Echocardiogram (ECHO)
An echocardiogram is a non-invasive cardiac imaging test that uses high-frequency ultrasound waves to produce detailed, real-time images of the heart. It visualises the chambers, valves, and overall cardiac motion, allowing clinicians to assess structural and functional integrity without radiation.
An echocardiogram is a cornerstone investigation in cardiology and is performed to:
- Evaluate cardiac function: Assess left and right ventricular performance, ejection fraction, and wall motion.
- Detect structural abnormalities: Identify valve stenosis or regurgitation, congenital heart defects, and chamber enlargement.
- Identify disease complications: Detects pericardial effusion, cardiomyopathy, or presence of intracardiac masses or thrombi.
- Monitor established cardiac conditions: Assess progression of heart failure, valvular disease, or cardiomyopathy.
- Pre-procedural and pre-operative assessment: Determine fitness for surgery or interventions requiring anesthesia or fluid shifts.
Who Should Undergo an Echocardiogram?
Echocardiography is indicated for:
- Individuals with symptoms such as chest pain, dyspnoea, palpitations, syncope, or leg swelling
- Patients with abnormal ECG or elevated cardiac biomarkers
- Individuals with hypertension, previous heart attack, or chronic cardiac conditions
- Patients undergoing cardiac follow-up or post-treatment monitoring
- Individuals requiring cardiovascular evaluation before major surgery
When is an Echocardiogram Recommended?
- During diagnostic work-up for suspected heart disease
- As routine assessment in patients with known cardiac conditions
- When new or worsening symptoms develop
- Prior to initiating cardiotoxic medications
- Before non-cardiac surgery to evaluate cardiac risk
Types of Echocardiography
1. Transthoracic Echocardiogram (TTE – Standard Echo)
A non-invasive ultrasound test where a transducer is placed on the chest to capture images of the heart.
When is a TTE Recommended?
- Routine heart assessment
- Evaluates heart chambers, valves, pumping function
- First-line test for most cardiac conditions
How the Test Is Performed
- Patient lies on the left side or supine.
- Ultrasound gel is applied to the chest.
- Transducer is moved across the chest to obtain multiple views.
- Duration: 30–60 minutes.
Key Advantages
- Non-invasive, painless, safe
- No sedation required
- No radiation exposure
2. Transesophageal Echocardiogram (TEE)
A specialized ultrasound performed by inserting a flexible probe down the esophagus to obtain clearer, closer images of the heart.
When is a TEE Recommended?
- When TTE images are unclear
- Suspected endocarditis, blood clots, valve abnormalities
- Detailed assessment of structures at the back of the heart
How the Test Is Performed
- Patient fasts for 6 hours beforehand
- Throat is numbed; mild sedation administered
- A flexible probe is guided into the esophagus
- High-resolution images of heart valves and chambers are captured
Key Advantages
- Much clearer imaging than TTE
- Better visualization of posterior structures
- Useful in critical diagnostic situations
3. Stress Echocardiogram (Stress Echo)
An echocardiogram performed while the heart is stimulated by exercise or medication to evaluate function under stress.
When is a Stress Echo Recommended?
- Detects coronary artery disease
- Evaluates exercise-induced symptoms
- Assesses how heart muscle contracts and relax upon exertion
How the Test Is Performed
- Patient walks on a treadmill or receives medication (e.g., dobutamine)
- Echo images are taken before, during, and after stress
- Compares heart wall motion upon rest and exertion
Key Advantages
- Helps detect hidden heart disease not seen at rest
- No radiation exposure
- Provides real-time functional assessment