Echocardiograms Explained: How Heart Ultrasound Works, What It Shows, and How to Prepare
Updated: Sep 29
If your doctor has ordered an echocardiogram, or you have heard the term and wondered what it involves, this guide covers everything a patient should know: what the echocardiogram procedure looks like, the different types of echocardiograms, how to prepare, what to expect during the exam, and what your echocardiogram results mean. There is no radiation, no needles, and most exams are painless. Same-day appointments are available at Urgent Diagnostic Imaging Center in Glendale, with walk-ins welcome and preliminary results at the end of your visit.
What Is an Echocardiogram?
An echocardiogram, sometimes called an echo test or heart ultrasound, is a non-invasive imaging exam that uses high-frequency ultrasound waves to create real-time pictures of your heart. A trained sonographer places a small handheld device called a transducer on your chest, and the ultrasound waves reflect off your heart to produce moving images of the heart chambers, heart valves, heart muscle, and blood flow. Because ultrasound does not use radiation, the exam is safe to repeat as often as your referring physician needs.
Why Doctors Order an Echocardiogram
So what is an echocardiogram used for? Cardiologists and primary care providers order echocardiogram tests for a wide range of reasons.
Evaluating chest pain, shortness of breath, or heart palpitations
Investigating a heart murmur
Assessing suspected heart failure or cardiomyopathy
Measuring the strength of your heart’s pumping function (ejection fraction)
Checking heart valves for valve regurgitation or narrowing
Looking for fluid buildup around the heart
Monitoring a known congenital heart condition in adults
Following up after a heart attack, cardiac surgery, or a change in medication
What is the purpose of an echocardiogram at its core? It gives your doctor a clear view of how your heart is working right now, without invasive procedures or radiation exposure.
What Does an Echocardiogram Show?
A complete echocardiogram gives your physician a real-time view of cardiac structure and function. So what does an echocardiogram show?
The size and shape of the heart chambers
The thickness and movement of the heart muscle
How well the heart valves open and close
The direction and speed of blood flow through the heart, using Doppler ultrasound
Fluid or masses around the heart
Signs of past damage from a heart attack
Suspected congenital defects
The images are reviewed by a board-certified physician who prepares a detailed report for your referring physician.
Types of Echocardiograms
Not every heart ultrasound is the same. Your provider may order one of the following, depending on what they need to see.
Transthoracic Echocardiogram (TTE)
The transthoracic echocardiogram is the most common echocardiogram test. Your sonographer places the transducer on the outside of your chest and captures images from several angles. Most patients receive a TTE. It is completely non-invasive and typically takes 30 to 45 minutes.
Transesophageal Echocardiogram (TEE)
A transesophageal echocardiogram provides more detailed images by placing the transducer at the end of a thin, flexible tube that is passed into the esophagus. Because the esophagus sits directly behind the heart, TEE gives sharper views. It is used when a TTE does not provide enough detail, or when your cardiologist needs a closer look at the heart valves, aorta, or the back of the heart. A mild sedative is used for comfort.
Stress Echocardiogram
A stress echocardiogram compares heart images at rest and after exercise, usually on a treadmill or stationary bike, or after a medication that mimics exercise. It shows how your heart performs under stress and can reveal blockages in the coronary arteries that a resting echo may miss.
Doppler Echocardiogram
A Doppler echocardiogram adds color-coded flow imaging to a standard TTE. It shows how blood moves through your heart and valves, which helps identify leaks (regurgitation), narrowing (stenosis), and abnormal shunts. Doppler is usually included as part of a routine transthoracic echocardiogram at our clinic.
How to Prepare for an Echocardiogram
Echocardiogram preparation is simple in most cases, so here is how to prepare for an echocardiogram based on the type of exam you are scheduled for.
For a standard transthoracic (TTE) echo: No fasting is required. You can eat normally, drink water, and take your prescribed medications unless your cardiologist tells you otherwise. Wear a two-piece outfit so you can change easily.
For a stress echocardiogram: Follow your provider’s fasting and medication instructions. You may be asked to hold certain heart medications the day of your exam.
For a transesophageal (TEE) echo: Do not eat or drink anything for at least 6 hours beforehand because of the sedation. Arrange for someone to drive you home.
