The information in this section applies to the more common, noninvasive forms of echocardiograms. Transesophageal echocardiograms (TEEs) and intravascular echocardiograms are more invasive and different procedures are used before, during and after these procedures.

Other than wearing loose-fitting clothing, there are no special restrictions or preparation prior to echocardiograms. In general, patients may continue to eat, drink fluids and take prescribed medication as normal. However, people who are scheduled for a chemical stress echocardiogram are usually told to stop eating and drinking for about four to six hours before the test. This helps prevent any nausea or vomiting during the test.

Occasionally a child undergoing a noninvasive echocardiogram will be given a sedative prior to the procedure.

An echocardiogram can be performed in a variety of settings, including hospitals, cardiac labs, testing centers or a physician’s office. Most tests take about 30 minutes. Stress echocardiograms (both exercise and chemical) make take up to 1-1/2 hours. Additional time may be needed for the physician or technician to record information about the patient and answer all of the patient’s questions. People scheduled for any of the noninvasive echocardiograms are free to drive after the test.

Patients are required to remove clothing from the waist up and are given a hospital gown to wear during the test. The physician or technician will prepare the chest area by applying a conductive gel. People scheduled for a chemical stress echocardiogram will receive an intravenous (IV) line via a needle inserted into a vein at the back of the wrist. The IV line allows medications to be given to the patient without sticking the patient with more needles. 

A hand-held device called a transducer is then placed on the chest directly over the gel and pictures of the chest are seen immediately on a video monitor. At that time, the lights in the examination room may be dimmed to allow a better view of the various monitors that are recording the results of the echocardiogram.

An electrocardiogram (EKG) may also be performed during this test. An EKG is a painless test in which about 10 to 12 small metal devices electrodes are taped to the chest and attached by wires to an electrocardiograph machine. The EKG gives information about the electrical activity of the heart and can help detect abnormal heart rhythms (arrhythmias).

Throughout the echocardiogram, the physician or technician may change the position of the transducer, reposition the patient, or ask the patient to take certain actions, such as holding his or her breath. Each of these changes may help create clearer images of the heart.

Following the echocardiogram taken while the person is at rest, people scheduled for a stress echocardiogram (both exercise and chemical) will have another echocardiogram taken under stress. For an exercise stress echocardiogram, the patient may be instructed to walk on a treadmill or pedal a stationary bike at varying levels of intensity while the echocardiogram is performed. For a chemical stress echocardiogram, a medication such as dobutamine will be given through the IV before additional echocardiogram testing.

When the test is complete, the transducer is removed and the gel is cleansed from the chest area.

There should be no side effects or complications from a noninvasive echocardiogram, although people who had a chemical stress echocardiogram may experience some minor side effects from the medication, such as:

The medication may also cause complications due to the stress it places on the heart. Complications may include abnormal heart rhythms (arrhythmias) or low blood pressure (hypotension).

If a child undergoing a pediatric echocardiogram was given a calming medication (sedative) prior to the procedure, the patient’s parent or guardian should discuss potential side effects with the physician.