An echocardiogram provides a comprehensive picture of how the heart looks and how it functions. Here is what a clinical report typically covers:

1. Heart Size and Structure

The echo measures the dimensions of each chamber, the left and right ventricles and atria. Abnormal enlargement (dilation) or thickening (hypertrophy) of the heart walls can indicate conditions such as hypertensive heart disease, cardiomyopathy, or long-standing valve disease.

2. Heart Valves

The heart has four valves. An echo assesses whether each one opens and closes correctly, identifying:

• Stenosis: Narrowing that restricts blood flow
• Regurgitation: A leaky valve that lets blood flow the wrong way
• Prolapse: Where a valve leaflet slips out of position; common, often harmless, but worth monitoring

3. Pumping Function (Ejection Fraction)

The ejection fraction is the percentage of blood the heart pumps out with each beat, a normal result is roughly 52% or above. Echo is also the key test for detecting heart failure, and crucially it can distinguish between two very different types: one where the heart muscle is weak and pumps poorly, and one where it contracts normally but has become stiff and doesn't fill properly between beats. The second type is actually more common in older patients and is just as clinically significant, but it's invisible on an ECG or blood test alone.

4. Wall Motion

The echo checks whether all parts of the heart wall are contracting normally. If a specific area is moving weakly or not at all, this often points to damage from a previous heart attack or reduced blood supply. If the whole wall is contracting poorly, it tends to suggest a different kind of heart muscle problem, such as cardiomyopathy or viral inflammation, rather than a blocked artery. The location and pattern help guide what further tests, if any, are needed.

5. The Pericardium

The pericardium is the protective sac surrounding the heart. Fluid can sometimes build up inside it, small amounts are common and usually harmless, but a large collection can press on the heart and prevent it filling properly, which is a medical emergency. The echo measures how much fluid is present and whether it needs to be drained.

6. The Aorta

The echo measures the aorta, the main artery leaving the heart. If it is wider than normal, this needs monitoring, as certain conditions can cause it to gradually widen over time and, in severe cases, increase the risk of a tear. Catching this early through a routine echo is one of the test's important preventive roles.

7. Congenital Abnormalities

The echo can identify structural heart defects present from birth, most commonly holes between the heart's chambers. A significant hole can cause blood to flow in the wrong direction, putting strain on the heart over time and raising the risk of stroke. Colour flow imaging can detect this even when symptoms are absent.