular system and return the ultrasound waves, creating a highly reflective image.

There are multiple applications in which contrast-enhanced ultrasound can be useful. The most commonly used application is in the enhancement of LV endocardial borders for assessment of global and regional systolic function. Your doctor and nurse will continue careful observation until your child is fully awake and tolerating juice or milk. Having your child wear a shirt or blouse that buttons down the front is helpful.

Your child may eat normally before the test; bring a bottle if you have an infant or a video for your child to watch. This is the simplest type of echocardiography, and produces an image that is similar to a tracing rather than an actual picture of heart structures. M-mode echo is useful for measuring heart structures, such as the heart's pumping chambers, the size of the heart itself, and the thickness of the heart walls. The Doppler technique is used to measure and assess the flow of blood through the heart's chambers and valves.

The amount of blood pumped out with each beat is an indication of the heart's functioning. Also, Doppler can detect abnormal blood flow within the heart, which can indicate such problems as an opening between chambers of the heart, a problem with one or more of the heart's four valves, or a problem with the heart's walls. Color Doppler is an enhanced form of Doppler echocardiography. With color Doppler, different colors are used to designate the direction of blood flow. This simplifies the interpretation of the Doppler technique.

This technique is used to see the actual structures and motion of the heart structures. A 2-D echo view appears cone-shaped on the monitor, and the real-time motion of the heart's structures can be observed. This enables the physician to see the various heart structures at work and evaluate them. No feeling comes from the sound waves themselves.

We have expertise in the full spectrum of cardiac imaging, including transesophageal, fetal, 3-D, intracardiac, and stress echocardiography and cardiac MRI. Our electrophysiologists, national leaders in pediatric arrhythmias, provide advanced treatment for babies and children with complex heart rhythm disorders. Find a Children's Location Near You.

Exercise testing is useful diagnostic and treatment tool for the assessment of the heart function in children. Olivieri is a pediatric cardiologist specializing in echocardiography at Children's National. Children's is a national leader in congenital heart disease imaging. We care about your privacy. Read about your rights and how we protect your data.

Risks Associated with an Echocardiogram | Stanford Health Care

In this section More on this Topic. Pediatric Echocardiography. What is echocardiography? What problems can echocardiography diagnose? Several cardiac conditions may be detected by echocardiography, including the following: Heart murmur Chest pain Aneurysm Cardiomyopathy Congenital heart disease Congestive heart failure Pericarditis Valve disease Echocardiography is utilized to diagnose cardiac problems, as well as guide heart surgery and complex cardiac catheterizations. How is an echocardiogram performed?

What are the different types of echocardiogram? There are four special types of echocardiography: M-mode echocardiography This is the simplest type of echocardiography, and produces an image that is similar to a tracing rather than an actual picture of heart structures. Doppler echocardiography The Doppler technique is used to measure and assess the flow of blood through the heart's chambers and valves. Color Doppler Color Doppler is an enhanced form of Doppler echocardiography. Does it hurt? Is it harmful? There are no known ill effects of the sound waves used during a standard echocardiogram.

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