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Echocardiogram

Also called: Echocardiography, Transthoracic Echocardiogram, Cardiac Ultrasound

- Summary
- About echocardiograms
- Types and differences
- Conditions diagnosed
- Before, during and after
- About TEE
- About intravascular echocardiograms
- Questions for your doctor

Reviewed By:
Abdou Elhendy, MD, PhD, FACC, FAHA
Kerry Prewitt, M.D., FACC

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Types and differences of echocardiograms

There are many types of echocardiograms, which include:

One-dimensional (M-mode; motion mode). A one-dimensional view of the heart, similar to having a straight line drawn through it. This can be black-and-white or color.
Two-dimensional (cross-sectional). A two-dimensional view of the heart, which shows both length and width of heart structures. This can be black-and-white or color.
Three-dimensional echocardiography (3DE). A new technique that may offer superior measurements of the left ventricle, evaluation of areas of the heart muscle vulnerable to damage from heart disease, and assessment of valvular structure and function.
Doppler ultrasound. A test that measures the speed at which blood is traveling through the heart. This allows physicians to analyze differences in blood pressures and speeds as blood flows across the valves. For example, abnormal velocity across the area of a heart valve may suggest the extent of valve narrowing or valve leaking.
Doppler tissue imaging. A test showing heart muscle movement during periods of contraction and relaxation. This technique is useful in identifying early stages of hypertrophic cardiomyopathy.

cardiomyopathy

Stress echocardiogram. An echocardiogram performed while the patient exercises in a controlled manner on a treadmill or stationary bicycle at varied speeds and elevations. The wall motion of the heart’s pumping chamber before and immediately after exercise may reveal evidence of a lack of blood supply to selected areas of the heart muscle. This can help detect blockages in the heart arteries.
Chemical stress echocardiogram. A type of stress test that is used with patients who are unable to perform physical activity. A chemical stress echocardiogram measures the reaction of the heart under chemically induced stress in order to assess the wall motion of the heart muscle. A drug (e.g., dobutamine, adenosine) causes the heart to react as if the person were exercising, though the patient is actually at rest. This can help detect blockages in the heart arteries.
Transesophageal echocardiogram (TEE). A minimally invasive echocardiogram that requires a transducer to be inserted down the patient’s throat into the esophagus (the long tube that connects the throat with the stomach). Because the esophagus is located so close to the heart, very clear images of the heart structures and valves can be obtained this position.
Intravascular echocardiogram. An echocardiogram performed as part of a cardiac catheterization in which a transducer is threaded into a blood vessel via a catheter. It provides information about plaque and calcium deposits on the inside of the blood vessel. This type of echocardiogram is minimally invasive and, therefore, has a different set of preparations and other considerations.
Contrast echocardiogram. An echocardiogram that is performed after a contrast medium is injected that causes blood vessels or other body structures to stand out more clearly.
Fetal echocardiogram. An echocardiogram that allows for the physician to view the heart of a baby while still in the mother’s womb. It may be used in the diagnosis of certain congenital heart diseases.

Each type of echocardiogram provides unique information to the physician regarding the heart structures and function. For example, a one-dimensional echocardiogram is very helpful in determining the size of one of the heart’s chambers (atria and ventricles), thickness of the chamber walls, function of the mitral valve and weight of the left ventricle.

The two-dimensional echocardiogram is particularly helpful in seeing the relation of the heart’s chambers to each other, the ejection fraction (a measurement of the strength of the left ventricle), and problems with the heart’s valves.

Doppler ultrasound and its colorized version (the color Doppler) are helpful in detecting a variety of problems, including those of the valves or functional structure below the valves. Doppler can also be an effective tool in screening for pulmonary hypertension in people at risk for developing the condition (e.g., patients with sickle cell anemia).

pulmonary hypertension