Transthoracic Echocardiogram (Echo)
An ultrasound of your beating heart. This test visualizes the heart's structures—chambers, valves, and muscle walls—in real time to assess how well your heart is pumping.
Key facts at a glance
The "engine check" for your heart.
Function vs. Arteries
An Echo checks the 'pump and valves' (muscle/structure), while a CAC scan checks the 'pipes' (arteries). You often need both for a full picture.
Distinct
Valve Disease
Mild leaks (regurgitation) or stiffness (stenosis) are common as we age and can be managed if caught early.
Common
Hypertension Sign
It can detect Left Ventricular Hypertrophy (thickening muscle)—a sure sign that blood pressure has been too high for too long.
LVH
Safety
Uses sound waves only. No radiation. No needles.
100% Safe
Who this is for
- Anyone with a history of high blood pressure (to check for heart strain).
- Endurance athletes (to distinguish "athlete's heart" from pathology).
- Those with a family history of valve disease, cardiomyopathy, or aortic aneurysm.
What it measures
- Ejection Fraction (EF): The percentage of blood pumped out with each beat (normal is ~55-70%).
- Valves: Are they opening fully? Are they leaking (regurgitating)?
- Wall Motion: Are all parts of the heart muscle moving vigorously, or are there weak spots (suggesting past damage)?
- Aorta Size: Screening for aneurysm (widening) of the ascending aorta.
The Procedure
- You lie on an exam table, usually on your left side.
- A sonographer places a probe with gel on your chest.
- You may hear "whooshing" sounds—this is the Doppler measuring blood flow speed.
- It takes about 30–45 minutes.
Important Distinction
An Echo sees the muscle and valves. It generally cannot see inside the coronary arteries to find plaque blockage (unless the blockage has already caused a heart attack). That is why an Echo is often paired with a CAC Score (which sees the plaque) for a complete heart health assessment.
References
Clinical guidelines.
- Guidelines for the Cardiac Sonographer — American Society of Echocardiography (2022)
- Vahanian A, et al.. 2021 ESC/EACTS Guidelines for the management of valvular heart disease — European Heart Journal (2021)View source — Discusses the prevalence of undiagnosed valve disease in older adults
Content is educational and not medical advice. For personal recommendations, consult your clinician.