Do I Need an Echocardiogram? 7 Signs Your Heart Needs a Closer Look

Sometimes your heart whispers before it screams.
An echocardiogram (heart ultrasound) is one of the safest, clearest ways to “see” how your heart is really doing – its structure, its valves, and how strongly it’s pumping blood. It’s painless, uses sound waves (no radiation), and gives your doctor powerful information about your heart’s health.

This blog is NOT here to scare you.
It’s here to help you notice red flags early, so you can talk to your doctor and get checked if needed.

Let’s walk through 7 signs your heart might need a closer look.1. You’re Short of Breath Doing Things You Used to Handle Easily

If simple activities suddenly feel like climbing a mountain – walking up a single flight of stairs, carrying groceries, light housework – and you’re gasping or need to stop and rest, your heart might be struggling to pump efficiently.

This can happen when:

• The heart muscle is weak (heart failure or cardiomyopathy).

• A heart valve is too tight (stenosis) or too leaky (regurgitation), making the heart work much harder.

• Fluid builds up in the lungs because the heart isn’t pumping properly.

When to pay attention:

• You’re more breathless than your friends of similar age doing the same activity.

• The breathlessness is new or clearly getting worse over weeks to months.

• You need extra pillows at night because lying flat makes it harder to breathe.

These are all reasons to talk to your doctor. An echocardiogram is often one of the first tests they order to check your heart function and valves.

2. You Have Chest Discomfort That Doesn’t Feel “Normal” for You

Chest pain isn’t always a sharp stab. Sometimes it’s:

• Pressure, heaviness, or tightness

• A “band” squeezing the chest

• Discomfort that spreads to the neck, jaw, back, or arm

While an echocardiogram doesn’t directly show blocked arteries, it does reveal how well the heart muscle is moving and pumping. If part of the heart isn’t moving normally, it can be a sign of past or ongoing damage from poor blood flow.

Urgent red flags (call emergency services):

• Sudden, intense chest pain or pressure

• Pain with sweating, nausea, or feeling like you might faint

• Crushing pain that lasts more than a few minutes

For ongoing, milder, or confusing chest symptoms, your doctor might use an echocardiogram to see whether your heart muscle has been affected.

3. Your Heart Feels Like It’s Racing, Skipping, or Fluttering

Palpitations – that sensation that your heart is:

• Racing out of nowhere

• Beating very hard

• Skipping beats

• Fluttering in your chest

…can be harmless or a sign of an abnormal heart rhythm (arrhythmia).

An echocardiogram doesn’t record the rhythm the way an ECG or Holter monitor does, but it answers a crucial question:

“Is there something structurally wrong with the heart that could be causing or worsening the arrhythmia?”

For example:

• Enlarged heart chambers

• Heart valve disease

• Thickened heart muscle

• Weakened pumping function

If your palpitations come with dizziness, fainting, chest discomfort, or shortness of breath, that’s even more reason to get evaluated.

4. Your Ankles, Legs, or Belly Are Swollen – and It’s Not Just Heat or Standing

Mild swelling at the end of a long hot day can be normal. But when swelling becomes:

• Persistent

• Worse in the evenings

• Present in both legs and ankles

• Sometimes accompanied by weight gain or tight shoes/rings

…it can be a sign of fluid retention because the heart isn’t pumping properly.

When the heart is weak, blood can back up into the veins, leading to swelling in the legs and sometimes the abdomen. An echocardiogram helps your doctor see:

• How strong your heart is pumping (ejection fraction)

• Whether your valves are working properly

• Whether there’s high pressure in the lungs (pulmonary hypertension)

If you notice swelling along with breathlessness, fatigue, or chest discomfort, don’t ignore it.

5. You’ve Fainted or Felt Like You Were About to Black Out

Passing out (syncope) is a big red flag that should never be brushed off.

