What Is An Echocadiogram?
An echocardiogram (also called "echo") is a test that uses ultrasound waves to examine the heart. It is a safe and painless procedure that helps doctors diagnose a variety of heart problems.

How Does It Work?
During the test, a small microphone-like device, called a transducer, is held against the chest. The transducer sends ultrasound waves that bounce off the various parts of the heart.

A computer uses the information coming from the transducer to construct an image of the heart. The image is displayed on a television screen, and it can be recorded on videotape or printed on paper.

The echocardiogram study usually combines three different techniques. The simplest technique, called M-mode echo, produces an image that looks more like a tracing than an actual heart. The M-mode echo is especially useful for measuring the exact size of the heart chambers.

A more advanced technique, the two-dimensional (2-D) echo, shows the actual shape and motion of the different heart structures. In a way, these images represent “slices” of the heart in motion.

A third technique, the Doppler echo, that allows doctors to asses the flow of blood through the heart. The signals the represent blood flow are displayed as a series of black-and-white tracings or as color images on the television screen.

If you are having a Doppler echo, you may hear a whooshing or pulsating sound. This is not the actual sound of your heart, but an amplified and computerized audio signal.

Why Is The Echo Done?
The echo gives doctors useful information about the heart, such as:

Before Your Echo
No special preparations are necessary. You may eat and go about your normal activities, unless you are told otherwise. Make sure you wear a two-piece outfit. The echo may be done at a hospital, test center, or doctor’s office.

What Happens During The Test?
You may be asked to undress from the waist up and put on a short hospital grown. Electrodes (small sticky patches) are placed on your chest and shoulders to monitor your heartbeat.

Then lie on a hospital bed or exam table. To improve the quality of the pictures, a colorless gel is applied to the area where the transducer will be placed. This way feel cool and a bit moist, but the gel will be wiped off at the end of the test.

A technician moves the transducer over the chest, to obtain different views of your heart. He or she may ask you to change positions. You may also be asked to exhale or hold your breath for a few seconds (air ini your lungs can effect the echo images).

The images are recorded on videotape or printed on paper, so the doctor can review them later.

How Long Does It Take?
An echo exam usually takes from 20 to 45 minutes, depending on the number of views and whether the Doppler echo is also used. Be sure to allow extra time to check in. When the test is over, you may eat and return to your normal activities.

Is The Echo Safe?
The echo test is very safe. There are no known risks from the ultrasound waves. It is also painless, even though you may feel slight discomfort when the transducer is held firmly against the chest.

What Are The Benefits?
A major benefit of the echo test is that it gives information about the heart’s structures and blood flow without anything entering the body.

The major limitation is that it is often difficult to obtain good quality images in patients who have broad chests, are obese, or are suffering from chronic lung disease (such as emphysema).

Your Test Results
If a doctor is present during the test, you may be able to get the results before you leave. Otherwise, your own doctor will discuss the test results with you during a future office visit.

The information gained from the echo test helps your doctor make an accurate diagnosis and develop a treatment plan that’s best for you.

What is an Exercise Echocadiogram?
An exercise echocardiograin (also known as a stress echocardiogram) is a test that combines an ultrasound study of the heart with an exercise test. The test allows doctors to learn how the heart functions when it is made to work harder.

The exercise echocardiogram is especially useful in diagnosing coronary artery disease, the presence of blockages in the coronary arteries (the vessels that supply oxygen-rich blood to the heart).

What Does It Show?
During an echocardiogram, a small device called a transducer is held against the chest. The transducer sends ultrasound waves that reflect (echo) off the various parts of the heart.

The echoes are converted into moving images of the heart. These images are displayed on a television screen and can be recorded on videotape.

An echocardiogram is first done at rest, then during or immediately after an exercise test. [For patients who cannot exercise, the test may be done after the injection of a drug that produces a stress on the heart similar to exercise].

