An echocardiogram is a test that uses sound waves to produce live images of your heart. This test allows your provider to monitor how your heart and its valves are functioning. An echocardiogram can also help spot blood clots in the heart, fluid in the sac around the heart, and problems with the aorta (the main artery connected to the heart).

Your provider may use an ECHO test to look at your heart’s structure and check how well your heart functions. The test helps your doctor find out:

  • The size and shape of your heart, and the size, thickness and movement of your heart’s walls.
  • How your heart moves.
  • The heart’s pumping strength.
  • If the heart valves are working correctly.
  • If blood is leaking backwards through your heart valves (regurgitation).
  • If the heart valves are too narrow (stenosis).
  • If there is a tumor or infectious growth around your heart valves.

The test also will help your doctor find out if there are:

  • Problems with the outer lining of your heart (the pericardium).
  • Problems with the large blood vessels that enter and leave the heart.
  • Blood clots in the chambers of your heart.
  • Abnormal holes between the chambers of the heart.

Types of Echocardiograms

  • Transthoracic Echocardiography (TTE): This is the most common type of echocardiography. It’s painless and noninvasive. A device called a transducer will be placed on your chest over your heart. The transducer sends ultrasound waves through your chest toward your heart. A computer interprets the sound waves as they bounce back to the transducer. This produces the live images that are shown on a monitor.
  • Transesophageal Echocardiogram (TEE): If a transthoracic echocardiogram doesn’t produce definitive images, your doctor may recommend a transesophageal echocardiogram. In this procedure, a much smaller transducer is guided through a thin, flexible tube in your mouth and down your throat. Your throat will be numbed to make this procedure easier. This tube is guided through your esophagus (the tube that connects your throat to your stomach). Your doctor can get a better view of any problems with the transducer behind your heart.
  • Stress Echocardiogram: Stress echocardiogram uses a traditional transthoracic echocardiogram. However, it’s done after exercise or in tandem with medication to make your heart beat faster. This allows your doctor to test how your heart performs under stress.
  • Three-Dimensional Echocardiography: A three-dimensional echocardiogram uses either transesophageal or transthoracic echocardiography to create a 3-D image of your heart. This involves multiple images from different angles. It’s used prior to heart valve surgery or to diagnose heart problems in children.
  • Fetal Echocardiography: A fetal echocardiography is used on expectant mothers sometime during weeks 18 to 22 of pregnancy. The transducer is placed over the woman’s belly to check the fetus for heart problems. The test is considered safe for an unborn child because it doesn’t use radiation (unlike X-rays).

About the Procedure

ECHO tests are done by trained sonographers. You may have your test done in your doctor’s office, an emergency room, an operating room, a hospital clinic or a hospital room.

  • You will lie on a bed on your left side or back.
  • The sonographer will put special jelly on a probe and move it over your chest area.
  • Ultra-high-frequency sound waves will pick up images of your heart and valves. No X-rays will be used.
  • Your heart’s movements can be seen on a video screen.
  • A videotape or a photograph can be made of the pictures.
  • You can sometimes watch during the test.
  • It usually takes one hour.
  • It’s painless and has no side effects.
  • Sound waves will pick up images as explained above.
  • When the test is finished, the cardiologist will gently pull the probe out.
  • You may feel a need to cough.

Sometimes the probe needs to be closer to your heart to give clearer pictures. You may need a special test called transesophageal echocardiography (TEE). As you swallow, a cardiologist will gently pass a tube with a probe on the end of it down your throat and into the esophagus. (This is the tube connecting your mouth to your stomach.)

Usually, you can resume your normal daily activities after an echocardiogram. If your echocardiogram is normal, no further testing may be needed. If the results are concerning, you may be referred to a cardiologist for more tests.


Alpharetta and Cumming Internal Medicine has experienced staff and physicians who can help you live your life to its fullest. If you live north of Atlanta in Roswell, Woodstock, Johns Creek, Suwanee or Canton, you are just a short distance from the best primary care in Georgia. Call us at 770/475-2377 to schedule an appointment today!