Bring your insurance card, photo ID, list of current medications, and any prior heart imaging on CD or in a patient portal. This helps your sonographer and radiologist compare studies over time.
What Happens During an Echocardiogram
Here is what happens during an echocardiogram, step by step, for a standard TTE. This is also the answer to how is an echocardiogram done and what is involved in an echocardiogram.
Check in and change. You will remove clothing from the waist up and put on a gown that opens in the front.
Electrodes. Small sticky pads are placed on your chest, arms, or legs to monitor your heartbeat during the scan.
Positioning. You lie on your left side on the exam table.
The scan. Your sonographer applies warm gel to your chest and moves the transducer to several positions. You may be asked to hold your breath briefly or shift position. You may hear a swishing sound during the Doppler portion, which is the sound of your blood flow.
Wrap-up. The gel is wiped off, the electrodes are removed, and you can get dressed and go about your day.
The entire exam is painless. Most patients feel only light pressure from the transducer.
How Long Does an Echocardiogram Take?
How long does an echocardiogram take? A standard transthoracic echocardiogram takes about 30 to 45 minutes. A stress echocardiogram takes about 60 minutes because it includes resting, exercise, and post-exercise imaging. A transesophageal echocardiogram takes about 30 to 60 minutes, plus additional recovery time from the sedative.
Understanding Your Echocardiogram Results
After your exam, a board-certified physician reviews the images and writes a report describing what they saw, including chamber sizes, wall motion, valve function, blood flow patterns, and any abnormal findings. At our clinic, preliminary echocardiogram results are available upon completion of the exam, final reports are faxed to your referring physician the same day, and STAT reports are delivered within one hour for urgent cases. Your provider will discuss the findings with you and outline any next steps.
Frequently Asked Questions
Is an echocardiogram painful?
No. A standard transthoracic echocardiogram is completely painless. You may feel light pressure from the transducer, but nothing invasive happens during the exam.
Does an echocardiogram use radiation?
No. Echocardiograms use ultrasound waves, not ionizing radiation, which is why they can be safely repeated as often as your doctor needs.
Can I eat before an echocardiogram?
Yes, for a standard TTE. Stress and TEE exams have specific fasting rules, which our office will confirm when you book.
Can I take my medication before an echocardiogram?
Take your usual medications unless your cardiologist tells you otherwise, particularly for a stress echocardiogram where certain heart medications may need to be held.
How long does an echocardiogram take?
A standard transthoracic echocardiogram takes 30 to 45 minutes. Stress echos and TEEs take longer.
Can an echocardiogram detect blocked arteries?
A resting echocardiogram does not directly image the coronary arteries. A stress echocardiogram can reveal areas of the heart that may not be getting enough blood, which may suggest an artery blockage. A coronary angiogram is required for direct visualization.
Can an echocardiogram detect heart failure?
Yes. An echocardiogram is one of the primary tools for diagnosing and monitoring heart failure by measuring the ejection fraction and evaluating the pumping function of the heart.
Can children have an echocardiogram?
Yes. Echocardiograms are safe for infants, children, and pregnant patients because they use ultrasound rather than radiation.
Do I need a referral for an echocardiogram?
A referral is often required for insurance coverage but not always for cash-pay patients. Call our office and we will confirm what your plan needs.
When will I receive my echocardiogram results?
Preliminary results are available at the end of your exam. Final reports are faxed to your referring physician the same day, and STAT reports are delivered within one hour when needed.
Same-Day Echocardiogram at Urgent Diagnostic Imaging Center in Glendale
If you need a same-day echocardiogram in Glendale, our team at Urgent Diagnostic Imaging Center accepts walk-ins during business hours (Monday through Friday, 9 AM to 8 PM, and weekends, 9 AM to 5 PM). Our ARDMS-licensed sonographers and board-certified radiologists deliver preliminary reports at exam completion and same-day finals for your referring physician.
To learn more about our full range of diagnostic imaging services, including vascular studies, general ultrasound, X-ray, and 3D breast ABUS, visit our services page. Ready to book an echocardiogram in Glendale? Call (818) 240-7744, book online, or walk into 1030 S. Glendale Ave, #405, Glendale CA 91205.
