Echocardiography

By using high-frequency sound waves, echocardiograms (echo) provide a graphic outline of the heart’s movement. Out of the four types of echocardiograms, a transesophageal echo (TEE) test may be used if a physician cannot get a clear picture using any other forms of tests. During the TEE test, an ultrasound transducer is guided down the patient’s throat into the esophagus. The TEE test offers a close examination into the heart valves and chambers without interference from the ribs or lungs.

Learning About Echocardiograms

Has your child experienced an irregular heartbeat, swelling in the legs, shortness of breath, or unexplained chest pain? If so, chances are your child’s doctor will recommend that he have an echocardiogram to help determine if his symptoms are caused by heart problems. An echocardiogram is a painless test that uses sound waves to create pictures of the heart. Doctors can use this information to pinpoint various abnormalities in valves or chambers of the heart and to evaluate the heart’s ability to pump. Echocardiograms are frequently used to learn about a wide range of heart problems. Your doctor may have this test done to:

• Check if the size of the heart is enlarged
• See if heart valves do not open normally or do not form a complete seal when closed
• Find blood clots or tumors in the heart
• Look for heart muscles that are not pumping properly
• Measure the thickness of heart walls
• Evaluate the size and shape of the chambers in the heart
• Locate defects in the heart’s structure
• Identify fluid around the heart

An echocardiogram does not use radiation like X-rays and some other tests. There are four main types of echocardiograms. Depending on what your doctor needs to learn about your child’s heart, he will probably undergo one of the following types of echocardiograms.

• The transthoracic echocardiogram is the most common type of test. This noninvasive echocardiogram involves spreading gel on the chest and then passing a device over the skin called a transducer that aims an ultrasound beam at your child’s heart. Ultrasound waves bounce off structures in the heart and are transmitted to a computer where they are converted to pictures on a video screen.
• A transesophageal echocardiogram may be necessary if your child’s doctor cannot get a clear picture of the heart with a transthoracic echocardiogram. In this type of test, a flexible tube with a transducer attached to the end is guided down the throat into the esophagus. Your child’s doctor should be able to get more detailed images of the heart from this location.
• A Doppler echocardiogram uses sound waves to bounce off blood cells moving through the heart and blood vessels. This technique is used during most transthoracic and transesophageal echocardiograms to measure the speed and direction of blood flow in the heart.
• A stress echocardiogram involves recording ultrasound images of the heart before and immediately after exercise to diagnose certain heart problems that occur only during physical activity. If your child is unable to walk on a treadmill or ride a stationary bicycle, his doctor may give him medicine to make his heart work hard and beat fast.

A standard transthoracic echocardiogram does not require any special preparation. You will be asked not to give your child anything to eat or drink anything for several hours before a transesophageal or stress echocardiogram. An echocardiogram, which usually takes less than an hour, can be performed in a hospital or doctor’s office. For more information about echocardiograms, visit the National Heart Lung and Blood Institute.