You might feel:

• Sudden lightheadedness

• Tunnel vision

• Nausea

• Sweating

• Then lose consciousness for a short time

Causes range from harmless (like standing up too fast) to serious heart issues such as:

• Obstructed blood flow (a tight aortic valve)

• Dangerous rhythm problems

• Weakened heart muscle

An echocardiogram helps rule in or out structural causes – especially valve disease or major abnormalities in the heart’s pumping chamber.

If you faint without a clear explanation, or during exertion (like climbing stairs or exercising), you need medical evaluation promptly.

6. You’ve Been Told You Have a Heart Murmur

A heart murmur is simply a sound of turbulent blood flow your doctor hears with a stethoscope. It can be:

• Innocent (harmless): Common in children, pregnancy, or very fit adults.

• Significant: Caused by a valve that’s narrowed, leaking, or both.

The only way to truly understand a murmur is to see what the valves are doing – and that’s exactly what an echocardiogram does.

It can:

• Show if a valve is too tight (stenosis)

• Show how much a valve is leaking (regurgitation)

• Measure how this affects the heart’s size and function

If your doctor mentions a new murmur, or a murmur that’s getting louder, they’ll often recommend an echocardiogram to get the full picture.

7. You Have Risk Factors – and Your Doctor Wants a Deeper Look

Sometimes you may not feel “sick,” but your risk profile makes your doctor want to check your heart more closely, especially if you have:

• Long-standing high blood pressure

• Diabetes

• History of rheumatic fever

• Autoimmune disease that can affect the heart

• A family history of heart failure or cardiomyopathy

• Known coronary artery disease (past heart attack, stents, or bypass)

High blood pressure, for example, can gradually thicken the heart muscle and stiffen it, making it harder for the heart to fill and pump efficiently. An echocardiogram can pick up these changes early, even before you have major symptoms.

It’s a bit like checking your car engine before it breaks down on the highway.

What Exactly Happens During an Echocardiogram?

Many people hear “heart test” and imagine wires, pain, or something scary. The reality is much gentler.

During a standard transthoracic echocardiogram:

• You lie on an exam table, usually on your left side.

• Gel is applied to your chest.

• A small handheld probe (transducer) is moved over your chest.

• Sound waves create live moving images of your heart on a screen.

No needles, no radiation, no incisions. You just lie there while the sonographer captures detailed views of your heart.

When Should You Absolutely See a Doctor Urgently?

Call emergency services or go to the ER if you have:

• Sudden chest pain or pressure, especially with shortness of breath, nausea, or sweating

• Sudden severe breathlessness

• Fainting, especially during activity

• Sudden weakness, difficulty speaking, or one-sided body changes (possible stroke)

An echocardiogram may be part of your evaluation, but don’t delay urgent care waiting for a scan.

The Bottom Line: Listen to Your Heart Early, Not Late

You don’t need an echocardiogram for every little twinge or random fast heartbeat. But you also shouldn’t ignore clear warning signs and hope they “go away.”

You’re more likely to need an echocardiogram if:

• Your symptoms are new, persistent, or getting worse.

• You have more than one concerning sign (e.g., breathlessness + swelling + fatigue).

• You already have heart risk factors or a known heart condition.

Your next best move is simple:
Talk to your doctor, describe your symptoms clearly, and ask whether an echocardiogram is appropriate for you.

Catching heart issues early can mean:

• Simpler treatment

• Better quality of life

• Lower risk of emergencies later

Your heart has been working non-stop since before you were born. Giving it a closer look when it’s sending signals isn’t overreacting – it’s smart, proactive care.

For those seeking expert ultrasound services, Atlanta Ultrasound offers quick, efficient, and comprehensive scans. Our team of skilled professionals is dedicated to providing you with the clarity and care you need.

Contact us today to schedule your ultrasound scan and take a decisive step towards understanding your health.

📍 Multiple locations in Metro Atlanta, GA

📞 Contact: 678-590-3300

🌐 Website:www.atlantaultrasound.com

Disclaimer: The content of this blog post, authored by a sonographer, is provided for educational and informational purposes only. It is not intended as medical advice, nor should it substitute for professional medical consultation, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition or health concerns.