How to Prepare for an Echocardiogram: A Patient Guide

At IPMC in Northeast Philadelphia, we make the process easy and comfortable in our dedicated cardiology center.

What Is an Echocardiogram?

An echocardiogram (often called an “echo”) is an ultrasound of the heart. A transducer placed on your chest sends sound waves that bounce off your heart structures, and a computer converts the returning echoes into real-time moving images.

A standard transthoracic echocardiogram (TTE) evaluates heart chamber sizes (are the chambers dilated or thickened?), wall motion (is every segment of the heart muscle contracting normally?), ejection fraction (EF) (the percentage of blood pumped out with each heartbeat — normal is 55-70%), valve function (are valves opening and closing properly? Is there stenosis or regurgitation?), pericardium (is there fluid around the heart?), blood flow patterns (using Doppler to measure flow velocities and directions), and congenital abnormalities (structural defects present from birth).

How to Prepare for a Standard Echocardiogram

For a standard (resting) echocardiogram, preparation is minimal:

• Eat and drink normally — there are no fasting requirements for a standard echo
• Take your regular medications as prescribed, unless your doctor gives specific instructions otherwise
• Wear a comfortable, two-piece outfit — you’ll need to undress from the waist up and will be given a gown. A two-piece outfit makes this easier
• Leave jewelry at home or be prepared to remove necklaces that might interfere with the exam
• Bring your insurance card, photo ID, and a list of current medications
• Arrive a few minutes early to complete any paperwork

If you are scheduled for a stress echocardiogram (exercise stress echo), additional preparation is needed: avoid caffeine for 24 hours before the test, eat only a light meal 2-4 hours beforehand, wear comfortable walking shoes, and ask your doctor whether any heart medications should be held. If you’re having a transesophageal echocardiogram (TEE) — where a specialized probe is passed through your mouth into your esophagus for closer images — you’ll need to fast for at least 4-6 hours, and the preparation is more involved (your doctor will provide detailed instructions).

What Happens During a Standard Echocardiogram?

You’ll lie on your left side on an exam table (lying on your left side brings the heart closer to the chest wall and improves image quality). The sonographer applies gel to your chest and presses a transducer against various locations on your chest wall to capture images from different angles — called acoustic windows.

You may hear a “whooshing” sound — that’s the Doppler detecting blood flow through your heart. The sonographer may ask you to breathe in, breathe out, or hold your breath briefly to optimize certain views. The exam is completely painless (you may feel light pressure from the transducer).

A standard echocardiogram typically takes 30 to 60 minutes. There is no recovery time — you can resume all normal activities immediately.

After Your Echocardiogram

A cardiologist will review the images, make measurements, and prepare a comprehensive report. Results are sent to your referring doctor, who will explain the findings and discuss any recommended follow-up or treatment.