An echocardiogram shows the size, shape and movement of your heart in real time. It lets a cardiologist see how well your heart muscle pumps, whether your four valves open and close properly, and how blood flows through the chambers. It is a safe, painless ultrasound scan that can help explain symptoms such as breathlessness, or follow up a heart murmur.
How does an echocardiogram work?
An echocardiogram, or "echo", uses high-frequency sound waves. A small handheld probe is placed on your chest with a little cool gel. The sound waves bounce off different parts of your heart, and a computer turns the echoes into moving images on a screen.
A special setting called Doppler shows the direction and speed of blood flow, often in colour. This is how leaking or narrowed valves can be spotted. There is no radiation, and nothing goes inside your body during a standard echo (called a transthoracic echocardiogram).
What can an echocardiogram show about your heart?
An echo gives a detailed look at several parts of the heart at once. The main things it can assess are explained below.
How well your heart pumps
The scan shows how strongly the heart muscle squeezes with each beat. This is often described as the ejection fraction: the share of blood pushed out of the main pumping chamber (the left ventricle) each time your heart beats. A reduced pumping strength can be a sign of heart failure or damage to the muscle. Your report will explain what your result means for you.
The size of the heart chambers
Your heart has four chambers: two upper atria and two lower ventricles. An echo measures each one. Enlarged chambers can develop after long-term high blood pressure, valve disease or certain rhythm problems.
The thickness of the heart walls
Thickened heart muscle can happen when the heart has worked harder than usual for a long time, for example because of raised blood pressure. Some inherited conditions, such as hypertrophic cardiomyopathy, also cause thickening, and an echo is one of the main tests used to look for them.
Your heart valves
The four valves keep blood flowing in one direction. An echo can show whether a valve is:
- Narrowed (stenosis): it does not open fully, so the heart has to push harder
- Leaking (regurgitation): it does not close fully, so some blood flows backwards
- Floppy (prolapse): the valve becomes floppy and may not close properly; this most often affects the mitral valve
Valve problems are a common cause of heart murmurs, which is why an echo is often the next step after a doctor hears one.
Other findings
- Fluid collecting in the sac around the heart (pericardial effusion)
- Areas of muscle that move less well, which may suggest a previous heart attack
- Some heart conditions present from birth, such as a hole between the chambers
- Pressure in the lungs' blood vessels, estimated from blood flow patterns
- Occasionally, blood clots or growths inside the heart
What an echocardiogram cannot show
An echo is very useful, but it has limits. It is good to know these so your expectations are realistic:
- Coronary arteries: it does not show the blood vessels that supply the heart muscle, so it cannot directly show narrowed arteries.
- Heart rhythm over time: it captures your heart only during the scan. For symptoms that come and go, a Holter monitor records your rhythm over one or more days.
- Electrical detail: an ECG is better for studying the heart's electrical signals. Our guide to ECG vs echocardiogram explains how the two tests differ.
Why might you be offered an echocardiogram?
A clinician may suggest an echo if you have:
- A heart murmur
- Shortness of breath, tiredness or swollen ankles without a clear cause
- Long-standing high blood pressure
- A family history of inherited heart muscle disease
- A known valve or heart muscle condition that needs regular checks
- An unusual ECG result
For background on the test itself, read what an echocardiogram is and why you might need one.
How long does an echocardiogram take, and what happens on the day?
Most scans take around 30–45 minutes. You will be asked to undress to the waist and given a gown or cover for privacy. You lie on a couch, usually on your left side, and a few sticky pads may be attached to track your heart rate.
The sonographer moves the probe to different spots on your chest and may ask you to breathe in, breathe out or hold your breath briefly. You might feel slight pressure from the probe, but it should not hurt. There is no recovery time, so you can drive, eat and return to work straight away. The NHS has a helpful overview of what happens during an echocardiogram.
What happens after the scan?
The images are reviewed and a written report is prepared. It describes the measurements taken and highlights anything that needs attention. Many people find their echo is normal, which can be very reassuring. If something is found, the report will help your GP or specialist decide whether you need treatment, further tests or simply a repeat scan in the future.
If you develop chest pain, collapse or severe breathlessness at any time, call 999. For symptoms that worry you but are not an emergency, speak to your GP or call NHS 111.
Frequently asked questions
Can an echocardiogram show a blocked artery?
Not directly. It may show areas of heart muscle that are not moving well, which can be a clue, but other tests are used to look at the coronary arteries themselves.
Can an echocardiogram detect heart failure?
An echo is one of the main tests used to assess heart failure, because it shows how well the heart pumps and fills. A diagnosis is made by a clinician using your symptoms and other results too.
Is an echocardiogram safe?
Yes. It uses ultrasound, not radiation, and a standard echo has no known side effects. The gel may feel cold, and removing the sticky pads can tug slightly.
Will I get my results straight away?
The sonographer may not be able to discuss findings during the scan. At The Heart Clinic, your written report is usually ready within 24 working hours.
Does a normal echo mean my heart is healthy?
A normal echo is a good sign that your heart's structure and pumping are working well. It does not check your rhythm over time or your coronary arteries, so your clinician will advise if other tests are needed.
Booking an echocardiogram with The Heart Clinic
You can book an echocardiogram for £365 all-inclusive, covering the scan, clinical review and written report, with Consultant Cardiologist oversight. Scans are available at our Luton clinic or as a home visit across London, Hertfordshire and Buckinghamshire; see our locations or contact us on 07853 215671 or info@theheart.clinic. No GP referral is needed.