Echocardiogram: Treatment, Effects & Risks

An echocardiogram is performed within echocardiography and is also known as “echo” for short. It is a special ultrasound examination of the heart. This procedure can be performed in two different ways: On the one hand, as transthoracic echocardiography (TTE) or as transesophageal echo (TEE).

What is an echocardiogram?

An echocardiogram is a special ultrasound examination of the heart. The echocardiogram represents an ultrasound examination of the heart, where the sound waves have such a high frequency that a human ear is not capable of perceiving them. The ultrasound waves penetrate the connective tissue as well as the organs, skin and muscles. If the sound waves hit certain surfaces, they are refracted or reflected in a similar way to light. The tissue areas that are hit reflect the waves back with very different strengths. An air-filled area reflects them back almost completely and a liquid area absorbs the sound waves almost entirely. The reflected waves can be converted electronically into an image, so that the interior of the body is depicted. To the best of our current knowledge, an echocardiogram has no harmful effects and is absolutely painless.

Function, effect, and purpose

Depending on which procedure is used, the echocardiogram or echocardiography achieves a variety of results about the heart function as well as the general condition of the heart. Thus, through the echocardiogram, the following information can be obtained, for example:

  • The exact size of the heart chambers and atria.
  • The pumping function or cardiac output, so that, for example, the extent of heart failure can be assessed
  • Possible movement disorders in the heart muscle; can indicate a heart attack.
  • The function as well as shape of the heart valves
  • The diameter and shape of the aorta (ascending aorta).
  • Certain changes in the pericardium (heart sac), especially the importance as well as size of a pericardial effusion.
  • An estimate to the blood pressure within the pulmonary artery.
  • As well as congenital malformations of the heart.

In an echocardiogram, the TTE and the TEE are further distinguished. The “Transthoracic Doppler Echocardiography” called TTE for short is an application procedure with which the function as well as anatomy of the heart above the thorax (chest) is made visible. The emitted sound waves are picked up again as an echo and visibly displayed on a screen. The other application procedure is known as “Transesophageal Doppler Echocardiography” or TEE for short. In this application of the echocardiogram, the examination takes place via the esophagus. This procedure is similar to a gastroscopy. The transducer is carefully guided into the esophagus, so that the ultrasound waves have a shorter path to reach the heart. In addition, this type of echocardiogram provides a much more accurate as well as clearer picture. The procedure with an echocardiogram can be planned with about half an hour of time. The goals of this examination are an accurate assessment of the heart chambers as well as the atria and valves and the pericardium. The heart continues to beat normally during the examination with an echocardiogram, allowing the physician to record the full pumping actions. He can assess whether the valve leaflets are optimally aligned and whether the ventricles are emptying completely. During the complete echocardiogram examination, an additional ECG is written to have a direct comparison on the ECG diagnostic strip. While the echocardiogram is being performed, the patient lies absolutely relaxed on the left side of his body.

Risks and dangers

With the echocardiogram, side effects or risks are basically extremely low. The standard TTE examination using external ultrasound does not have any dangers, nor is it uncomfortable. TEE (transesophageal echocardiography), on the other hand, could be somewhat uncomfortable. Here, the transducer is inserted through the esophagus and positioned exactly behind the beating heart. A gag reflex and increased salivation are often observed during this echocardiogram (TEE). These are natural reactions to the echocardiogram.TEE cannot be used, for example, if varicose veins (esophageal varices) occur within the esophagus, if esophageal cancer (esophageal carcinoma) has been diagnosed, or if there is an uncontrollable risk of bleeding. In addition, side effects of the locally administered anesthetic (local anesthetics) may possibly occur. The primary risk with such an echocardiogram is injury to the esophagus and pharynx and subsequent infections.