Echocardiogram: a powerful diagnostic tool for the heart

Written by: Dr Malcolm Burgess
Edited by: Emma McLeod

When your heart is undergoing stress and needs to be evaluated for cardiac conditions, you may be referred to have an echocardiogram. With this procedure, your cardiologist can get a visualisation of your heart in a safe and painless way. Read on to learn about the capabilities and types of echocardiograms, as well as what the results could mean for you, as explained by Dr Malcom Burgess, a leading UK cardiologist.

A doctor is using an echocardiogram on a patient. The machine's monitor shows images of the heart that are generated through ultrasound.

When and why are echocardiograms used?

An echocardiogram is an ultrasound technique used to gather a wealth of information about the structure and function of the heart. It is relevant to many types of heart disease and one of the most frequently performed tests for patients with known or suspected heart disease.


Common reasons to perform an echocardiogram would be if there is a heart murmur  detected after a physical examination or if a patient is suspected of having heart failure. Echocardiograms are also performed after a heart attack to assess the damage to the heart. Echocardiography is suited to performing follow-ups of patients with long-term cardiac conditions because it is very safe (no radiation exposure is involved), easily repeated and painless.


Are there types of echocardiogram? 

A transthoracic echocardiogram

This is the most commonly performed type of echocardiogram. It is non-invasive with the ultrasound probe being placed on the chest. Ultrasound gel is used to get good contact with the skin and to improve the image quality.


Transoesophageal echocardiogram

This is a more invasive technique reserved for selected patients. A specialised probe is passed through the mouth into the oesophagus and the ultrasound emerges from the tip. This technique is used when information from a transthoracic echocardiogram doesn’t provide enough information.


Stress echocardiogram

Sometimes, echocardiography while a patient is in a resting state only provides part of the information required. In these situations, echocardiography is performed under conditions of stress. This can be with physical exercise (using a bicycle) or using an intravenous drug to increase the patient’s heart rate. This type of test is commonly done if coronary artery disease is suspected, although coronary angiography can be provided as an alternative (using CT imaging or with an invasive catheter).


How reliable are the results?

Echocardiography provides direct visualisation of the heart on a monitor screen and it’s an accurate test. Measurements of the heart chamber sizes, wall thickness, heart function and blood flow across the valves can be made. However, the ability to make all these measurements does depend on the quality of the images and some patients are challenging to scan, meaning that sometimes limited information is available.


What is usually the next step after an echocardiogram?

Echocardiography often makes a diagnosis and depending on what is found, treatment might be required. For many patients, the test will identify a problem that does not require immediate treatment but will require follow-up scans over time to look for its progression. Occasionally, the echocardiogram might require more in-depth imaging with other techniques such as cardiac CT (computed tomography) scan or an MRI (magnetic resonance imaging) scan.


Dr Burgess is a leading cardiologist with a specialist interest in echocardiograms. Click here to see his profile and learn how he can help you improve your heart’s health.

By Dr Malcolm Burgess

Dr Malcolm Burgess is an experienced and accredited consultant cardiologist who provides a highly personalised service for patients with known or suspected heart disease. His range of expertise covers all aspects of diagnosing and managing common cardiological conditions, and this includes providing invasive and non-invasive treatments for his patients. His specialist interest is cardiac ultrasound (echocardiography) which is integral to the assessment of most types of heart disease. Dr Burgess sees patients with a wide range of presenting complaints including but not restricted to heart palpitations, valvular heart disease, angina and chest pain, high blood pressure (hypertension) and heart failure.

Dr Burgess completed his medical training at the Univerity of Dundee in 1993 and pursued his cardiology career from 1996 onwards. This training involved an MD thesis on echocardiography and a Post-doctoral Research Fellowship at the University of Queensland, Australia, where he undertook advanced training in echocardiographic techniques presenting his work at international meetings. Whilst serving as a consultant in the NHS since 2007 Dr Burgess has made a major contribution to echocardiography locally and further afield including the development of services for patients with specialist conditions.

Consultations for private patients are provided by Dr Burgess at the Sefton Suite Private Patient Unit located at Aintree Hospital (where he is also a consultant for the NHS) and in Crosby. He also sees private patients at the Pall Mall Medical Liverpool and Newton-le-Willows clinics.

When not treating patients Dr Burgess dedicates his time to other contributions in the field of cardiology. He is an Honorary Lecturer at the University of Liverpool. He participates in the development of junior doctors and future cardiologists by organising teaching programs and conducting examinations at a local and national level. Furthermore, he undertakes research into various topics within the field of cardiovascular disease, particularly echocardiography. This work has resulted in over 50 published articles in peer-reviewed journals.

View Profile

Overall assessment of their patients

  • Related procedures
  • Heart attack
    Hypertension (high blood pressure)
    Heart failure
    Injury valves
    Heart murmur
    Ambulatory electrocardiogram (Holter)
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