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Symptoms That Require an Echo

Q: Will an echo show blocked arteries?

Not directly. Echo shows structure and function. Coronary artery assessment is usually a different pathway (often ECG/bloods ± CT or stress testing depending on scenario).

Q: Is an echocardiogram painful?

A standard transthoracic echo is non-invasive and usually feels like gentle pressure from the probe. The gel can feel cool at first.

Q: How fast do I get results?

You receive a written report with guidance on next steps. If something needs urgent clinical attention, you’ll be advised clearly and promptly.

Q: I’m not sure if echo is the right test. What should I do?

Describe your main symptom, when it happens, and what you’re worried about. That usually reveals whether the first test should be echo, ECG/rhythm monitoring, CT, or a vascular Doppler scan.

If you’re dealing with breathlessness, palpitations, dizziness, a new murmur, or you just feel “something isn’t right” — you want a test that answers the right question. This guide shows which symptoms echocardiography is designed to investigate, what it can and can’t clarify, and the safest next step if your symptoms are urgent.

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Typical scan: 30–45 minutes

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If you have severe chest pain, severe breathlessness at rest, collapse, or you feel acutely unwell, seek urgent medical care first. A private scan is for clarity and next-step guidance — not emergency treatment.

Red flags: when you should seek urgent care first

This page is here to reduce uncertainty — not to push you into the wrong pathway. If any of the situations below fit, treat it as a safety-first moment and seek urgent medical care.

Urgent symptoms (don’t wait for a private scan)

Chest pain that is severe, persistent, or associated with sweating, nausea, or collapse.
Severe breathlessness at rest or breathlessness that is rapidly worsening.
Fainting (syncope) or near-fainting with injury risk, especially during exertion.
Stroke symptoms (face droop, arm weakness, speech difficulty) — treat as an emergency.

Why this matters

A transthoracic echo (TTE) is excellent for structure and function. But if your symptoms suggest an acute event, the priority is immediate clinical assessment and the right time-critical tests.

Echo safety and risks (plain English) Limitations of echocardiography (what it can’t show)

Symptom matrix: when an echo is usually the right test

Think of an echo as a “moving heart assessment”. If the question is about pumping, valves, heart size or fluid around the heart, an echo is often a strong first imaging step.

Symptom / trigger	Typical pathway	Why echo helps	Practical next step
New or worsening breathlessness (especially on exertion)	Book soon	Assesses pumping function, valve disease, chamber size, and pericardial fluid.	Echo + clinical review. If breathlessness is severe at rest or rapidly worsening: urgent care first.
Palpitations with dizziness or reduced exercise tolerance	Book soon	Checks structural contributors (valves, cardiomyopathy patterns) and baseline function.	Often best combined with ECG/rhythm monitoring. Echo vs ECG.
Heart murmur found on examination	Book soon	Directly evaluates valve opening/closing, narrowing, and leakage with Doppler.	Echo is commonly the next step. See conditions diagnosed by echo.
Swollen ankles/legs with a cardiac query	Depends	Can support heart-failure assessment when combined with symptoms and history.	If swelling is one-sided with pain/redness: you may need a clot pathway. Consider vascular assessment.
Chest symptoms (non-acute) or reduced exercise capacity	Depends	Echo can show consequences (function, valves), but doesn’t directly image coronary arteries.	If coronary disease is the main concern, CT/other pathways may be used. Echo vs CT.
Known heart condition needing monitoring (as advised)	Book soon	Tracks function, chamber size, valve severity trends, and response to treatment.	Echo at the interval recommended by your clinician. Keep copies of prior reports for comparison.
Severe chest pain, collapse, severe breathlessness at rest	Urgent care	Echo may be used in hospital assessment — but the priority is emergency evaluation.	Seek urgent medical care immediately.

Heart conditions diagnosed by echo Normal ejection fraction explained

Breathlessness: when an echo adds clarity

Breathlessness is one of the most common reasons people book an echo — and one of the easiest symptoms to misinterpret. Echo is useful when the question is: “Could this be related to heart function or valves?”

Echo is particularly relevant when breathlessness is:

New or worsening on exertion (stairs feel harder than they used to).
Associated with reduced exercise tolerance, fatigue, or swelling.
Linked with a murmur or a known valve issue.

Helpful mental model

Echo doesn’t diagnose every cause of breathlessness. It answers the heart-specific part of the question: how well your heart pumps, how the valves behave, and whether there’s fluid around the heart.

Clinician discussing echocardiogram findings with a patient in a calm private clinic

Palpitations and dizziness: echo vs ECG (and why you may need both)

Palpitations are usually an electrical rhythm question first — that’s where ECG and rhythm monitoring shine. Echo becomes important when we need to check whether there’s a structural reason the rhythm is misbehaving.

Echo is often added when palpitations come with:

Dizziness, near-fainting, or reduced exercise tolerance.
Breathlessness or chest symptoms (not acute).
A family/personal history of cardiomyopathy or valve disease.

