Echocardiogram

An echocardiogram (echo) uses ultrasound waves to create moving images of the heart. It shows the heart's size, shape, and function, including how well the chambers and valves are working. Types include transthoracic (TTE), transesophageal (TEE), stress echo, and 3D echo.

Echocardiograms evaluate heart murmurs, heart failure, valve disease, cardiomyopathy, congenital heart defects, blood clots, pericardial disease, and to assess heart function before and after surgery or chemotherapy.

No preparation is needed for a standard TTE. For TEE, fast for 6 hours. For stress echo, avoid caffeine and certain heart medications as directed. Wear comfortable clothing.

For TTE, a technician applies gel to your chest and moves an ultrasound probe to obtain images from different angles. You lie on your left side. For TEE, a probe is passed through the mouth into the esophagus under sedation. A standard echo takes 30-60 minutes.

No recovery is needed for TTE. For TEE, you rest until sedation wears off (1-2 hours) and should not drive for the rest of the day. Mild sore throat is common after TEE. Resume normal diet once the numbness wears off.

TTE is completely safe with no radiation. TEE risks include sore throat, rare esophageal injury or perforation (extremely rare), and sedation-related risks. There are no risks associated with standard ultrasound imaging.

Alternatives include cardiac MRI (more detailed but more expensive), nuclear stress test (uses radioactive tracer), and cardiac CT (uses radiation). Each has specific strengths for different clinical questions.

Covered by insurance when ordered for medical indications. TTE is widely approved. TEE and stress echo may require prior authorization. Coverage is standard for most heart-related evaluations.