What an echocardiogram shows
An echocardiogram is a moving picture of a working heart. A probe on the chest wall sends sound into the chest and listens to what comes back, and from that we build an image of the muscle, the chambers, and the valves as they open and close.
Four chambers: the two upper chambers (atria) that receive blood, and the two lower chambers (ventricles) that pump it. Four valves — mitral, aortic, tricuspid, pulmonic — that are supposed to open freely and close completely. We look at each of them.
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Pumping function. The ejection fraction — the share of blood the left ventricle pushes out with each beat — and whether the walls are moving evenly.
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Valve disease. Whether a valve is narrowed (stenosis), leaking (regurgitation), or both, and how severely.
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Chamber size and wall thickness. The signature of long-standing high blood pressure, of a heart working against a tight valve, or of a heart that has stretched.
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Pressures. An estimate of the pressure in the lungs’ arteries, and of the pressure the heart is filling against.
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The lining and the space around it. Fluid around the heart, and clot or vegetation inside it.
Why it matters
Valve disease is common, it grows more common with age, and it carries a measurable survival cost. Most of it is silent until it is not. An echocardiogram is how it is found, graded, and followed.
Why it might be ordered
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Shortness of breath, swelling in the legs, or fatigue that is out of proportion to activity
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A murmur heard on exam
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Known or suspected heart failure — an echocardiogram is how heart failure is classified, because treatment depends on ejection fraction. Congestive Heart Failure →
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Atrial fibrillation, to assess chamber size and valve function →
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After a heart attack, to see how much muscle is affected
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Before certain procedures, and to follow a known valve problem over time
What to expect
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You lie on your left side. A technologist places warm gel on the chest and moves a probe between the ribs, asking you to hold your breath at moments. You will hear the whoosh of blood flow through the machine’s speaker — that is the Doppler signal, and it is normal. Nothing is injected. Nothing hurts. Plan on roughly 30 to 45 minutes.
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A transesophageal echocardiogram (TEE) is a different study — a probe passed into the esophagus under sedation, giving a much closer view of the valves and the left atrial appendage. It is done when a chest-wall study cannot answer the question, most often before a cardioversion. Heart Rhythm Treatment →
For referring providers — We perform transthoracic echocardiography in the office and transesophageal echocardiography with our interventional team. Reports are read by the treating cardiologist. Refer: (918) 943-5303 · fax (855) 312-3594.
Refer urgently: a new murmur with syncope, or suspected endocarditis · Routinely: a murmur, unexplained dyspnea, suspected heart failure, or surveillance of known valve disease. Full referral guide →