Echocardiogram – Part 1: Why do I have to have an echocardiogram?

Written by: Dr Allan Harkness
Edited by: Cal Murphy

The heart is one of the strongest muscles in the body, never tiring as it beats over 3 billion times during our lives to pump blood around the body. However, as with all parts of your body, things can go wrong. When this happens, one test that can help your doctor identify the problem is an echocardiogram. Dr Allan Harkness is a leading cardiologist who sits on the education committee of the British Society of Echocardiography. In the first of this series of articles, he explains why echocardiograms are done.

Why have an echocardiogram?

The commonest reason to have an echocardiogram, or echo, is to check that your heart is functioning normally.

Symptoms that suggest your heart may not be working well include:

Signs your doctor may notice are:

  • Crackles when listening to your chest
  • A murmur when listening to your heart
  • An abnormal rhythm to your pulse
  • Your neck veins appear distended

It is possible to have a heart that is not working normally and yet still feel completely well. Looking for heart disease before you have symptoms is a form of health screening. If a close member of your family has a heart condition that could be inherited, you may be advised to have your heart tested with an echocardiogram.


What are they looking for in an echocardiogram?

Your heart is a muscular pump with four main chambers and four valves. The pipes filling the heart with blood are the veins and the pipes carrying blood away from the heart are the arteries.

An echocardiogram will look at the size, shape and function of all the pipes, chambers and valves in your heart.

The ultrasound waves pass through your chest and reflect off the muscle, blood and fat inside. The reflections are picked up by the echo probe and turned into pictures. Most of the time, the image created is a black and white, fan-shaped 2D picture.

The latest machines can also take a 3D picture, which is very useful for looking at damaged heart valves.

The sonographer can also add a bit of colour. The colour shows which way the blood is flowing. A heart valve that functions normally should just let blood flow in one direction. If it is leaky, the coloured picture will show blood leaking back the wrong way.


Learn more about the procedure in part 2 and discover the different types of heart scans in part 3.

By Dr Allan Harkness

Dr Allan Harkness is a highly acclaimed consultant cardiologist, based in Essex and Suffolk, with a special interest in CT coronary angiography and advanced echocardiography. Dr Harkness works privately at the Oaks Hospital, Colchester and the Nash Basildon Private Unit at The Essex Cardiothoracic Centre.

After graduating from the University of Glasgow in 1994, Dr Harkness went on to complete further specialist training in London and Glasgow, gaining accreditation in both general medicine and cardiology. During his research into heart failure, he worked with the British Heart Foundation on a nurse-led community heart failure service which became the NICE-approved standard of care nationwide.  

Dr Harkness has been a consultant cardiologist at Colchester Hospital since 2006 and at the Essex Cardiothoracic Centre since it opened in 2007. In 2010, he became the clinical lead for cardiology at Colchester Hospital, where he has extensively developed their cardiac services. Thereafter, he was appointed as Divisional Director for Medicine and Emergency Care for Colchester Hospital in 2017. He continued this role after the merger of Ipswich and Colchester Hospitals in the new East Suffolk and North Essex NHS Foundation Trust.  

Dr Harkness is a core member of the Education Committee of the British Society of Echocardiography and lectures for national training programs. He also developed the BSE android app EchoCalc, which is the number one app for cardiac physiologists worldwide. He is currently updating the UK national standards for echocardiography in heart failure and valve disease. For his contribution to education, research, leadership, volunteering and national reputation, he was awarded Fellow of the British Society of Echocardiography in October 2019.

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