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An echocardiogram is a diagnostic imaging test that involves using ultrasound to look at the structure of the heart. Just as an ultrasound scan can reveal the structure of a baby growing in a woman’s uterus, echocardiography can be used to visualise the muscles, valves and major blood vessels of the heart. A two dimensional echocardiogram (2-D echo) can provide a picture of different cross-sections through the heart at any point in the heartbeat sequence, showing how much blood is in each chamber and the position of the heart valves.

Types of echocardiography

  • A 2-D echocardiogram is performed with you lying on your back. Electrode patches are placed at different points on your body and you will have an electrocardiogram (ECG) at the same time so that the images can be tallied with your heartbeat. The ultrasound transducer is placed on your skin to which a jelly has been applied. The procedure is completely painless and takes about 20-30 minutes. You may be asked to hold your breath at some point, or to breathe in, out or slowly. No special preparation is needed and this test is done as an outpatient procedure with the images available immediately for analysis by your consultant.
  • A Doppler echocardiogram can be used to look at blood flow through the heart, rather than at the muscle or other structures.
  • Transoesophageal echocardiography (TOE) is also available. In this test, the ultrasound probe is placed into your oesophagus using an endoscopic procedure. You may need a sedative to make you comfortable for this. The images provided are much clearer than those produced when the probe is placed on the skin. A TOE may therefore be required by your consultant if a diagnosis is proving difficult from images obtained using a 2-D echo or Doppler ECG. You need to avoid eating six hours before a TOE, and you should have nothing to drink four hours before.

Why would I need echocardiography?

Echocardiography is a flexible imaging test that can be used to diagnose a wide range of heart conditions. You may be advised to have an echocardiogram if your consultant suspects you have a heart valve abnormality, congenital heart disease, heart failure or cardiomyopathy.

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