transthoracic echocardiogram (echo) : what to expect
The transthoracic echocardiogram, commonly referred to as an "echo" is a very simple, non-invasive procedure. It is designed to allow your cardiologist to take a good look at the way your heart looks and how well it functions. The best way to think about this is to recall sonograms performed in an obstetricians' office to look at a pregnant mothers' baby. Well, an echo is exactly the same thing; except in this case the baby is your heart. The echo can not only show your cardiologist the structure and dimensions of your heart, but it can also measure complex parameters like blood flow speed, pressure drop offs etc, giving an intricate look into the function of your heart as well. This is fabulous news for cardiologists, because this gives us a mechanism to look directly into both structure and function of your heart, without even as much as a single needle stick. Isn't that amazing?
In our office, echoes are generally performed right within the comfort of the office itself, or rarely, at an outside facility, and sometimes in the hospital. Where we choose to get the echo depends largely on the day you visit us, and the urgency with which we need to have this information.
Echo Machine
The machine we use for this purpose, called an echo machine is essentially a large computer with a probe attached to it. This probe emits ultrasound energy, which is not visible or detectable by the patient. When the probe is placed on the your chest right above the heart, the probe sends out ultrasound signals that penetrate your skin, bone, soft tissue, muscle and reaches your heart. It penetrates the full extent of your heart, and bounces back off the heart muscle and returns back into the probe. Depending on how much energy was lost when it makes this trip and how long it takes, the computer in the echo machine can translate that information into an image, which shows us what your heart looks like.
On the left of the screen is what an echo machine looks like. The operator of the machine, also known as the sonographer will accompany you into a private room, where you will be asked to change into a hospital gown. Your chest will be exposed, and EKG leads will be attached to your chest so that the machine can not only see your heart, but also monitor your heart rate and rhythm.
The sonographer will then use a lubricant (also called "ultrasound jelly") and apply a little bit of this to your chest and place the echo probe (as shown in this picture) over your chest. When he or she does so, the computer in the echo machine will display an image of your heart in real time.
The echo provides two types of information to cardiologists. First, it shows us the structure of your heart. This includes the size of your heart muscle, the size of the heart chambers, and the presence of any unexpected growths or blood clots within your heart.
Second, the echo can also give us function information of your heart. By using complex mathematics, the echo machine can actually measure how fast blood flows through your heart, how stiff your heart muscle is and how rapidly it recoils after contracting. It can also give us an incredible amount of information about the function of your heart valves, including whether or not they are narrowed (called stenosis) or whether there those heart valves are leaking (called regurgitation). If you'd like to know more about heart valve disease, read up about this on our section on heart valve diseases.
WHAT TO EXPECT BEFORE AN AFTER YOUR ECHO
The echo is a simple, non-invasive, office-based diagnostic test. In some ways, it is even less invasive than having your labs drawn (blood tests). There are no needle sticks, no anesthesia or sedation and nothing you need to do on your part in preparation for it. You will go home immediately after the test is complete.