Echocardiogram

An echocardiogram, or echo, is an ultrasound scan of the heart, much like the scans used in pregnancy. It shows the heart's chambers and valves, how blood flows through them and how well the heart is pumping. It is often used to diagnose or keep an eye on:

• heart failure
• heart valve problems, including a heart murmur heard through a stethoscope
• damage to the heart muscle after a heart attack
• congenital heart conditions and inherited ones such as cardiomyopathy

It is a common next step for breathlessness, or after an ECG that needs a closer look.

You remove your clothing from the waist up and wear a gown, behind a curtain or in a private room. You lie on a couch, often turned on your left side, and small sticky pads are put on your chest to follow your heart rate.

The person doing the scan, called a sonographer, spreads a cold gel on your chest and moves a small probe over it. Pictures of your heart appear on a screen. You may hear a swishing sound, which is the sound of blood flowing through the heart. Sometimes a contrast agent is injected into a vein in your arm to make the pictures clearer, and you may be asked to wait up to 30 minutes afterwards.

A standard echo has no risks or side effects, and you can go home as soon as it is finished.

Dr Vasudeva has a special interest in echocardiography, both trans-thoracic (the standard scan through the chest) and trans-oesophageal. Depending on the question being asked, you may be offered:

• A transoesophageal echo (TOE). A thin probe is passed down the throat, which sits just behind the heart, to give more detailed pictures. Your throat is numbed with a spray and you can have a light sedative. It takes about 30 minutes, you may need to avoid eating for several hours beforehand, and you must not drive for 24 hours if you are sedated. A sore throat afterwards should pass within a day or two.
• A stress echo. The scan is repeated while your heart is beating faster, either through exercise or with a medicine given into a vein. It can show whether part of the heart muscle is short of blood, a sign of coronary heart disease.

An echo does not show the coronary arteries, the blood vessels that feed the heart muscle. A CT coronary angiogram looks at those. It also cannot catch a rhythm problem that comes and goes, which needs a longer recording such as an ambulatory ECG.