Of all the tests we order, the echocardiogram is probably the one patients find easiest to live with and hardest to picture beforehand. There is no needle, no radiation, and no recovery time — just a handheld probe and a moving ultrasound picture of your heart on a screen. Yet that picture tells us a remarkable amount: how strongly your heart pumps, whether its valves open and close properly, and whether fluid, thickening, or damage is present. At Northwest Cardiovascular Clinic, we perform echocardiography in our own office for patients across Tomball, Cypress, Spring, and northwest Houston. Here is what the test is, why you might need one, and what the visit is like.
What is an echocardiogram?
An echocardiogram works on the same principle as the ultrasound used during pregnancy. A technician, called a sonographer, places a small probe (a transducer) coated with warm gel on your chest. It sends out high-frequency sound waves that bounce off the heart and return as moving images. Because the heart is shown in motion, we can watch the chambers squeeze and relax and see blood flowing through the valves — information a still picture or an EKG cannot give us.
It is worth separating the echo from the test people often confuse it with. An EKG records the heart’s electrical activity and is excellent for rhythm problems. An echocardiogram shows the heart’s structure and function. They answer different questions, and we frequently use them together.
What does an echo show?
A complete study lets your cardiologist evaluate several things at once:
- Pumping strength. The ejection fraction (EF) estimates the percentage of blood the left ventricle pushes out with each beat. A normal EF is generally about 50 to 70 percent. A lower number can indicate a weakened heart muscle.
- Valves. Narrowed (stenotic) or leaky (regurgitant) valves can be seen and graded for severity. This is how a heart murmur is usually explained.
- Chamber size and wall thickness. Enlarged chambers or thickened walls, often from long-standing high blood pressure, show up clearly.
- Areas of damaged muscle. Segments that move poorly can suggest a prior heart attack or reduced blood flow.
- The pericardium. Fluid around the heart can be detected and measured.
- Pressures and clots. Estimates of pressure in the heart and lungs, and sometimes clots or masses inside the heart.
Why might you need an echocardiogram?
An echo is not just for people who already have heart disease. Common reasons we order one include:
- Shortness of breath that is new, worsening, or unexplained — one of the most important symptoms to sort out.
- Swelling in the legs or ankles, which can be a sign of heart failure (see our guide to leg swelling and when to see a cardiologist).
- A heart murmur heard on exam, to tell a harmless flow sound from a valve problem.
- Chest pain, palpitations, or fainting, when we need to know whether the heart structure or pumping function plays a role (see heart palpitations: causes and evaluation).
- Known heart conditions — heart failure, valve disease, prior heart attack, or coronary artery disease — where periodic repeat echoes track whether things are stable.
- Long-standing high blood pressure, to look for thickening of the heart muscle.
- Before certain treatments or surgeries, or while monitoring medications that can affect the heart.
Types of echocardiograms
Transthoracic echocardiogram (TTE) is the standard test, done with the probe on the chest while you rest. It is what most patients mean by “an echo.”
Stress echocardiogram combines an echo with exercise (usually a treadmill) or, if you cannot exercise, a medication that makes the heart work harder. Images are taken before and right after, so we can see whether any part of the heart muscle is not getting enough blood flow under demand. Learn more about stress testing.
Transesophageal echocardiogram (TEE) uses a thin probe passed down the esophagus, under sedation, to take closer pictures from behind the heart. It is used for specific questions and is typically arranged in a hospital setting rather than as a routine office test.
Bubble (agitated saline) study. A small amount of saline with tiny bubbles is injected into a vein during an echo to look for a hole between the heart’s chambers, such as a patent foramen ovale.
What to expect during your echo
Preparation for a standard resting echo is simple. You can eat, drink, and take your usual medications unless we tell you otherwise, and wear comfortable clothing, since you will undress from the waist up and be given a gown. (A stress echo has its own instructions — we will tell you what to avoid beforehand.)
You lie on your left side on an exam table while small sticker electrodes are placed on your chest to track your heart rhythm. The sonographer applies gel and moves the probe across several positions, pressing firmly at times to get clear views. You may be asked to roll slightly, hold your breath for a few seconds, or breathe in a certain way. You may also hear a swooshing sound — that is simply the Doppler measurement of blood flow. The test is not painful; some patients feel mild pressure from the probe.
A standard echo typically takes about 30 to 60 minutes, and you can drive yourself home and go straight back to normal activity. There is no radiation and no contrast dye in a standard echo.
Understanding your results
The sonographer captures the images, and your cardiologist interprets them and explains what they mean in the context of your symptoms, exam, and other tests. A finding such as a mildly leaky valve is very common and often needs nothing more than periodic follow-up, while a reduced EF or a significant valve problem leads to a treatment plan. Because we perform the study in our office, results are reviewed in one place with the physician who is caring for you, rather than being passed back and forth between facilities. If you are curious how findings are described, see our overview of a normal vs. abnormal echocardiogram.
When symptoms need urgent care
An echocardiogram is a planned test, not an emergency tool. Call 911 for chest pressure or pain lasting more than a few minutes, sudden severe shortness of breath, fainting, or symptoms of a stroke such as one-sided weakness or slurred speech. Do not wait for an appointment in those situations.
Echocardiography in Tomball & Cypress
Northwest Cardiovascular Clinic is located just off SH 249 (Tomball Parkway) in northwest Houston, serving Tomball, Cypress, Spring, and the surrounding communities. Dr. Ismail Dairywala is a board-certified cardiovascular specialist, and we perform EKG, echocardiography, stress testing, and vascular ultrasound on site. If you have been told you need an echo — or you have breathlessness, swelling, or a murmur no one has explained — contact our office to schedule, or call (281) 807-5253.
Frequently asked questions
What is an echocardiogram used for?
An echocardiogram is a heart ultrasound used to evaluate how well the heart pumps, how the valves work, the size and thickness of the chambers, and whether there is fluid around the heart. It is commonly ordered for shortness of breath, leg swelling, heart murmurs, chest pain, palpitations, or to monitor known heart disease.
Is an echocardiogram painful or safe?
A standard echocardiogram is painless and uses sound waves rather than radiation, so it is considered very safe. You may feel mild pressure from the probe against your chest. There is no needle or contrast dye in a routine resting echo.
How long does an echocardiogram take, and do I need to prepare?
A standard resting transthoracic echo usually takes about 30 to 60 minutes. In most cases no special preparation is needed: you can eat, drink, and take your medications as usual unless your doctor says otherwise. A stress echo or transesophageal echo has additional instructions, which your care team will give you.
What is the difference between an echocardiogram and an EKG?
An EKG records the heart's electrical activity and is best for detecting rhythm problems and some signs of heart attack. An echocardiogram uses ultrasound to show the heart's structure and pumping function in motion. They answer different questions and are often used together.
What is a normal ejection fraction?
Ejection fraction (EF) is the percentage of blood the left ventricle pumps out with each beat. A normal EF is generally about 50 to 70 percent. A lower EF can indicate a weakened heart muscle, but your cardiologist interprets it alongside your symptoms and other test results.
Where can I get an echocardiogram near Tomball or Cypress?
Northwest Cardiovascular Clinic performs echocardiography in our office just off SH 249 in northwest Houston, serving Tomball, Cypress, Spring, and the surrounding communities. Call (281) 807-5253 or use our contact page to schedule.