There are no risks involved in a standard transthoracic echocardiogram. You may feel some discomfort similar to pulling off an adhesive bandage when the technician removes the electrodes placed on your chest during the procedure.
If you have a transesophageal echocardiogram, your throat may be sore for a few hours afterward. Rarely, the tube may scrape the inside of your throat. Your oxygen level will be monitored during the exam to check for any breathing problems caused by sedation medication.
During a stress echocardiogram, exercise or medication — not the echocardiogram itself — may temporarily cause an irregular heartbeat. Serious complications, such as a heart attack, are rare.
How you prepare
No special preparations are necessary for a standard transthoracic echocardiogram. You can eat, drink and take medications as you normally would.
Your doctor will ask you not to eat for a few hours beforehand if you're having a transesophageal or stress echocardiogram. If you have trouble swallowing, let your doctor know, as this may affect his or her decision to order a transesophageal echocardiogram.
If you'll be walking on a treadmill during a stress echocardiogram, wear comfortable shoes. If you're having a transesophageal echocardiogram, you won't be able to drive afterward because of the sedating medication you'll likely receive. Before you have your transesophageal echocardiogram, be sure to make arrangements to get home.
What you can expect
An echocardiogram can be done in the doctor's office or a hospital. After undressing from the waist up, you'll lie on an examination table or bed. The technician will attach sticky patches (electrodes) to your body to help detect and conduct the electrical currents of your heart.
During the echocardiogram, the technician will dim the lights to better view the image on the monitor. The technician will apply a special gel to your chest that improves the conduction of sound waves and eliminates air between your skin and the transducer — a small, plastic device that sends out sound waves and receives those that bounce back.
The technician will move the transducer back and forth over your chest. The sound waves create images of your heart on a monitor, which are recorded for your doctor to review. You may hear a pulsing "whoosh," which is the ultrasound recording the blood flowing through your heart.
If you have a transesophageal echocardiogram, your throat will be numbed with a numbing spray or gel to make inserting the transducer into your esophagus more comfortable. You'll likely be given a sedative to help you relax.
Most echocardiograms take less than an hour, but the timing may vary depending on your condition. During a transthoracic echocardiogram, you may be asked to breathe in a certain way or to roll onto your left side. Sometimes the transducer must be held very firmly against your chest. This can be uncomfortable — but it helps the technician produce the best images of your heart.