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Echocardiogram (Echo) Tests

If you have certain physical symptoms, such as shortness of breath, difficulty exercising, or fatigue, your doctor may recommend an echocardiogram  (echo) test.

There are several different kinds of echo tests, but they all use sound waves to produce and record moving pictures of your heart at rest and during exercise. The test shows how well your heart muscle pumps blood at rest.

How to Prepare for an Echo Test

For 24 hours prior to most* echo tests, avoid all foods, beverages and medications containing caffeine. Many over-the-counter medications have trace amounts of caffeine, so please discuss this with your doctor.

If you use an inhaler for asthma or other respiratory conditions, please speak with your doctor to find out whether you will need to bring it with you. If you have diabetes, please talk with your doctor about the recommended preparations as there are some precautions you should take. On the day of the test, do not eat or drink anything, except water, for four hours prior to the test (not needed for a resting/regular echocardiogram).

If you smoke, do not smoke on the day of testing. Questions regarding your morning medications should be directed to your physician.

Dress in comfortable, loose-fitting clothes, and wear your normal walking or tennis shoes (not needed for a resting/regular echocardiogram). For echo tests, like the transesophageal echocardiography (TEE), you will not be allowed to drive yourself home since you will have received a sedative. You may resume driving the following day.

*A simple echo test does not require this, so please be sure to check with your doctor regarding any food/beverage and/or other special restrictions.

Types of Echocardiogram Tests

Stress Echo

When you come to the lab, the technologist will place 10 tiny electrodes on your chest that are attached to an electrocardiography unit (EKG or ECG). This will record the electrical activity while you are exercising.

This test combines exercise with ultrasound (sound waves) and can help determine if you have coronary artery (heart) disease. It also helps determine if your heart is getting the blood and oxygen it needs during exercise. 

Before a Stress Echo Test

If you have any special medical conditions or other issues, your physician needs to know because there may be special instructions or precautions that need to take place prior to your test. That said, be sure to discuss the following with your doctor:

  • Any medications that you are on (so that your doctor can advise you what medications to take or not to take the day of the stress test

On the Day of the Stress Test

  • Do not drink for four hours prior to the test.
  • Wear comfortable clothes & walking shoes.

You will undergo an EKG that records your heart rate at rest. The technologist will also take your blood pressure to ensure that it is safe to proceed with exercise. Before you begin the exercise phase of the test, the sonographer (a specialist trained in ultrasound tests) will have you lie on your left side.

The technologist will perform a non-invasive and painless ultrasound of your heart. This involves running a transducer over the chest to perform a “resting” ultrasound. This will show movement within the heart from vibrations that are “echoed” from the heart. These echoes provide a graphic illustration of inside the heart and its movement.

The Stress Echo test involves three phases:

  • Warmup
  • High intensity exercise
  • Cool down

Once on the treadmill, you will begin walking slowly and increase the intensity as much as possible. You will be monitored throughout the procedure to check for symptoms such as dizziness, pain or discomfort. The test will be stopped if you have these signs of distress.

When you are at the point of exhaustion, you will quickly get off the treadmill and return to the table. The sonographer will have you lie on your left side again and get a “post exercise” echocardiogram.

Afterwards, you will remain on the stretcher. During this time, the technologist will continue to monitor your heart rate, blood pressure and EKG readings to make sure they return to normal.

Test results will be sent to your physician who will discuss them with you.

Transthoracic 2D Echocardiography (Echo)

Transthoracic echocardiogram (TTE) is helpful in determining the:

  • Strength of the heart
  • Size, structure & movement of the heart, including valves, septum & walls of the heart chamber
  • Condition of the heart valves
  • Lining of the heart (the endocardium) 
  • Aorta

A TTE test can also determine if you have had a heart attack or if there is enlargement of the heart or cardiac tumors.

During the exam, you will be positioned on your back or left side. The sonographer (a specialist trained in ultrasound tests) will tape electrodes to your arms and legs to record your heart rate. A small amount of gel will be rubbed onto your chest to help amplify the sound waves from the ultrasound. The sonographer will use a wand or transducer, moving it across your chest to get images of your heart. At times, the sonographer will ask you to hold your breath so that images will be clear.

The images from the test are stored on digital files for interpretation. In most cases, the test is finished in less than one hour.



Transesophagel Echocardiogram (TEE)

Transesophageal echocardiogram (TEE) is a minimally invasive test that helps diagnose many kinds of heart disease, including: 

  • Problems with your heart valves 
  • Myocardial (heart muscle) disease 
  • Pericardial (sac that covers the heart) disease 
  • Infective endocarditis (infection of the inner lining of the heart)
  • Cardiac masses
  • Congenital heart disease

How TEE is Performed

The TEE test is performed by running a small – less than ½ inch – endoscopic instrument down the esophagus (throat). Since the esophagus travels past the heart, images can be obtained without interference from surrounding structures, such as the ribs or lungs.

Before the Test

Before the test begins, the cardiovascular nurse will place a blood pressure monitor on your arm and a pulse oximeter to measure your oxygen levels. You will gargle with a numbing agent, followed by additional numbing/pain medication that will be sprayed in the back of your throat. Additionally, an IV will be placed in your arm to give you a medication to relax you throughout the procedure. Three electrodes will be attached to your chest to monitor your heart’s electrical activity.

Be sure to discuss with your doctor If you have swallowing problems, cancer, been diagnosed with a hiatal hernia, have an inhaler for asthma (or other respiratory conditions), or have diabetes.

During the Test

Lying on your left side, the tube will be run down your throat by the cardiologist, which takes only a few seconds. You may feel slight pressure, but it will not be painful. Once the endoscope reaches the location near the heart, pictures will be taken by the sonographer (a registered specialist trained in ultrasound tests) that will help diagnose your condition.

The test takes about 90 minutes, and once you have fully recovered, you will be able to go home. You will not be able to drive, so please bring a driver.

Some patients fall asleep during the exam, which is fine. The main goal is to keep you comfortable throughout the test. Afterward, you may have a slight sore throat. This is completely normal.

Since your throat has been numbed, please do not eat or drink for at least one hour after completion of the test. After your throat regains feeling, start by drinking cool or room temperature drinks, and advance to solid foods later in the day.

For additional information about echocardiogram tests, contact us today at 919-350-3146.