2D Echo (Echocardiography)
A focused scan for Heart chambers, Valves, Pumping (EF) and more.
Overview
Examines Heart chambers, Valves, Pumping (EF), Blood flow. Performed at an NABL-accredited Meridian Health centre with a same-day report and a free doctor review.
The full panel
4 areas across 1 groupEvery parameter, grouped by body system — no clicking to expand.
What this scan measures
An ultrasound of the heart in motion. It shows the four chambers and their sizes, the thickness of the heart muscle, all four valves opening and closing, the pericardium around the heart, and — through Doppler — the speed and direction of blood flow. The headline number is the ejection fraction (EF), the proportion of blood the left ventricle pushes out with each beat.
2D echo is the standard test for breathlessness, murmurs, palpitations, suspected heart failure and valve disease. It is also done before chemotherapy that can affect the heart, before major surgery in some patients, and to follow up known valve or muscle disease.
Symptoms that lead to this scan
- Breathlessness on exertion or when lying flat
- Swelling of the ankles or unexplained weight gain
- A murmur heard on examination
- Palpitations, chest discomfort or fainting
- Monitoring during cardiotoxic chemotherapy
Understanding your results
An ejection fraction in the region of 55–70% is generally described as normal; a reduced EF describes impaired pumping, which is a finding with many possible causes — previous heart attack, long-standing hypertension, a viral cardiomyopathy, valve disease — and is not itself a diagnosis. Trivial or mild regurgitation across the mitral, tricuspid or pulmonary valves is found in many normal hearts and is usually of no consequence. Diastolic dysfunction describes a stiff ventricle that fills poorly and is common with age and hypertension. The echo describes structure and function; the cause comes from the clinical picture, the ECG and sometimes further imaging.
Indicative only. Reference ranges vary between laboratories and between testing methods, and shift with age, sex and pregnancy — always read your own result against the range printed on your own report, with the doctor who ordered it.
| Parameter | Indicative range | Unit |
|---|---|---|
| Left ventricular ejection fraction | 55–70 (generally described as normal) | % |
| Left ventricular wall thickness | Up to about 1.1 | cm |
Why the preparation matters
No preparation, no fasting, no medication changes. You will be asked to undress to the waist (a gown is provided), lie on your left side, and follow breathing instructions — the heart sits behind the ribs and sternum, and turning onto the left side brings it forward into the small acoustic windows between the ribs. Breath-holds in expiration are used because inflated lungs block ultrasound completely.
Cardiac — safety and who should not be scanned
Full Cardiac guideNone of these tests uses ionising radiation — there is no X-ray dose at all in an ECG, an echocardiogram, a Holter or a treadmill test, and they can be repeated as often as clinically useful. The risk lies somewhere else entirely, and it belongs specifically to the stress tests: pushing the heart hard is how the test works, and in a small number of people that provokes chest pain, a significant rhythm disturbance or a fall in blood pressure. That is exactly why a stress test is performed in a room with a doctor present, continuous monitoring and a defibrillator to hand, why it is stopped the moment a stopping rule is met, and why it is not done at all when the heart is known to be unstable. A resting ECG or echocardiogram carries no such risk.
- Unstable chest pain, or a recent heart attack
- Chest pain that is new, worsening or happening at rest, and a heart attack within the last few days, are reasons not to perform a stress test — the test asks the heart to do the very thing that is already failing. Resting tests are safe and are usually what is done instead. Stress testing after an infarct happens later, on a defined protocol, once the picture is stable. The same applies to acute inflammation of the heart muscle or its lining, and to any acutely unwell patient.
- Uncontrolled arrhythmia, or severe aortic stenosis
- A rhythm disturbance that is not controlled, and a severely narrowed aortic valve causing symptoms, both make exercise testing hazardous, because exercise is what tips each of them over. An echocardiogram is done first in anyone with a known or suspected valve problem, precisely so this is known before a treadmill is considered.
- Blood pressure that is very high on the day
- Exercise raises blood pressure further, so it is measured before the test starts and a treadmill test is deferred when the reading is well above target — departments commonly use a threshold in the region of 200 systolic or 110 diastolic. This is a postponement, not a cancellation: the test is rebooked once the pressure is controlled.
- Being unable to walk on a treadmill
- Arthritis, a previous stroke, peripheral arterial disease, severe breathlessness at rest or any mobility limitation makes a treadmill test either unsafe or uninterpretable, because the heart never reaches the workload the test depends on. There is a well-established alternative — a pharmacological stress test, where a drug is given into a vein to make the heart behave as if it were exercising. Say what you can and cannot manage when you book, so the right test is arranged first time.
- Asthma or wheezy lung disease, if a vasodilator drug is planned
- Adenosine and dipyridamole, the drugs used for vasodilator stress testing, can trigger severe bronchospasm in people with asthma or other bronchospastic lung disease, and they are avoided in that situation. Dobutamine, which works differently, is generally used instead. Tell the team about any wheeze, inhaler use or lung disease before the test is booked, not on arrival.
- Caffeine and certain medicines before a pharmacological stress test
- Caffeine directly blocks the drugs used for vasodilator stress, so a scan can be wasted by a single cup of coffee. Avoid coffee, tea, cola, energy drinks, chocolate and decaffeinated coffee for 12 to 24 hours beforehand as instructed, and mention any theophylline-based tablet or inhaler. Which of your regular heart medicines to take or hold on the morning of a stress test — beta blockers especially, since they blunt the heart-rate response and can make the test uninterpretable — is decided by the doctor who requested it, never on your own.
- Practicalities for a 24-hour Holter
- The recorder and its electrodes must stay dry, so you cannot shower or bathe while wearing it. Tell the team about any adhesive or skin allergy, and keep the symptom diary honestly and by the clock — the report's most valuable line is whether what you felt matched what the trace was doing at that minute.
Who should consider this scan
- Anyone with breathlessness, ankle swelling or a suspected murmur
- People with known valve disease under surveillance
- Patients with hypertension or diabetes and cardiac symptoms
- Anyone starting or on cardiotoxic chemotherapy
- People with a family history of cardiomyopathy
Conditions it helps detect
How it works
Patient stories
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