An echocardiogram, often called an “echo,” is a widely used, non-invasive diagnostic tool that employs high-frequency sound waves to create moving images of the heart. This procedure allows healthcare providers to assess the heart’s structure, measure its size, and evaluate its pumping function in real-time. The test is routinely ordered to diagnose and monitor various conditions, including heart valve problems, muscle disease, and congenital defects.
Required Clothing and Preparation
The direct answer to the question is yes, you must remove your bra for a standard transthoracic echocardiogram. To ensure the technician obtains clear, unobstructed images of the heart, patients are required to undress from the waist up and change into a gown that opens in the front. This requirement applies to all types of chest coverings, including sports bras and underwire bras, because any fabric barrier prevents the necessary direct skin contact.
Physical interference from clothing, especially seams, metal underwires, or thick bands, can block the transmission of the sound waves and distort the resulting image. The procedure also requires the placement of small, sticky EKG electrodes onto the chest and shoulders to monitor the heart’s electrical activity. These electrodes must adhere directly to the skin, making the removal of upper-body clothing necessary for a successful setup.
The ultrasound probe, or transducer, must be placed firmly against the skin in specific locations to capture the heart from various angles. These locations include the front of the chest, near the sternum, and underneath the left breast, which is often difficult to access without removing the bra. Patients should also remove any necklaces or chains that might hang over the chest area, as metal can interfere with the image quality. Avoiding the application of body lotions, creams, or powders to the chest is also required, as these can affect the adhesion of the EKG electrodes and the quality of the ultrasound images.
How the Echocardiogram Scan is Performed
The procedure begins with the attachment of small, sticky electrodes to the chest and shoulders, which connect to an electrocardiograph (EKG) monitor. This monitoring allows the sonographer to track the heart’s electrical rhythm and rate simultaneously while capturing the ultrasound images. The sonographer then applies a water-based, colorless gel directly to the skin of the chest. This gel is fundamental to the process, as it eliminates air pockets and ensures optimal transmission of the high-frequency sound waves from the transducer into the body.
The patient is typically positioned on an examination table, often asked to lie on their left side with their left arm extended above their head. This specific position is requested because it shifts the heart slightly closer to the chest wall, helping to improve image quality by reducing the amount of lung tissue the sound waves must pass through.
The sonographer then moves the handheld transducer across various points on the chest to acquire a full picture of the cardiac structure. They utilize several acoustic “windows” to examine specific areas like the heart chambers, walls, and valves. During the scan, the sonographer will apply a slight, steady pressure with the probe and may ask you to take a deep breath or hold your breath momentarily.
These actions are deliberate maneuvers to improve the clarity of the images by shifting the heart’s position or moving the lungs and ribs out of the path of the sound waves. The echoes returning from the heart tissue are processed by a computer to create the detailed, real-time video of the heart beating on the monitor. The procedure often includes Doppler technology, which specifically measures the speed and direction of blood flow to help detect issues like leaking valves or abnormal flow patterns.
Maintaining Patient Privacy and Comfort
While the procedure requires undressing from the waist up, medical staff prioritize patient comfort and dignity throughout the scan. Upon changing, you will be provided with a gown or a sheet, which is used strategically to drape the chest area. The technician will only uncover the small section of the chest needed to place the transducer at any given moment, ensuring the rest of the upper body remains covered.
If chest exposure causes anxiety, you have the option to request a chaperone to be present in the room during the test. Many facilities will also accommodate a request for a technician of a specific gender, provided staffing schedules allow for the change. Communicating any anxieties to the staff beforehand is encouraged, as they work to make the 30 to 60-minute procedure comfortable and reassuring as possible.