Preparing for echo patient guide

Overview

An echocardiogram (often called an echo) is a painless ultrasound scan of your heart. It uses sound waves to create moving pictures of your heart’s size, shape, and how well it pumps blood. An echo does not use radiation and is very safe.

Yes, echocardiograms are one of the most common heart tests performed worldwide. Millions of people have one each year.

An echo may be recommended for anyone with symptoms like chest pain, shortness of breath, palpitations, or a murmur. It is also used to monitor known heart conditions, before certain surgeries, or after a heart attack.

Symptoms

Common symptoms

• Chest discomfort or pain
• Shortness of breath, especially with activity or when lying flat
• Feeling your heart race, flutter, or skip beats (palpitations)
• Swelling in your ankles, feet, or legs
• Unexplained tiredness or reduced ability to exercise

Symptoms in children

• A heart murmur heard by a doctor
• Turning blue during crying or feeding
• Poor growth or feeding difficulties
• Fainting or dizziness during activity

Symptoms in older adults

• Shortness of breath that is new or worsening
• Leg swelling that does not go away with rest
• Decreased energy or feeling lightheaded
• New or worsening heart murmur

Causes

Main causes

• To evaluate symptoms like chest pain, shortness of breath, or palpitations
• To check the structure and function of heart valves
• To assess how well the heart is pumping (ejection fraction)
• To look for blood clots or tumors in the heart
• To monitor known conditions such as heart failure, cardiomyopathy, or valve disease

Risk factors

• High blood pressure (hypertension)
• Coronary artery disease or previous heart attack
• Heart valve problems, including a history of rheumatic fever
• Heart failure or weakened heart muscle
• Family history of heart disease or sudden cardiac death
• Diabetes, obesity, or high cholesterol

When to see a doctor

See a doctor urgently if:

• If you have chest pain, shortness of breath, or palpitations that are new or getting worse, seek medical advice promptly – call your doctor or local health service.

Book a routine appointment if:

• If your doctor has recommended an echo as part of a routine check-up or to monitor a known condition, schedule it soon. Follow the instructions you are given for preparation (usually no special preparation needed).

Diagnosis

During an echocardiogram, a trained sonographer or doctor places a small handheld device (transducer) on your chest after applying a gel. The transducer sends sound waves that bounce off your heart and create images on a screen. The test usually takes 30 to 60 minutes.

Tests that may be done

• Transthoracic echocardiogram (TTE) – the standard echo done through the chest wall.
• Stress echocardiogram – an echo done before and after exercise or medication to see how your heart responds to stress.
• Transesophageal echocardiogram (TOE/TEE) – a more detailed test where a small probe is passed down your throat. This may require sedation.
• Doppler ultrasound – often done as part of an echo to measure blood flow through the heart.

What to expect at your appointment

You will be asked to remove clothing from the waist up and wear a hospital gown. You lie on your left side on an exam table. The room may be dim to help the sonographer see the images clearly. You will feel a cool gel on your chest, and the transducer will be moved gently across your chest. You may be asked to breathe slowly or hold your breath for a few seconds. The test is painless. Afterward, you can wipe off the gel and dress normally. No recovery time is needed.

Treatment

An echocardiogram itself is not a treatment – it is a diagnostic test. The results help your doctor decide if you need any treatment for your heart condition. Treatment – if needed – may include lifestyle changes, medications, or procedures. Your doctor will discuss the results and next steps with you in plain language.

Self-care at home

• Wear a two-piece outfit to the appointment so you can easily undress from the waist up.
• Do not apply lotion, oil, or powder to your chest on the day of the test – it can affect the images.
• Eat and drink normally unless your doctor gives you other instructions (for a stress echo you may need to avoid caffeine).
• Bring a list of your current medicines, including any supplements, to the appointment.

Medical treatments

Based on echo results, your doctor might suggest lifestyle changes (like increasing physical activity or quitting smoking), prescribe medications to help your heart work better, or recommend a procedure such as valve repair or a pacemaker. Your healthcare team will explain any recommended treatments in a way that is easy to understand.

When is surgery considered?

If the echo shows a serious valve problem, a hole in the heart, or other structural issue, surgery may be an option. Your cardiologist and a heart surgeon will explain the risks and benefits, and help you decide what is best for you.

Living with this condition

Most people do not need to change their daily routine because of having an echo. The test is brief and has no side effects. After the test, you can drive, go back to work, and do all your regular activities immediately.

Lifestyle tips

• If you have a heart condition, follow your doctor’s advice about physical activity, diet, and medications.
• Keep all follow-up appointments to monitor your heart health.
• Learn to recognize symptoms that need medical attention (chest pain, shortness of breath, swelling).

Diet and exercise

Unless you have a specific heart condition that requires dietary changes, you do not need to change what you eat or drink before or after a standard echo. If you are having a stress echo, ask your doctor whether you can eat or drink coffee beforehand.

Mental health and emotional wellbeing

It is normal to feel a little anxious before any medical test. Remember that an echo is painless and safe. If you feel stressed, talk to your healthcare team – they can explain the process and answer your questions. Deep breathing or listening to calming music before the test may help.

Prevention

An echocardiogram is a test, not a condition. There is nothing to prevent about the test itself. However, you can reduce your risk of needing an echo by maintaining a healthy heart: keep blood pressure and cholesterol in check, eat a balanced diet, stay physically active, avoid smoking, and limit alcohol.

Vaccines

There are no vaccines related to echocardiograms. However, staying up to date with flu and pneumonia vaccines can help prevent infections that might stress your heart.

Screening programmes

An echo may be used as a screening test if you have a family history of certain heart conditions or if your doctor hears a murmur. Talk to your doctor about whether screening is right for you.

Complications

If left untreated

• If a heart condition is found on an echo and left untreated, it could worsen over time – for example, a faulty valve might lead to heart failure.
• Delaying treatment for a heart problem that is discovered on an echo may increase the risk of serious complications like a heart attack, stroke, or arrhythmia.

Long-term outlook

The outlook for most people who have an echocardiogram is excellent. The test is very safe and provides crucial information to help your doctor manage your heart health. With proper follow-up – whether that means lifestyle changes, medications, or a procedure – many heart conditions can be treated effectively, allowing you to live a full and active life.

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