An echocardiogram (echo) is a non-invasive medical procedure that uses high-frequency sound waves to create moving images of the heart’s chambers, valves, and blood flow. This common diagnostic tool provides physicians with detailed visual information about the heart’s structure and function. Since the test requires access to the chest area, many people have questions about preparation, particularly concerning clothing and undergarments.
The Direct Answer: Bra Removal and Adjustment
For the most common type of heart ultrasound, the transthoracic echocardiogram, you must remove clothing from the waist up, including your bra. Medical staff understand this can be a sensitive issue and will provide a hospital gown that opens in the front to ensure patient dignity. You will be covered by this gown or a sheet for the duration of the 30- to 60-minute procedure, except for the small area being scanned. While the bra must be removed for the standard scan, some facilities may allow a wireless or tube-style bra for specialized tests, such as a stress echocardiogram. The main interference comes from underwire, metal clasps, and the bulk of the fabric that prevents proper transducer placement. If you have concerns about privacy, you can often request a female sonographer or a chaperone to be present.
Why Chest Access is Essential During the Procedure
Direct skin contact is required due to the physics of how the ultrasound technology operates. The handheld device, known as a transducer, sends sound waves through the chest wall and into the heart tissue. These sound waves bounce back, or “echo,” off the heart structures, and the transducer receives them to generate moving images on a monitor.
To ensure the sound waves travel efficiently, a clear, water-based gel is applied to the skin, which eliminates air pockets between the transducer and the body. Any layers of clothing, including bra fabric, obstruct the path of these sound waves, causing “artifacts” or shadows that severely compromise image quality.
The sonographer must move the transducer to several specific locations on the chest, including directly under the left breast, to capture all necessary views of the heart valves and chambers. A significant portion of the test involves lying on your left side, a position that shifts the heart closer to the chest wall for clearer pictures. Optimal imaging angles and pressure adjustments are impossible to achieve effectively through clothing or a rigid undergarment.
Practical Clothing Guidance for Your Appointment
To make your appointment as smooth as possible, choose an outfit that minimizes the need to undress completely. A simple two-piece outfit is ideal, such as a loose-fitting top and comfortable trousers or a skirt, as you will only need to remove the top layer. Tops with buttons or zippers can slow down the process, so a simple T-shirt or short-sleeved shirt is preferred.
Leave necklaces, long chains, or any jewelry that rests on the neck or chest at home, as they must be removed to place small electrode patches on your skin. These electrodes monitor your heart’s electrical activity (ECG) during the scan and must adhere directly to the skin. Avoid applying body oils, lotions, or heavy moisturizers to your chest area on the day of the test, as these prevent the electrodes from sticking securely. If you are scheduled for a stress echocardiogram, which includes an exercise component, wear comfortable walking shoes or sneakers.