Doctors then compare the images. Normally, alL areas of the heart muscle pump more vigorously during exercise. If an area of the heart muscle does not pump as it should during exercise, this often indicates that it is not receiving enough blood because of a blocked or narrowed artery.

The exercise echocardiogram shows doctors which areas ofthe heart muscle do not receive an adequate blood supply. However, it does not provide images of the actual coronary arteries. If your doctor suspects blocked or narrowed arteries, he or she may recommend additional tests.

What Happens During the Test?
The exercise echocardiogram can be performed in the doctor’s office or at the hospital.

The test is divided into three parts: First, a resting echocardiogram is performed. Next, you walk on a treadmill or pedal a stationary bicycle. Then another echocardiogram is performed while your heart is still beating rapidly.

Resting Echocardiogram
You will be asked to lie on a hospital bed or examination table. To improve the quality of the pictures, a colorless gel is applied to the area of the chest where the transducer will be placed.

A technician moves the transducer to various places over the left side of your chest. Pictures of your heart at rest are recorded on videotape.

Exercise Test
You will either walk on a treadmill or pedal a stationary bicycle. The treadmill moves slowly at first, then the speed and incline increase gradually. If you pedal a stationary bicycle, it feels easy to pedal at first, then it gradually gets harder.

You will be instructed to report any symptoms, such as chest pain, shortness of breath, leg fatigue, or dizziness. The doctor may end the test when you reach your peak heart rate, when you get too tired, or when you experience significant symptoms.

After-Exercise Echocardiogram
You will be helped back to the examination table. The technician records a second set of images immediately after you finish exercising.

Doctors then compare the two sets of images (before and after exercise) side by side to see how your heart responds to the stress of exercise.

How Long Does It Take?
You should allow one and a half to two hours which includes preparation for the test, the exercise portion, and the imaging portion.

Is the Exercise Echocardiogram Safe?
The echocardiogram is very safe. There are no known risks from the ultrasound waves.
The exercise test is also safe. A small amount of risk does exist; however, because it stresses the heart. Possible rare complications include abnormal heart rhythms and a heart attack. Experienced personnel are available to handle any emergency.

The Results
The doctor conducting the test may be able to give you preliminary results before you leave. A complete interpretation may take several days.

The information gained from this test helps your doctor make an accurate diagnosis and develop a treatment plan that’s best for you.

What Is an Exercise Stress Test?
An exercise stress test is also called a stress electrocardiogram (ECG or EKG). It records your heartbeat while you walk on a treadmill or ride a stationary bike. This test helps your doctor evaluate the cause of chest pain. It also measures the strength of your heart after a heart attack or surgery. Don’t worry about
having to exercise. The stress test measures your heart, not your athletic ability. It is done in hospitals, test centers, and doctors’ offices.

Before Your Test
When you schedule the test, be sure to mention what medicines you take. Ask if you should take any before the test. Don’t eat, drink, smoke, or have any caffeine for 3 hours before your test. Sips of water are okay. Make sure you wear walking shoes and a 2-piece outfit. You may need to undress from the waist up and put on a short hospital gown. Although you don’t have to exercise for long, the entire test takes about 30 minutes. Also, allow extra time to check in.

Don’t eat, drink, smoke, or have any caffeine for 3 hours before the test.
Coffee, tea, chocolate, cola drinks, and some over-the-counter pain relievers may contain caffeine. If you are diabetic, ask what you may eat before the test.

During Your Test
• Small pads (electrodes) are placed on your upper body to monitor your heart rate.
• Then you are shown how to use the treadmill or bike. You need to exercise for several minutes.
• The exercise is very easy at first. Then it slowly gets harder.
• You should exercise for as long as possible.
• Your heartbeat and blood pressure are monitored during and after the test.

After Your Test
As soon as the test is over, you may eat and return to your normal routine. Ask your doctor about taking any medicine that you were told to skip before the test.

Your Test Results
Your doctor will discuss your test results with you during a future office visit. The test results help the doctor plan your treatment and any other tests that are needed.