Cardiac Ultrasound (Echocardiography)

Cardiac ultrasound (echocardiography) is a noninvasive test that uses sound waves to visualize the heart and surrounding structures.

The ultrasound probe sends sound waves, which the patient does not hear or feel, through the body. When the sound waves bounce off internal structures, the technology interprets the "echos" of the returning waves and reconstructs a moving picture (echocardiogram) of the patient’s heart in real time. It is a valuable, noninvasive way to evaluate the size and function of the heart chambers, observe the flow of blood through the heart, and check the function of heart valves.

Brigham and Women’s Hospital (BWH) Heart & Vascular Center offers one of the few multidisciplinary cardiovascular imaging programs in the country that includes cardiologists, radiologists, and other imaging experts. The BWH Cardiovascular Imaging Program combines the treatment, education, and research expertise of multiple disciplines – cardiology, radiology, nuclear medicine, molecular biology, medical physics, and chemistry – and incorporates the use of all available imaging types, including echocardiography, cardiac CT, cardiac MRI, nuclear cardiology, PET/CT, CT/MRI, and ultrasound.

Our patients with heart and vascular conditions have access to top specialists throughout the fields of cardiovascular medicine, cardiac surgery, cardiac imaging, vascular surgery, and cardiac anesthesia. These physicians practice at the BWH Heart & Vascular Center, consistently ranked as a top Heart and Vascular program by U.S. News and World Report.

Cardiac Ultrasound (Echocardiography) Topics

Why Have Cardiac Ultrasound?

Cardiac ultrasound may be used to evaluate signs and symptoms of a number of conditions, including: atherosclerosis, cardiomyopathy, congenital heart disease, congestive heart failure, aneurysm, valvular heart disease, cardiac tumor, and pericarditis.

Cardiac Ultrasound Procedures

Your physician may prescribe one or more variations of echocardiogram, depending on the clinical question and scenario, including:

Full transthoracic echocardiograms

This standard echocardiogram is performed for general cardiac diagnosis. Measurements, moving images, and the flow of blood through each valve of the heart are systematically examined.

A limited transthoracic echocardiogram, however, is used to diagnose a specific cardiac condition. It might be performed to evaluate heart size and function, valve function, response to medications, or infections and blood clots.

Transesophageal echocardiography (TEE)

This exam uses a miniaturized ultrasound probe, inserted into the esophagus via the mouth, to obtain high-definition images of the heart from a posterior view. This technique helps to visualize specific cardiac structures and valves at higher resolution than transthoracic images. A registered nurse and/or anesthesiologist will ensure that you are comfortable by using topical anesthesia to numb the throat and possibly add mild sedation with intravenous medication.

TEEs also are used to detect clots in the atria of the heart and to evaluate and/or guide percutaneous (minimally invasive) heart procedures.

Stress echocardiography

An echocardiogram may be performed simultaneously with treadmill or stationary bike stress testing, or with a medication (dobutamine) that simulates exercise for the heart.

Other echocardiography techniques

As appropriate, additional techniques may be used during an echocardiogram, including:

  • Saline contrast study (or "bubble study") - This tests for the diversion of blood within the heart or lungs.
  • Echo contrast study – This provides a better view of the endocardium (inner lining) of the heart.
  • Tissue Doppler techniques to examine the pattern of heart muscle contraction and relaxation.
  • Assessment to optimize settings on pacemakers and defibrillators (AICDs) to increase cardiac output and reduce valvular regurgitation.
  • Assessment to evaluate and optimize settings on ventricular assist devices (VADs) and defibrillators (AICDs).
What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of cardiovascular services in one location, fostering seamless and coordinated care for all patients.

Prior to your imaging procedure, you will check in at the Watkins Cardiovascular Clinic in the Shapiro Cardiovascular Center. During your procedure, family and friends can wait in the Shapiro Family Center.

Multidisciplinary Care

In addition to our cardiovascular imaging experts, patients also benefit from the teamwork of cardiologists, interventional cardiologists, cardiac surgeons, cardiac electrophysiologists, and anesthesiologists, all experts in cardiovascular disorders. These specialists work alongside nurses, physician assistants, physical therapists, dietitians, and social workers to achieve better outcomes for patients.


Learn about the Watkins Cardiovascular Clinic in the Shapiro Cardiovascular Center.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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