What is the heart and how does it work?

The heart is a muscle inside your chest, which pumps blood around your body to your vital organs. It’s a very special piece of plumbing, made up of four chambers with pipes into and out of it. Between each chamber, and in each of the tubes, there are valves which control the flow of blood.

Why do I need an echocardiogram?

There are many reasons someone may need an echocardiogram. Your heart may not be pumping as well as it should, have weak or hardened valves, a clot, an infection, a bulging of the muscle, a tear in its wall, or be too large. There are many other reasons for an echocardiogram, and your doctor will explain yours to you before you have your scan.

What is an echocardiogram, and how is it performed?

An echocardiogram, also known as an “echo” for short, is an ultrasound scan to look at how well your heart pumps, and how the valves in your heart are working. It is a very similar procedure to the scans pregnant women have to check up on their babies.

There are two types of echocardiogram – a transthoracic echocardiogram (TTE), and a trans-oesophageal echocardiogram (TOE).

During a transthoracic echocardiogram, some jelly will be put on the end of an ultrasound probe, which will then be placed against your chest. You may be asked to lie on your side or hold your breath at various times during the scan. The person scanning you will be able to see the chambers and valves of your heart this way.

During a transoesophageal echocardiogram, you will receive a needle in your arm, called a cannula. Through this, you will receive some sedatives to relax you during the procedure. You’ll receive a numbing spray at the back of your throat, and then the person scanning you will put the ultrasound probe into your mouth and down your throat. You might be asked to swallow to help move the probe down. This procedure should not be painful or very uncomfortable. You might have to fast for a few hours beforehand.

Which type should I have?

Your doctor will decide which scan you should have, taking into consideration your reasons for the scan, your medical history and preferences.

A transthoracic echocardiogram is less invasive and gives us information about the chambers and valves in your heart. However, it does not give us as much information as possible, as your ribs and muscles are in the way between the ultrasound probe and your heart.

A transoesophageal echocardiogram is slightly more invasive, but can give us much clearer images and more information about your heart, since there are no bones or muscles in the way.

What will it tell us?

An echocardiogram will tell us how effectively your heart is filling and pumping blood. It will tell us whether the valves in your heart are flapping ineffectively, or sealed too tightly to let blood out. It will also tell us if there is anything wrong with the way your heart has developed or aged. Doctors will use the pictures and numbers from your echocardiogram to decide what the best treatment for you is. This is a very helpful test with almost no risks.

What are the risks?

There are almost no risks associated with a transthoracic echocardiogram, apart from a reaction to the ultrasound jelly and some pain if the person scanning you pushes hard on your chest.

The risks of a transoesophageal echocardiogram are also small, but include a reaction to the sedative, numbing spray, or ultrasound jelly, an infection from the needle in your arm, and some mouth or throat pain for a few hours after the scan. There is a very small risk of bleeding, or injury to your oesophagus (gullet), throat, mouth or teeth. You may be drowsy for a few hours after the scan, but should be back to normal within a day.

Where to from here?

Once your doctor has the results from your scans, they will be able to see how well your heart is working, and decide if you need more tests before they can give you a diagnosis. They can use the information from the scan to create a treatment plan that is best suited to you.