Echocardiogram Explained: What the Heart Ultrasound Can Show

An echocardiogram, often called an echo, uses sound waves to create moving pictures of the heart. It is different from an electrocardiogram (ECG or EKG), which records electrical activity. NHLBI explains that an echo can show the heart's size and shape, how well it pumps, and how blood moves through chambers and valves.

Common types

A transthoracic echocardiogram is the most common type. A technician applies gel and moves a handheld transducer over the chest to capture images. A stress echocardiogram takes images before and after exercise or medicine makes the heart work harder. A transesophageal echo uses a transducer on a flexible tube passed into the esophagus to provide a closer view; a clinician may use medicine to help the patient relax. Fetal echocardiography looks at an unborn baby's heart when recommended.

The type chosen depends on the clinical question. An echo may help clinicians evaluate heart structure, valve function, blood flow, or how the heart responds to treatment. It does not answer every question about chest symptoms and does not by itself explain every abnormal result.

Preparation and results

Most people do not need special preparation for a standard transthoracic echo. Preparation differs by test; NHLBI notes that people having a transesophageal study may be asked not to eat or drink for a period beforehand. Follow the specific instructions from the testing facility rather than assuming all echoes are the same.

Ask why the test was ordered, which type is planned, whether you need to fast, when results will be available, and who will explain them. A report should be interpreted with symptoms, history, examination, and other tests. Do not change heart medicines based on an isolated measurement or internet interpretation; discuss the result with the clinician who ordered it.

What the journal evidence adds

The 2015 professional guideline in the Journal of the American Society of Echocardiography standardizes measurement of cardiac chambers. It illustrates why image acquisition, measurement methods, and appropriate comparison values matter when an echo is interpreted.

An ultrasound report can contain many technical measurements, but a general reader's task is not to independently classify every number. Ask which finding answers the question that prompted the study and whether any result needs follow-up. Bring a previous report if the team wants a comparison, and ask whether differences in technique could matter. This older guideline is cited for measurement context, not as a current personal threshold chart. It does not establish that a normal echo excludes every cause of chest pain or that an abnormal measurement determines a medicine change.

Sources and further reading

• Heart Tests - National Heart, Lung, and Blood Institute. Authoritative public-health, government, or professional guidance.
• Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography (2015). professional guideline.

Health disclaimer

This article is for general education only. Its information and suggestions are not medical advice, diagnosis, or treatment and may not be right for everyone. Ask a qualified health professional for advice that fits your health, medications, and needs before changing your diet, exercise, supplement use, or care.