Echocardiogram (Cardiac Ultrasound): Procedure, Uses, and What to Expect

An echocardiogram ("echo") is a non-invasive ultrasound examination of the heart that provides real-time moving images of cardiac structure and function.

Procedure Overview

• Performed by: Cardiac sonographer; interpreted by cardiologist.
• Duration: 30–60 minutes (standard transthoracic echo/TTE).
• Setup: Lie on left side; electrodes for ECG gating; gel on chest; transducer (probe) moved across chest windows (parasternal, apical, subcostal, suprasternal).
• No radiation, no contrast (usually), no recovery time.

Types of Echocardiography

• Transthoracic (TTE): Standard, non-invasive.
• Transesophageal (TEE): Probe in esophagus for higher-resolution images (valves, LA appendage, shunts). Requires sedation.
• Stress echo: TTE at rest + during exercise or dobutamine infusion. Detects ischemia.
• Doppler/Color flow: Assesses blood flow velocity/direction (valvular stenosis/regurgitation, shunts).
• 3D echo: Volumetric imaging for complex structural assessment.
• Contrast echo: IV microbubbles enhance endocardial border detection.

Diagnostic Capabilities

• Chamber sizes, wall thickness, mass
• Systolic function: EF, regional wall motion
• Diastolic function: filling pressures, relaxation
• Valvular structure/function: stenosis, regurgitation, prolapse
• Congenital defects: ASDs, VSDs, complex anatomy
• Pericardial disease: effusion, tamponade, constriction
• Aortic root/ascending aorta dimensions
• Infective endocarditis: vegetations, abscesses
• Cardiac masses: thrombi, tumors
• Pulmonary hypertension estimation (TR velocity)

Clinical Indications

Heart failure, murmur evaluation, chest pain, dyspnea, syncope, post-MI, pre-op assessment, chemotherapy monitoring, congenital heart disease follow-up, valve surveillance.

Results guide medical management, procedural planning, and surgical timing. Serial echoes track disease progression/therapeutic response.