Echocardiogram patient guide

Overview

An echocardiogram (say 'ek-o-kar-dee-o-gram') is a safe, painless ultrasound scan that uses sound waves to create moving pictures of your heart. It shows how your heart is pumping, the size and shape of the chambers and valves, and how blood flows through it. It is sometimes called an 'echo' for short.

Echocardiograms are very common – thousands are performed every day in NHS hospitals and clinics around the world. It is a routine test for anyone with suspected heart problems.

An echocardiogram can be performed on people of any age, from newborn babies to older adults. It is often used for people who have symptoms like chest pain, shortness of breath, or an irregular heartbeat, or for those with known heart conditions needing monitoring.

Symptoms

Common symptoms

• Chest discomfort or pain
• Unexplained shortness of breath (especially on exertion or lying flat)
• Feeling your heart racing, fluttering, or skipping beats (palpitations)
• Swelling in your ankles, feet, or legs
• Feeling dizzy, lightheaded, or fainting
• Unexplained tiredness or weakness

Symptoms in children

• Fast breathing or difficulty feeding (in infants)
• Blue colour around the lips or skin (cyanosis)
• Poor weight gain or growth
• Frequent chest infections
• A heart murmur heard by a doctor

Symptoms in older adults

• Shortness of breath during normal activities (like walking)
• Fatigue that limits daily tasks
• Swelling in the legs or abdomen
• Irregular pulse or palpitations
• Chest pain or pressure

Causes

Main causes

• An echocardiogram itself does not cause anything – it is a test. It is used to investigate possible causes of heart symptoms, such as coronary artery disease, heart valve problems, heart muscle disease (cardiomyopathy), or congenital heart defects (problems from birth).

Risk factors

• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• Obesity
• Family history of heart disease
• Older age
• History of rheumatic fever or heart infections

When to see a doctor

See a doctor urgently if:

• If you have chest pain that comes on suddenly while at rest or with very little exertion
• If you collapse or faint without explanation
• If you have severe shortness of breath that makes it hard to speak or breathe

Book a routine appointment if:

• If you have mild palpitations that come and go
• If you have mild swelling in your ankles
• If you have been told you have a heart murmur and need a baseline echo
• If you have a known heart condition and your doctor recommends a regular follow-up echo

Diagnosis

An echocardiogram is performed by a specially trained sonographer or cardiologist. They will apply a clear gel to your chest and gently move a small handheld device (transducer) over your skin. You may be asked to breathe slowly or hold your breath for a few seconds to get clear images. The test is painless and takes about 30 minutes.

Tests that may be done

• Transthoracic echocardiogram (TTE) – the most common type, done through the chest wall
• Transesophageal echocardiogram (TOE) – a thin tube is passed down your throat to get closer images of the heart (you are given sedation)
• Stress echocardiogram – done before and after exercise or medication to see how your heart works under stress
• Doppler ultrasound – used with echo to measure blood flow through the heart

What to expect at your appointment

You will lie on a bed or reclining chair. The room is dimly lit. A small amount of gel is placed on your chest, and the sonographer will move the probe over your skin. You may hear whooshing sounds – that is normal. The test is painless. You can eat and drink normally beforehand unless told otherwise. For a transesophageal echo, you will be asked not to eat for several hours.

Treatment

An echocardiogram itself is a diagnostic test, not a treatment. After the test, your doctor will discuss the results and recommend next steps. If a heart condition is found, treatment may include lifestyle changes, medications, or procedures. Each person's treatment plan is individual.

Self-care at home

• Follow a heart-healthy diet low in salt, saturated fat, and added sugars
• Stay physically active as per your doctor's advice
• Maintain a healthy weight
• Stop smoking and limit alcohol
• Manage stress through relaxation techniques or counselling

Medical treatments

Depending on the findings, your doctor may recommend medications to control blood pressure, reduce cholesterol, prevent blood clots, or help the heart pump more efficiently. Some people may need procedures such as valve repair or coronary stenting. Always follow your doctor's specific plan and never change medications without speaking to them.

When is surgery considered?

In some cases, such as severe valve disease or certain congenital heart defects, heart surgery may be recommended. This could involve repairing or replacing a heart valve, or bypass surgery for blocked arteries. Your heart team will discuss all options with you.

Living with this condition

If your echocardiogram shows a heart condition, you can still live a full life. Most people manage their heart health with regular checkups, medications, and healthy habits. Your healthcare team will help you understand your condition and how to manage it day by day.

Lifestyle tips

• Take all medications exactly as prescribed
• Attend all follow-up appointments and cardiac rehabilitation if offered
• Learn to recognise your symptoms and when to seek help
• Carry a list of your medications and any allergies

Diet and exercise

A heart-friendly diet includes plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats like olive oil. Aim for at least 30 minutes of moderate exercise most days – walking is excellent. Always check with your doctor before starting a new exercise programme.

Mental health and emotional wellbeing

Having a heart condition can be worrying. Anxiety and depression are common. It is important to talk to your doctor or a counsellor about how you feel. Support groups can also help. Remember, many people with heart conditions live long, active lives.

Prevention

While you cannot prevent needing an echocardiogram if symptoms arise, you can reduce your risk of heart disease by adopting a heart-healthy lifestyle. Regular checkups can catch problems early.

Vaccines

Getting vaccinated against flu and pneumonia can help protect your heart, as these infections can worsen existing heart conditions. Ask your doctor which vaccines are recommended for you.

Screening programmes

Your doctor may recommend a baseline echocardiogram if you have a strong family history of heart disease, certain genetic conditions, or if you are at high risk. Routine screening is not needed for most people.

Complications

If left untreated

• If an underlying heart condition is not treated, it can lead to worsening heart failure, irregular heart rhythms (arrhythmias), blood clots, stroke, or heart attack.

Long-term outlook

The outlook for people who have an echocardiogram and receive appropriate care is generally very good. Many heart conditions can be managed effectively with lifestyle changes, medications, and sometimes procedures. Early detection and treatment greatly improve outcomes and quality of life. Your healthcare team will work with you to create the best plan for your situation.

Find support

International organisations

• World Heart Federation
• European Society of Cardiology – Patient Information

Local organisations

• British Heart Foundation · United Kingdom
• American Heart Association · United States

Helplines

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