An echocardiogram, or echo, is a heart ultrasound. It uses sound waves to create an image of the heart. Doctors can use this image to diagnose heart failure, as well as assess whether heart failure has progressed.

Heart failure is when the heart cannot pump enough oxygen and blood to the body. It increases mortality risk and can affect a person’s quality of life. However, treatment can slow the progression of heart failure, and an echocardiogram can help diagnose the disease and identify treatment options.

An echocardiogram uses sound waves to create an image of the heart. This allows a doctor to see how effectively the heart pumps blood.

In heart failure, the heart may not be strong enough to pump out enough blood, reducing the ejection fraction. Or the heart muscle may contract as usual, but the heart’s ventricles do not relax, making it more difficult for the body to get enough blood. An echocardiogram allows a doctor to identify both scenarios.

This article explains how echocardiograms help detect heart failure. It also details what results can mean, overall signs of heart failure, treatment, and more.

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Heart failure means the body is not getting enough blood from the heart. This can occur for two reasons:

  • Reduced ejection fraction: This means that the heart pumps out 40% less of the blood inside of it. It happens when the heart muscle cannot effectively contract. This reduces the ability of the heart to pump blood to the body. Doctors also call this systolic heart failure.
  • Preserved ejection fraction: This means that the heart muscle contracts strongly enough, but the ventricles cannot fully relax. This slows the release of blood from the heart, reducing the rest of the body’s access to blood. Doctors call this diastolic heart failure.

An echocardiogram uses sound waves to create an image of the heart. The image is not an actual picture of the heart, but doctors can use it to better understand its anatomy and behavior.

This image can show the heart’s ejection fraction. It may also show damage to the heart, including the ventricles, that can reduce the ability to relax in a person with a standard ejection fraction.

Read more about heart failure.

An echocardiogram is usually the first test a doctor recommends to diagnose and monitor heart failure. It can detect ejection fraction, damage to the ventricles, and issues with the heart valves.

It can also identify other potential causes of heart disease symptoms. A doctor may recommend an echocardiogram if a person experiences the following:

As an echocardiogram creates an image of the heart, it allows doctors to see:

  • how blood travels through the heart
  • how quickly blood moves through the heart
  • how well the various chambers of the heart work

A doctor may recommend an echocardiogram if a person shows any signs of heart disease. Some signs of heart failure that may warrant testing include:

  • Shortness of breath: A person may have breathing issues when exerting themselves. As the disease worsens, they may have difficulty breathing when relaxing or lying down. They may wake up gasping for air.
  • Swelling: A person may have swelling, especially in the legs or ankles.
  • Fatigue: A person may have low energy. This can affect their ability to participate in daily activities.
  • Coughing: A person may have a chronic cough or a cough that worsens when lying down.
  • Chest congestion: A person may have feelings of congestion in their chest.

The standard treatment for heart failure usually involves taking medication such as:

A person may also need other treatments, such as diuretics, or aim to reduce their fluid intake. If the disease is severe enough, an individual could eventually need a heart transplant.

A doctor may recommend that a person also makes any necessary lifestyle changes, such as:

Read more about how to improve heart health.

Heart failure is a long-term condition that may shorten a person’s life. A 2019 study followed 55,959 people living in the United Kingdom who had recently been diagnosed with heart failure. A year after diagnosis, 80.8% were still living. At 5 years, the figure was 48.2% and 26.2% at 10 years.

A person’s survival depends on factors such as:

  • the severity of and cause of heart failure
  • access to treatment
  • lifestyle
  • overall health

Learn more about the survival rates of heart failure.

A heart-healthy lifestyle can help prevent heart failure and other forms of heart disease. This includes:

  • managing heart disease risk factors — for example, by treating any other condition such as diabetes
  • remaining physically active
  • minimizing alcohol consumption
  • quitting smoking
  • following a balanced diet low in sodium and trans fats
  • taking medications to treat chronic medical conditions such as high blood pressure

An echocardiogram can help determine what is causing symptoms of heart failure. It can diagnose how severe a person’s heart failure is, assess whether they have other types of heart disease, and may help with guiding treatment decisions.

The test is painless, safe, and noninvasive. People with any heart disease symptoms should talk with a doctor about scheduling testing.