Echocardiography, also called cardiac sonography or cardio echo, deals with performing ultrasounds on the heart and structures surrounding the heart. Echocardiographers or echocardiography technicians operate intricate medical equipment that uses sound waves to produce real-time images of the heart. The two types of ultrasounds include echocardiograms (echos) which assess the heart’s chambers and valves and electrocardiograms (EKGs) which measure the rate and rhythm and overall electrical activity of the heart.
Echocardiographers perform these echo tests on patients that may have experienced heart murmur, heart attack, unexplained chest pain, congenital heart defect, or rheumatic fever. Cardiac sonographers can specialize in certain areas of echocardiography, including adult, pediatric, and fetal, and they can obtain certification within these particular specialties.
Types of Echocardiograms Performed
An echocardiogram is a type of ultrasound performed that uses high-pitched sound waves sent through a device called a transducer. The device picks up the echoes of the sound waves as they bounce off different areas of the heart and turns these waves into moving pictures of the heart. There are four different types of echocardiograms performed, including:
- Transthoracic Echocardiogram (TTE)
The most common type of echocardiogram, this painless and noninvasive procedure involves a transducer placed on the patients’ chest. The device sends sound waves or ultrasounds, through the chest wall to the heart. A computer converts the sound waves into pictures on a screen.
- Stress Echocardiogram
During a stress test, patients exercise or receive medicine injected to make their heart work hard and beat fast. The technician uses the echocardiogram to create pictures of the heart before the patients exercise and immediately thereafter for comparison.
- Transesophageal Echocardiogram (TEE)
This type of echocardiogram surveys the aorta and other parts of the heart by the use of a standard transthoracic echo. Attached to the end of a flexible tube, the transducer glides down the throat into the esophagus. This allows the doctor to receive detailed pictures of the heart.
- Doppler Echocardiogram
Doppler echocardiograms survey how blood flows through the heart valves, chambers, and blood vessels. The computer measures the direction and speed of the blood flowing, and the Doppler displays the measurements in either color or black and white.
Future echocardiographers have several schooling options including certificate, associate, and bachelor’s degree programs. The one-year certificate and associate degree choices in echocardiography are the most popular option and are available at vocational schools and community colleges throughout the country. In addition to classroom instruction, students may also need to complete a clinical externship where they can gain hands-on experience. Online bachelor’s degree programs are also available for current registered cardiac sonographers.
Echocardiography curriculum typically begins with basic introductory-level courses so that students may gain theory and technical skills and work their way into more program specific courses. Coursework usually starts with human anatomy and physiology, general chemistry, and medical terminology and then progress into more specific courses, such as clinical pharmacology, cardiovascular physiology, and sonographic principles and instrumentation. In addition to the in-class instruction, students may need to fulfill a certain number of clinical laboratory hours to show what they’ve learned. Possible courses include:
- Human Anatomy and Physiology
- Introduction to Medical Imaging
- Cardiovascular Physiology
- Sonographic Principles and Instrumentation
- Invasive Cardiology
- Cardiopulmonary Patient Management Practices
- Stress and Transesophageal Echo
- Pediatric Echocardiography
Although only some states require licensure or registration to work in echocardiography, many employers require certification. The American Registry for Diagnostic Medical Sonography (ARDMS) offers credentialing exams to become a Registered Diagnostic Cardiac Sonographer (RDCS). Within the RDCS credential, you may specialize in adult, pediatric, or fetal echocardiography. In order to sit for the ARDMS exams you must complete a diagnostic medical sonography program or general health degree and have clinical experience.
The Cardiovascular Credentialing International (CCI) organization offers certification in echocardiography. Under CCI you may earn the following credentials:
- Certified Cardiographic Technician (CCT)
- Certified Rhythm Analysis Technician (CRAT)
- Registered Cardiac Electrophysiology Specialist (RCES)
- Registered Congenital Cardiac Sonography (RCCS)
- Registered Vascular Specialist (RVCS)
- Registered Cardiac Sonographer (RCS)
- Registered Phlebology Sonographer (RPhS)
*Credentialing requirements for each certification vary.
According to the U.S. Bureau of Labor Statistics (BLS), as of May 2013 the mean annual salary for echocardiography technologists and technicians was $53,990, while the mean hourly wage was $25.95. Approximately 51,000 echocardiographers are employed in the United States. Total employment is expected to grow 30.4% by 2022. Factors that may increase salary include possessing higher education, having several years of experience, obtaining certification, working in a large metropolitan area, and working for a specialized or private facility.