What does a heart echo show?

If an echo has been requested for you, you probably have a few questions: does it hurt? Does it use radiation? What will the result say? This article deals with those questions and points to the source throughout. Interpreting your own result is for your own doctor.

What is an echo, and how is it different from an ECG?

An echo is a scan that uses sound waves. The NHS compares it to an ultrasound scan in pregnancy. Cleveland Clinic states clearly that an echo does not use radiation, unlike a plain X-ray and a CT scan, which use a small amount.

An ECG is something else. The BHF explains that an ECG records the rhythm, the heart rate and the electrical activity, while an echo looks at the structure of the heart, including the valves, and shows the blood flow and pumping strength. A doctor often looks at both together.

What does an echo report usually talk about?

Based on what Cleveland Clinic and the BHF say, an echo gives information about:

• The structure of the heart
• Pumping strength: how well the heart sends blood out
• The valves: how they open and close and the blood flow through them. The NHS says a valve may be narrowed (does not open fully) or may leak (does not close fully)
• The effects of conditions such as an earlier heart attack, heart failure, valve disease and congenital heart disease
• In some cases, clots in the heart chambers or inflammation of the lining around the heart (Cleveland Clinic)

An echo report is usually written in technical language, and its numbers mean different things for each person and each situation. The sources we read do not give one fixed “normal” figure for everyone. Ask your doctor what the numbers in your own report mean.

What does an echo not show?

• The heart rhythm is recorded by an ECG, not by a standard echo. If the problem comes and goes, a portable ECG may be needed (NHS).
• Not every part is seen equally well. Cleveland Clinic says an echo through the food pipe gives better quality pictures and shows the back of the heart better. The BHF also says this type shows closer the areas that are hard to see on a standard echo.
• A standard echo is a picture at rest. To check during activity there is the exercise echo. The BHF says an exercise echo can help in diagnosing coronary artery disease.

So an echo alone does not answer every question. The doctor weighs its result together with your history, examination and the other checks.

Types of echo

The NHS and the BHF list these:

• Standard echo on the chest, the most common
• Exercise or stress echo
• Echo through the food pipe
• Echo with contrast
• Bubble echo (BHF): salt solution with tiny bubbles injected into a vein in the arm, used to look for a hole in the heart, which may be needed after a stroke or TIA or complex heart surgery
• Foetal echo, to look for a heart defect before birth

Which type of echo you need is decided by your doctor. Which of them this clinic carries out is not stated in this article.

After the echo

The NHS says sometimes the doctor tells you the result on the same day; otherwise there is usually a separate appointment to explain it. The doctor says what was seen and whether further tests or treatment are needed. If you hear nothing after a few weeks, contact the referring doctor.

To prepare, write down your questions:

• What does the result say, and was anything unusual seen?
• Is another test needed?
• What should I do and not do with this result?
• When is the next follow-up?
• Which signs should I report straight away?

When to seek urgent care

If any of these appears before you see the echo result, call 115 (Iran’s emergency number) and do not wait:

• Sudden chest pain or pressure that does not go away, or that spreads to the arm, jaw, neck, back or belly
• Severe breathlessness, fainting, cold sweat with nausea
• Sudden weakness on one side of the face or body, or trouble speaking

An echo result, or a report you are holding, should not make you ignore these signs.

Symptoms and treatment plans differ from patient to patient. Talk to a doctor about your own situation.