What is an echocardiogram (echo)?

An echocardiogram (echo) is a test that uses sound waves to build a moving picture of your heart. This sort of technique is like an ultrasound that you would have if you were pregnant.

There are different types of echo scans that have specific elements to them, like a Dobutamine (stress) echo.

Exercise (stress) echocardiogram

An exercise echo, or stress echo, combines a standard echo with an exercise test. It will help your doctor understand how your heart is coping when it is working harder, like when you exercise. The test can help your doctor see if:

• your symptoms are due to underlying heart disease
• your heart would function better with surgical intervention
• there is a problem with one of your heart valves

The test

We will ask you to remove any clothing from the waist up and then lie down on an echo bed, on your back. We will give you a hospital gown to wear with the front open. This is so we can track your heart's activity. We then place sticky patches (electrodes) to your chest, which are connected to the echo machine. This first echo is called a resting echo, so we can see what your heart is doing when you are resting.

We then repeat the echo, but after you have done some exercise, such as walking on a treadmill or using an exercise bike. If you are not able to do the exercise, your doctor might do a Dobutamine echo test instead.

Treadmill exercise

You find treadmills (a small, moving walkway) in most gyms. When you get on the treadmill, your cardiac physiologist will put nine more electrodes on your chest for the echo. This will record your heart's electrical activity. We will also record your blood pressure before you start and at different points of the test.

You will start walking at a slow speed, then we will increase the treadmill's speed and slope every three minutes.

When you reach your target heart - which we calculate on your age - we stop the treadmill. Your doctor might stop the treadmill early if you start getting symptoms like:

• chest discomfort
• shortness of breath
• weakness
• dizziness
• significant changes in your blood pressure or ECG.

Once the treadmill has stopped, you will lie back down on the echo bed, and your doctor will do another echo whilst your heart is still beating fast.

You will stay on the echo bed until your blood pressure and your heart rate are back to your resting levels. As soon as you feel well enough, we will take off the electrodes.

Bicycle exercise

This test is done on a custom-made exercise bed that looks like an echo bed, but has a pedal attachment. You will stay lying down on the bed for the whole test.

When you start, your cardiac physiologist will put nine more electrodes on your chest to record your heart's electrical activity. We will also record your blood pressure before you start and at certain points during the test. To start the test, we will remove the bottom half of the bed and the bicycle pedals are then set up to best fit your legs. You will then start pedalling as you lie down, and every three minutes we will make it more difficult to pedal.

Once you reach your target heart rate - based on your age - you can stop pedalling and we will do another echo. We may get you to stop earlier if you start experiencing:

• chest discomfort
• shortness of breath
• weakness
• dizziness
• leg discomfort
• significant changes in your blood pressure or ECG

It is important to do your best during this test, but you should not push yourself too much so that you become unwell. At the end of the test, your doctor will get you to carry on pedalling slowly so your muscles can warm down.

You can relax on the bed until your blood pressure and heart rate return to their resting levels. As soon as you fell well enough, your doctor will take the electrodes off your chest.

For information about how to prepare for the test and how to get the results, click on the 'Information' tab.