An echocardiogram (often called an "echo") is a painless ultrasound scan of your heart. It uses sound waves to create moving pictures of your heart, so a clinician can see how well it pumps and how its valves are working. You might need one if you have symptoms such as breathlessness or a heart murmur, or to keep an eye on a known heart condition.
What is an echocardiogram?
An echocardiogram works in the same way as an ultrasound scan in pregnancy. A small handheld probe sends sound waves into your chest. These bounce off your heart and are turned into live images on a screen.
There is no radiation and nothing goes inside your body. Most standard scans need no needles, although occasionally a contrast agent is injected into a vein in your arm to make the pictures clearer. It is one of the safest and most widely used heart tests.
The most common type is a transthoracic echocardiogram (TTE), where the probe is moved over the outside of your chest. This is the type most people mean when they talk about "having an echo". In hospital, there are also specialist versions, such as a stress echo or a transoesophageal echo (TOE), which are used for particular questions and arranged by a specialist when needed.
Why might you need an echocardiogram?
A doctor may suggest an echo to check whether your symptoms could be linked to your heart, or to see how a known heart problem is doing. Common reasons include:
- Breathlessness, especially when walking, climbing stairs or lying flat
- A heart murmur heard by your GP through a stethoscope that needs checking
- Swollen ankles or legs, which can sometimes be linked to how well the heart pumps
- Palpitations, if a rhythm problem has been found or a structural heart problem is suspected
- Chest discomfort that is not an emergency but needs investigating
- Dizziness or fainting episodes that have already been assessed for urgent causes
- An abnormal ECG that needs a closer look
- High blood pressure, if there are concerns it may be affecting the heart
- A family history of an inherited heart condition, such as cardiomyopathy, in a close relative
- Monitoring a known condition, such as valve disease, heart failure, or after a heart attack
Some people also choose an echo for peace of mind, or before taking up demanding sport or exercise. If you are not sure whether an echo is right for you, your clinician will advise.
When should you get urgent help instead?
An echocardiogram is a planned test, not emergency care. Call 999 if you have chest pain, collapse, or severe breathlessness. If you have new or worrying symptoms that are not an emergency, speak to your GP or contact NHS 111 first.
How do you prepare for an echocardiogram?
There is very little you need to do. For a standard echo:
- you can eat, drink and take your usual medicines as normal
- wear a two-piece outfit, as you will need to undress from the waist up
- bring a list of your medicines and any previous heart test results
You will be covered as much as possible to keep you comfortable, and you can ask for a chaperone.
What happens during the appointment?
Knowing what to expect can make the test feel much less daunting. A typical echo goes like this:
- A short chat. You will be asked about your symptoms, medical history and why the scan has been requested. This is a good time to ask questions.
- Getting ready. You undress from the waist up and lie on a couch, usually turned onto your left side. A few small sticky pads are usually placed on your chest to track your heart rate during the scan.
- The scan. Cool gel is put on your chest, and the probe is moved to different spots, including under your ribs and near your neck. You may be asked to breathe in, breathe out or hold your breath briefly to get clearer pictures.
- Finishing up. The gel is wiped off, the pads are removed, and you can get dressed and go about your day as normal.
The probe may press firmly at times, but it should not hurt. Let the person scanning you know if anything is uncomfortable. You may hear a loud "whooshing" sound from the machine. This is the sound of blood flowing through your heart and is completely normal.
How long does an echocardiogram take?
A standard echocardiogram usually takes around 30 to 40 minutes. Allow a little extra time for the chat beforehand and for getting changed. After a standard echo there is no recovery time, so you can drive, work and eat as usual straight afterwards. (Specialist hospital tests that use sedation, such as a TOE, are different: you should not drive for 24 hours.)
Can you have an echocardiogram at home?
Yes. Modern portable equipment means an echo can be done in your own home. This can help if you find travelling difficult, care for someone, or simply feel more relaxed in familiar surroundings. You will need a bed or sofa to lie on and a little space for the equipment.
What happens after the scan?
Your images are reviewed and you receive a written report explaining the findings. If anything needs follow-up, the report will say so, and you may be advised to see your GP or a cardiologist. Keep a copy to share with your GP.
To understand what the scan measures and what your results mean, read What Does an Echocardiogram Show? If you are unsure whether you need an echo or a simpler test, ECG vs echocardiogram: which heart test do I need? explains the difference.
Frequently asked questions
Is an echocardiogram painful?
No. A standard echo is painless. The gel can feel cold, and the probe may press firmly at times, but most people find it comfortable.
Is an echocardiogram safe?
Yes. It uses sound waves rather than radiation, so it is safe to repeat, and a standard echo has no known risks or side effects. If a contrast agent is needed, you may be asked to wait for a short time afterwards to check for a reaction.
Do I need to fast before an echocardiogram?
Not for a standard echo. You can eat, drink and take your usual medicines. You would only be asked to fast for some specialist types done in hospital.
What is the difference between an ECG and an echocardiogram?
An ECG records your heart's electrical activity using sticky pads. An echocardiogram is an ultrasound scan that shows your heart's structure, pumping and valves.
Do I need a GP referral for an echocardiogram?
No. You can refer yourself. GP and specialist referrals are also welcome.
Can I bring someone with me?
Usually, yes. Many people find it reassuring to bring a friend or relative. If you would like a chaperone during the scan, mention it when you book.
Booking an echocardiogram with The Heart Clinic
You can book an echocardiogram without a GP referral, at our Luton clinic or at home across London, Hertfordshire and Buckinghamshire. The price includes the scan, clinical review by our team with Consultant Cardiologist oversight, and a written report, usually within 24 working hours. See our prices or contact us to book.