Echo vs ECG: which one answers your question?

The most common mistake

People book an echo expecting it to “catch” a rhythm problem. Echo is a snapshot of structure and function. Rhythm capture is an ECG/monitoring job. If the symptom is episodic palpitations, consider pairing the pathways.

What an ultrasound echo actually measures

A heart murmur: the classic “echo symptom”

A murmur is a sound — echo is how we figure out what’s behind it. In practical terms, echo checks whether a valve is narrowing, leaking, or simply creating harmless flow noise.

What the echo looks for

Valve opening and closing (motion and structure).
Doppler flow patterns to assess narrowing or leakage.
Heart chamber size and pump function (impact, not just diagnosis).

Heart conditions diagnosed by echo (valves, EF, cardiomyopathy)

Clinician performing a transthoracic echocardiogram with an ultrasound machine and Doppler image visible

Swelling in ankles/legs: when echo is helpful — and when it isn’t the first step

Swelling can be cardiac, vascular, kidney-related, medication-related, or due to prolonged sitting/standing. Echo contributes when the clinical question is heart function and valve status — but it’s not the best test for every swelling scenario.

Echo is more relevant if swelling comes with:

Breathlessness, fatigue, or reduced exercise tolerance.
A known cardiac history (valve disease, cardiomyopathy, prior heart failure).

One-sided swollen leg?

One-sided swelling with pain, redness, or warmth can be a clot pathway. That usually needs urgent clinical assessment and/or a DVT ultrasound route. If you’re unsure, call and describe your symptoms so you’re directed correctly.

Explore vascular scans (circulation-focused)

Calm private clinic environment designed to reduce patient anxiety

Chest symptoms: echo can help — but it’s not the coronary artery test

People often book an echo hoping it will rule out “blockages”. Echo is a function/structure test. If your main worry is coronary artery disease, clinicians may use ECG, blood tests, CT coronary angiography or stress pathways depending on your symptom pattern and risk profile.

Use the “best question” approach

If the question is “is my heart pumping normally?” or “is a valve the issue?”, echo is a strong option. If the question is “are my coronary arteries narrowed?”, echo is not the direct test.

Echo vs CT: anatomy vs function (and why it matters)

Echo is still useful for chest symptoms when you need to check:

Valve disease (murmur, known valve issue, unexplained breathlessness).
Pump function (especially if exercise tolerance has changed).
Pericardial fluid (certain clinical scenarios).

What happens after you decide to book?

This is the moment most people want: a simple, respectful process with a clear output. Here’s what the appointment typically looks like, and how the report is used.

Typical appointment flow

Arrive and clarify the question We confirm your symptoms, relevant history, and what you want the test to answer (so the scan stays focused).

Transthoracic echocardiogram (TTE) You’ll undress to the waist. Gel is applied and the probe is placed on the chest to capture standard views and Doppler flows.

Report + next-step guidance You receive a written report designed to share with your GP or specialist, with clear “what this means” guidance.

If you’re using insurance, check whether you need authorisation before booking. Prefer to talk it through first? Call 020 3633 4902.

Context matters (and it reduces anxiety)

An echo rarely “stands alone”. It sits inside a pathway: symptoms → the right test → the right next step. If your symptom is mainly electrical (palpitations), you’ll often need ECG/rhythm capture. If it’s mainly coronary concern, CT/stress pathways may be needed.

Echo vs ECG Limitations of echocardiography

FAQs (the questions people ask right before booking)

Short answers, no fluff.

Do I need a GP referral for an echo?

Many patients self-refer for private scans. If you’re using insurance, your insurer may require a referral letter or authorisation code — check your policy.

Will an echo show blocked arteries?

Not directly. Echo shows structure and function. It can sometimes show the consequences of coronary disease (for example motion changes), but coronary artery assessment is usually a different pathway (often ECG/bloods ± CT or stress testing depending on scenario).

Is an echocardiogram painful?

A standard transthoracic echo is non-invasive. Most people feel only gentle pressure from the probe. The gel can feel cool at first.

How fast do I get results?

You receive a written report with clear guidance on what to do next. If something needs urgent clinical attention, you’ll be advised clearly and promptly.

I’m not sure if echo is the right test. What should I do?

Describe your main symptom (what it feels like, when it happens, and what you’re worried about). That usually reveals whether the first test should be echo, ECG/rhythm monitoring, CT, or a vascular Doppler scan. If you’d like to read before you call: What is an ultrasound echo?

Ready for clear answers? Book a private echocardiogram (ultrasound echo) at Sonoworld, Marylebone (W1G). You can self-refer, and insurance routes are available. You’ll receive a structured report designed to share with your GP or specialist.

Book echocardiogram About the echocardiogram service Explore cardiovascular scans

Prefer to talk first? Call 020 3633 4902. Clinic address: 29 Weymouth Street, Marylebone, London W1G 7DB.

Sonoworld clinic environment in Marylebone, London