An echocardiogram, or heart ultrasound, is a safe, noninvasive imaging test that allows doctors to evaluate the structure and function of the heart and major blood vessels. The procedure uses sound waves to create real-time images of the heart, helping identify both congenital and acquired heart conditions. Because it is painless, radiation-free, and suitable for people of all ages—including newborns and pregnant women—echocardiography remains one of the most commonly used diagnostic tools in cardiology.

How to Prepare for a Heart Ultrasound

Preparing for a standard echocardiogram is simple:

• Eat a light meal no later than 1.5–2 hours before the examination.
• Avoid coffee, tea, energy drinks, and other caffeinated beverages before the test.
• Do not smoke or engage in vigorous physical activity for at least 1.5–2 hours beforehand.
• Continue taking prescribed medications unless your doctor advises otherwise.
• Wear comfortable clothing that allows easy access to the chest area.

When Is an Echocardiogram Recommended?

A doctor may recommend a heart ultrasound to investigate symptoms, evaluate known heart conditions, or monitor treatment progress. Common indications include:

• Shortness of breath
• Irregular heartbeat or palpitations
• High blood pressure
• Unusually fast or slow pulse
• Unexplained chest pain
• Weakness and fatigue
• Dizziness or fainting
• Pale or bluish skin coloration
• Swelling of the ankles or feet
• Frequent nausea
• Heart failure
• Suspected heart attack or stroke
• Previous heart attack
• Heart murmurs
• Arrhythmias and tachycardia
• Suspected heart tumors
• High levels of physical activity
• Participation in professional sports

Echocardiography is also commonly performed before and after cardiac or major surgical procedures.

What Does a Heart Ultrasound Show?

An echocardiogram provides detailed information about the size, structure, and function of the heart.

The examination can assess:

• Heart chamber size and volume
• Thickness of heart walls
• Heart valve structure and function
• Pumping ability of the heart muscle
• Condition of the pericardium (the sac surrounding the heart)
• Large blood vessels connected to the heart
• Blood flow through the heart

The test can also help detect:

• Valve disorders
• Mitral valve prolapse
• Coronary artery disease
• Myocarditis (heart muscle inflammation)
• Cardiomyopathy
• Hypertension-related heart changes
• Blood clots within the heart
• Aneurysms
• Enlargement or thickening of heart chambers
• Congenital heart defects
• Heart tumors
• Early signs of heart failure

How Is the Procedure Performed?

A standard echocardiogram usually takes 15–20 minutes. During the examination:

• The patient removes clothing from the upper body and lies on an examination table.
• A special ultrasound gel is applied to the chest.
• The sonographer moves a handheld probe across the chest to capture images from different angles.
• The patient may be asked to turn onto their side during the procedure.

The examination is painless and does not require recovery time.

Transesophageal Echocardiography

In some situations, a more detailed examination is needed. Transesophageal echocardiography (TEE) may be recommended for patients with:

• Artificial heart valves
• Atrial fibrillation
• Recent stroke
• Suspected blood clots within the heart

During this procedure, a thin flexible probe is passed through the mouth into the esophagus, allowing doctors to obtain highly detailed images of structures located near the left atrium.

Patients must avoid food, drinks, and smoking for at least six hours before the procedure.

Stress Echocardiography

A stress echocardiogram evaluates how the heart performs during physical exertion. Images are taken while the patient exercises on specialized equipment or after medication that simulates exercise. This test is particularly useful when evaluating suspected coronary artery disease or exercise-induced symptoms.

Understanding the Results

An echocardiogram report provides information about:

• Heart wall thickness
• Chamber dimensions
• Heart muscle contraction strength
• Valve function
• Pericardial health
• Pressure within major blood vessels

Because heart size and blood flow vary with age, measurements differ between children and adults.

Normal Left Ventricle Values

Typical adult measurements include:

• Myocardial mass:
  • Men: 137–172 g
  • Women: 95–141 g
• Myocardial mass index:
  • Men: 71–94 g/m²
  • Women: 71–89 g/m²
• End-diastolic dimension: 46–57 mm
• End-systolic dimension: 31–43 mm
• Wall thickness at rest: approximately 1.1 cm
• Ejection fraction: 55–60%
• Stroke volume: 60–100 mL

A wall thickness of 1.6 cm or greater may indicate ventricular hypertrophy, while an ejection fraction below normal often suggests heart failure.

Normal Right Ventricle Values

Typical measurements include:

• Wall thickness: approximately 0.5 cm
• Size index: 0.75–1.25 cm/m²
• End-diastolic dimension: 0.95–2.05 cm

Common Abnormal Findings

An echocardiogram may reveal:

• Hypertrophy – thickening of the heart muscle
• Dilation – enlargement of heart chambers
• Dyskinesia – abnormal wall motion
• Akinesia – absence of contraction in part of the heart muscle
• Systolic dysfunction – impaired pumping function
• Diastolic dysfunction – impaired relaxation of the heart

Valve abnormalities may also be detected. Narrowing of a valve opening is known as stenosis, while incomplete valve closure that allows blood to flow backward may contribute to heart failure.

Why Echocardiography Is Important

Echocardiography provides a comprehensive view of heart structure and function without exposing patients to radiation. It plays a crucial role in diagnosing heart disease, monitoring treatment effectiveness, evaluating symptoms, and detecting cardiovascular problems before they become serious.

Do you think preventive heart screening, such as echocardiography, should be used more frequently in healthy adults, especially those with risk factors or a family history of cardiovascular disease?