A trained technician performs the test. A transducer (an instrument that transmits high-frequency sound waves) is placed on your ribs near the sternum and directed toward the heart. The transducer picks up the echoes of the waves and transmits them into an electrical impulse and relays it to an echocardiogram machine where the impulse is displayed and recorded.

If the echocardiogram is unclear due to a barrel chest, congestive obstructive pulmonary disease (COPD) or obesity, your health care provider may choose to perform a transesophageal echocardiogram, or TEE. (With TEE, the back of your throat is anesthetized and a scope is inserted down your throat -- you are requested to swallow it. On the end of the scope is an ultrasonic device that an experienced technician will help introduce down to the inferior part of the esophagus, where it is used to obtain a more clear two dimensional echocardiogram of your heart).

Conductive gel is placed on your chest. The transducer is placed directly on your chest. There may be pressure on your chest from the transducer. You may be asked to breathe in a certain way or to inhale a medication to dilate the blood vessels. You must remain still during the test.

Additional echocardiographic techniques include color Doppler (used to measure flow and pressures), and MCE (myocardial contrast echocardiography), in which a special contrast liquid is injected into a vein to visualize the myocardial blood supply.

Abnormal results may indicate heart valve disease, cardiomyopathy, pericardial effusion, or other cardiac abnormalities.

Additional conditions under which the test may be performed:

• acute MI
• alcoholic cardiomyopathy
• aortic dissection
• aortic insufficiency
• aortic stenosis
• arrhythmias
• arterial embolism
• atrial fibrillation/flutter
• atrial myxoma; left
• atrial myxoma; right
• atrial septal defect
• cardiac tamponade
• cardiogenic shock
• coarctation of the aorta
• ectopic heartbeat
• heart failure
• hypertensive heart disease
• hypertrophic cardiomyopathy
• idiopathic cardiomyopathy
• infective endocarditis
• ischemic cardiomyopathy
• left-sided heart failure
• mitral regurgitation; acute
• mitral regurgitation; chronic
• mitral stenosis
• mitral valve prolapse
• patent ductus arteriosus
• pericarditis; bacterial
• pericarditis; constrictive
• pericarditis; post-MI
• peripartum cardiomyopathy
• primary amyloidosis
• primary pulmonary hypertension
• pulmonary valve stenosis
• restrictive cardiomyopathy
• right-sided heart failure
• secondary systemic amyloidosis
• senile cardiac amyloidosis
• stroke
• tetralogy of Fallot
• transient ischemic attack (TIA)
• transposition of the great vessels
• tricuspid regurgitation
• ventricular septal defect