Echocardiography is a complete ultrasonic examination of the heart. It involves imaging the heart in two dimensions to get the sizes of the ventricular cavity and the left ventricular wall. Motion of the walls and thus the function of heart can be clearly appreciated. The opening and closing of the valves can be seen and any abnormality detected. Blood flow direction across the valves can be evaluated using doppler color flow imaging. The intensity of any obstruction to the blood flow across a stenosed valve can be calculated and the area of the valve determined using doppler echocardiography. Similarly, color flow imaging can help quantify the amount of blood leaking through an abnormal valve. Certain morphologic abnormalities like dysplasia and asymmetric hypertrophy (enlargement) of the heart can be easily documented.

The most common reason for an echo examination is referral from a physician for evaluation of an abnormal murmur detected on physical examination. A history of syncope or near syncope in an athletic individual especially in conjunction with an outflow murmur, prompts an examination to look for Idiopathic Hypertrophic Cardiomyopathy. Referral may also be made for known family history of Hypertrophic Cardiomyopathy or history of sudden death in the family. Detecting Marfans habitus with a murmur may prompt a physician to study the aortic valve or aorta clearly. Severe fatigue with inability to work in the setting of a previous viral illness in conjunction with signs of heart failure may signify a cardiomyopathy with diminished contractility of the heart. This can be clearly seen on an echocardiogram.

Although the echocardiogram is an excellent test to see the morphology of the heart and to distinguish common causes of sudden death in athletes, it is not indicated as a screening test.