Echocardiography with or without Color Doppler

An echocardiogram, also called an echo or diagnostic cardiac ultrasound, is a safe, noninvasive test that uses high frequency sound waves to create pictures of your heart and transmit them onto a video monitor. An echo records moving images of the heart’s chambers and the blood flowing through them, valves, walls, and blood vessels.¹

Doctors may use an echo to determine the cause of cardiac symptoms like chest pain² or heart murmur,³ to check for problems in the outer lining of the heart (pericardium) or blood vessels, or to identify blood clots or holes in the heart chambers.⁴

An echo shows the heart’s structure and function, including:

• Heart size and shape
• Heart wall size, thickness, and movement
• Blood flow within the heart
• Heart beats & pumping strength
• Valve function
• Regurgitation (blood leaking backwards through a valve)
• Stenosis (narrowing of valves)
• Presence of tumors or infections⁵
• Heart rhythm problems or atrial fibrillation

• Transthoracic echocardiography: a standard echo, performed by passing a transducer across your chest.
• Transesophageal echocardiography: an echo performed by passing a transducer through a flexible tube directed into the esophagus. This type of echo may be recommended if you need more detailed pictures than a standard echo can provide.
• Doppler echocardiography: Doppler ultrasound techniques can be used as part of either transthoracic or transesophageal echo, or can be used to monitor the blood flow and pressure in the arteries. The sound waves bouncing off of blood cells change pitch as they move, and these changes, called Doppler signals, determine the blood’s speed and direction. Color doppler uses colorized images on the monitor to track blood flow.⁶

Typically, you will have no special preparation for an echo. Your doctor may ask you not to eat for a few hours before a transesophageal echo, and afterwards, you may need to arrange a ride home if you are given a sedative.

During a transthoracic (standard) echo:

• You’ll be asked to undress from the waist up so the technician can attach sticky disks called electrodes to your chest.
• These will monitor your heart beat during the echo.⁷
• The technician, called a sonographer, will apply a gel to the transducer, which helps transmit the sound waves.
• The sonographer will pass the transducer across your chest and moving images of your heart will be transmitted to the video monitor.
• You may need to have an IV enhancing agent administered if your lungs or ribs interfere with the view.⁸

During a transesophageal echo:

• Your throat will be numbed and you will typically be given a sedative to help you relax.
• The transducer, inside a thin, flexible tube, will be guided through your throat into your esophagus to record images of your heart.

An echo typically lasts less than an hour, and most people can resume regular routines after the test. Your doctor may keep you for observation after an transesophageal echo.⁹

Insurance coverage for echocardiography depends on your insurance company and often depends on the purpose of the test. For example, some medical insurance will cover an echo to diagnose symptoms, but not as a routine screening test.¹⁰ If you have a high deductible health plan, you will be responsible for your medical bills before your deductible is met. If you have to pay out of pocket, the price range of an echo in the MDsave network is updated in real time at the top of this page.

1,4,5,7 American Heart Association. “Echocardiogram (Echo).” https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/echocardiogram-echo
2,6,8,9 Mayo Clinic. “Echocardiogram.” https://www.mayoclinic.org/tests-procedures/echocardiogram/about/pac-20393856
3 National Heart, Lung, and Blood Institute. “Heart Murmur.” https://www.nhlbi.nih.gov/health-topics/heart-murmur
10 Costhelper Health. “Echocardiogram cost.” https://health.costhelper.com/echocardiograms.html