Echocardiography Plays a Key Role in Diagnosing Heart Disease

Concerns about overuse of echocardiography---imaging techniques such as electrocardiograms and echocardiograms---appear to be misplaced. Research suggests cardiography isn't used in enough patients who need it.

If you’ve ever experienced unexplained chest pains, a heart attack, or a heart murmur, chances are you underwent echocardiography, a commonly performed imaging test sometimes referred to as just an “echo.”

The number of echoes performed each year in the U.S. and around the world has been steadily rising, leading to a perception that the test is being overused. But a recent study, published in the Journal of the American College of Cardiology (JACC), suggests that, in fact, echocardiography is being underused. Researchers found that it is ordered for less than 10 percent of the patients who have appropriate indications for the test.

Experts have praised the study, noting that echocardiography is associated with lower rates of hospital mortality.



  • …is safe and does not involve radiation.
  • …is portable and readily accessible within most hospital and outpatient settings.
  • …can provide supportive information to a good clinical assessment of a patient’s heart, thereby allowing more accurate diagnosis and ongoing monitoring.

Echocardiography Advantages

Unlike X-rays or CT scans (which are essentially very sophisticated X-rays), echocardiography does not use radiation. Instead, echocardiograms are produced with sound waves that create moving pictures of your heart. These images illustrate the function and structure of the heart, and can reveal any abnormalities. They’re also useful to track the effectiveness of medications or a procedure or to see if a condition is worsening over time.

Echos can also reveal whether a person has had a previous heart attack, has heart failure, or has valve problems. Plus, the technology is more portable than such other imaging techniques as nuclear imaging, CT scans, and magnetic resonance imaging, so it can be utilized at bedside.

Boosting Survival

Another important benefit of echocardiography is that it helps save lives by providing doctors detailed images used in diagnosing a condition or making changes to a treatment plan.

How It’s Done

Echocardiography is a non-invasive procedure. Typically, it’s done while you lie on your back or your left side. A special “jelly” is placed on a probe, which is moved around your chest by a trained sonographer. Ultra-high frequency sound waves are used to create images that appear on a nearby video screen.

There is also a test, called stress echocardiography, or “stress echo,” in which a patient pedals a type of stationary bike or walks on a treadmill while heart activity is monitored. Another type of echocardiography is called transesophageal echocardiography (TEE), which is used when a closer look at your heart is needed. In this test, a cardiologist will pass a tube down your throat as you swallow. At the end of the tube is a probe that produces images similar to those taken with standard echocardiography. Once the images are taken, the probe is removed.

Echocardiography takes about an hour and is painless. There are also no side effects. If your doctor orders echocardiography, feel free to ask why it’s necessary. During the test, ask questions, too. You may learn a little more about your heart along the way.

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Jay Roland

Jay Roland has been executive editor of Massachusetts General Hospital’s Mind, Mood & Memory since 2017. Previously, he held the same position with Cleveland Clinic’s Heart Advisor, since 2007. In … Read More

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