An echocardiogram test is one of the most commonly used investigations in cardiology. Many patients are referred for an echocardiogram test after reporting symptoms, following an abnormal ECG, or as part of a routine heart assessment. Although the name may sound technical, the test itself is straightforward and painless.
An echocardiogram test uses ultrasound to create moving images of the heart. It allows doctors to see how the heart muscle and valves are working in real time.
What an echocardiogram test looks at
The heart is a mechanical pump, and its structure and movement matter just as much as its electrical activity. An echocardiogram test focuses on how the heart looks and how well it functions.
During an echocardiogram test, doctors can assess:
- the size of the heart chambers
- how strongly the heart muscle contracts
- how well the heart relaxes between beats
- the structure and function of the heart valves
- blood flow through the heart
This information helps identify many common heart conditions and guides decisions about further tests or treatment.
Why an echocardiogram test is requested
Doctors request an echocardiogram test for several reasons. It often forms part of the initial assessment when heart disease is suspected.
Common reasons for an echocardiogram test include:
- breathlessness or reduced exercise tolerance
- chest pain or chest tightness
- palpitations or abnormal heart rhythms
- heart murmurs detected on examination
- monitoring known heart conditions
- assessment of heart function after illness or heart attack
The echocardiogram test helps clarify whether symptoms relate to heart structure or function.
What happens during an echocardiogram test
An echocardiogram test usually takes place in a quiet clinical room. You will lie on an examination couch, often on your left side, to allow clear views of the heart. A small probe is placed on the chest with a clear gel. The probe sends sound waves into the body and receives echoes as they bounce back from the heart structures. These echoes create images on a screen.
The test does not involve needles, injections, or radiation. You may feel light pressure from the probe, but it should not be uncomfortable. The test usually lasts between 20 and 40 minutes.
Do you need to prepare for an echocardiogram test?
In most cases, no special preparation is required for an echocardiogram test. You can eat, drink, and take your usual medications unless advised otherwise. It helps to wear comfortable clothing that allows easy access to the chest. You may be asked to remove clothing from the upper body for the test.
What an echocardiogram test can diagnose
An echocardiogram test can identify many heart conditions. These include:
- heart valve disease
- heart failure
- cardiomyopathy
- congenital heart conditions
- fluid around the heart
- changes in heart size or thickness
The test also helps assess the severity of these conditions and whether they are stable or progressing.
What an echocardiogram test cannot show
While an echocardiogram test provides detailed information, it does not assess everything. The test does not directly show the coronary arteries, which supply blood to the heart muscle. Other investigations, such as CT coronary angiography, are used for that purpose.
An echocardiogram test also does not diagnose heart rhythm problems on its own. ECGs and heart rhythm monitoring assess electrical activity rather than structure. For this reason, doctors interpret echocardiogram results alongside other tests and symptoms.
Types of echocardiogram test
The most common form is a transthoracic echocardiogram. This is the standard test described above.
In some cases, other types are used:
- stress echocardiograms assess heart function during exercise or medication induced stress
- transoesophageal echocardiograms provide more detailed images by passing a probe into the oesophagus
These tests are used when additional detail is required and are chosen carefully based on clinical need.
Understanding the results of an echocardiogram test
Results from an echocardiogram test are interpreted by trained specialists. Some findings are clearly abnormal, while others fall within normal variation.
A normal echocardiogram test is reassuring and often rules out significant structural heart disease. Mild abnormalities may require monitoring rather than treatment.
An abnormal result does not always mean serious disease. Many findings remain stable for years and never cause symptoms. Context is essential when deciding next steps.
How echocardiogram results guide treatment
An echocardiogram test helps guide decisions about treatment and follow up. It may confirm that no treatment is needed, support the use of medication, or prompt further investigation. The aim is always to tailor management to the individual rather than treat test results in isolation.
When an echocardiogram test is repeated
Doctors may repeat an echocardiogram test to monitor known conditions or assess changes over time. The timing depends on the condition and how stable it appears.
Regular follow up allows early detection of progression and supports timely intervention when needed.
When to seek advice
It is sensible to discuss an echocardiogram test if you have symptoms such as breathlessness, chest discomfort, palpitations, or unexplained fatigue. It is also helpful to review results if you have already had the test and are unsure what they mean.
If you would like to discuss whether an echocardiogram test is appropriate for you, or to talk through results in context, you can get in touch with me to arrange an assessment and a clear explanation of the findings.
An echocardiogram test is a safe and valuable tool. When used appropriately, it provides detailed insight into heart structure and function and plays an important role in guiding diagnosis, reassurance, and long term care.