Cardiologist Dr Carl ShakespeareOne of the tests that we carry out across our hospitals and outpatient centres is the echocardiogram, or ‘echo’ as it’s otherwise known – and each year, we carry out 19,000 of these tests across our healthcare system.

Here, we spoke to Dr Carl Shakespeare, Consultant Cardiologist at The Lister Hospital, part of HCA UK, about what happens when you come in for an echocardiogram and what this tool can be used to diagnose.

What is an echocardiogram?

An echo is an ultrasound of the heart, which is used to look at the structure and function of the heart. It’s a quick and painless test, and unlike an X-ray, it doesn’t involve any radiation. It measures the impact that blocked or narrowed arteries have on the heart muscle. 

Why might I be referred for an echocardiogram?

A patient might be asked to have an echo if they have already received clinical findings that need investigation. For example, a common reason for referral is if a patient has a heart murmur – an echo can be used to check if the murmur is being caused by leakages in the valves which can cause changes in blood flow. 

Other times, a patient might come in with symptoms such as breathlessness. Recently, we have seen patients recovering from COVID-19 who are experiencing breathlessness. This is because COVID-19 can sometimes cause inflammation of the heart, but we are usually able to reassure patients through the use of an echo that no long-term heart muscle damage has occurred. 

We also use an echo to screen those who have a family history of heart disease to check for heart muscle abnormalities. 

What happens when I come in for the test?

When a patient comes in for an echo, they’ll lie down on a couch or bed, and electrodes will be applied to their chest. These are non-invasive, sticky patches that are connected to a monitor. The test will then be carried out either by a technician or a cardiologist, who will move an ultrasound probe across the chest to assess the function of the heart.

The test only takes about 20 minutes and patients can usually go home and carry out normal activities after it’s complete.

What sort of further investigations might a patient need?

Depending on the outcome of the echo, we may carry out further investigations to rule out more serious conditions such as coronary artery disease. Patients might be referred for an angiogram, or a cardiac CT or MRI scan so we can have a more detailed look at the blood vessels.

We may also want to examine a patient’s blood pressure. The heart is basically a pump, but if you have high blood pressure (hypertension) your blood has to pump harder. 

What sort of cardiac conditions can an echo help diagnose?

Echos can help determine the presence of a number of heart conditions such as valve disease and cardiomyopathy - when the walls of the heart become thickened or enlarged. We can look for any congenital conditions, that will have been present since birth and check for heart muscle damage.

It’s important to note that heart failure is remediable, so if you are experiencing symptoms such as breathlessness and exhaustion, you should seek medical advice soon, so any damage to your heart muscles can be quickly treated.

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