Prof. Dr. Ali Serdar Fak
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- 29+years exp.
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Heart Diagnostics
Echocardiography
What echocardiography is, how sound waves create moving images of the heart, the difference between a standard scan, stress echo and a transoesophageal study, what the test can and cannot show, approximate costs in Turkey against the UK, US and Germany, preparation, how long it takes, safety, how to read the report and how to choose a clinic.
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Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
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Echocardiography in Turkey: what it is and how it works
Echocardiography is an ultrasound scan of the heart. A small probe (the transducer) sends high-frequency sound waves into the chest; the waves bounce back from the heart muscle, valves and blood, and a computer turns the echoes into a moving picture on a screen. There is no radiation and no needle in the standard version, and the images show the heart beating in real time: how thick the walls are, how well the chambers squeeze, whether the valves open and close properly and which way the blood flows. Cardiology departments in Turkey perform it daily, often on the same day as a consultation.
This guide explains the main types of echocardiography, what the test can and cannot show, what it costs in Turkey compared with the UK, US and Germany, how to prepare, how to read a report and how to choose a clinic. For the wider range of heart services see our overview of cardiology treatments in Turkey.
Which type of echocardiogram do you need?
The word covers several tests, and the quote you receive should name the one that is planned.
- Transthoracic echocardiography (TTE) is the standard scan. The probe is moved over the chest wall with gel, and the test takes 20 to 45 minutes.
- Stress echocardiography repeats the scan after exercise on a treadmill or bike, or after a drug (usually dobutamine) that makes the heart work harder. It looks for areas of muscle that stop moving normally when blood supply is limited.
- Transoesophageal echocardiography (TOE or TEE) passes a thin probe down the gullet after throat numbing and light sedation. Because the oesophagus lies directly behind the heart, the pictures of the valves, the left atrium and the heart's inner wall are much clearer.
- Contrast (bubble) echocardiography uses a safe microbubble injection to outline the heart chambers when standard images are poor, or to look for a hole between the upper chambers.
What can echocardiography show, and what can it miss?
Well-established uses, described by the NHS and by cardiology societies such as the European Society of Cardiology, include measuring the pumping strength of the left ventricle (the ejection fraction), checking for leaking or narrowed valves, looking for fluid around the heart, finding congenital defects, assessing enlargement of the chambers and the aorta, and looking for clots or growths inside the heart. It is the usual first test for breathlessness, a heart murmur, swollen legs or after a heart attack.
It also has limits. A standard scan does not show the coronary arteries directly, so it cannot rule out a narrowing that is not yet affecting how the muscle moves. It cannot capture a rhythm problem that comes and goes, and image quality falls with obesity, lung disease or a narrow gap between the ribs. A normal result is reassuring about the heart's structure and pumping, but not a guarantee that nothing is wrong. If symptoms continue after a normal scan, further testing such as a cardiac exercise test or coronary angiography may be suggested.
Echocardiography cost in Turkey compared with the UK, US and Germany
The ranges below are approximate prices for a single study, not hospital quotes. Prices rise with the type of test (stress and transoesophageal studies cost more), the use of contrast, whether a consultant cardiologist writes the report and whether the visit includes an ECG and a consultation. Each hospital confirms its own price in a written quote.
| Country | Standard scan (approx.) | Stress or transoesophageal (approx.) |
|---|---|---|
| Turkey | €40 – €200 | €150 – €600 |
| United Kingdom | €180 – €500 | €500 – €1,400 |
| United States | €400 – €2,500 | €1,000 – €4,000 |
| Germany | €100 – €350 | €300 – €900 |
Because the scan itself is inexpensive in every country, a trip made only for echocardiography is rarely worthwhile. It makes more sense as part of a wider cardiology check-up, or as the first step before a procedure. A package that bundles consultation, ECG and echo is usually priced lower than the separate items.
Who should have an echocardiogram, and who may not need one?
Doctors commonly request the test for breathlessness, chest pain that needs explaining, palpitations, fainting, a murmur heard on examination, high blood pressure with signs of heart strain, a family history of cardiomyopathy, before or after valve or heart surgery, during chemotherapy that can affect the heart, and to follow known conditions such as heart failure.
You do not usually need one just because you feel anxious about your heart with no symptoms and a normal examination. Screening echo in healthy people is not routinely recommended, and a clinic that sells a heart scan to everyone should be able to explain what it expects to find. A cardiologist will begin with your history and an electrocardiogram (ECG), and choose the type of echo from there.
What happens during the test, step by step?
For a standard scan you undress to the waist and lie on your left side on a couch. Three small stickers connect you to an ECG trace so the images can be timed to the heartbeat. The sonographer or cardiologist spreads warm gel on the chest and presses the probe between the ribs and under the breastbone, asking you to hold your breath or breathe slowly at certain moments. Pressure from the probe over the ribs can be uncomfortable, but the scan is not otherwise painful.
For a transoesophageal study you fast for about six hours, a numbing spray is applied to the throat, and you are usually given mild sedation. The probe is about the width of a finger, and the passage takes a few minutes. You need someone to accompany you and should not drive for the rest of the day. Stress echo takes about an hour in total, including exercise and the scans before and after.
Echocardiography compared with ECG, exercise test and CT angiography
These tests answer different questions and often work together.
| Test | Best suited to | Typical limits |
|---|---|---|
| Echocardiography | Pumping strength, valves, chamber size, fluid, structural defects, in real time | Does not show coronary arteries directly; quality depends on body shape and operator |
| ECG | Heart rhythm, signs of old or acute heart attack, conduction problems | A normal tracing at rest can hide disease; no view of valves |
| Exercise test | Provoking symptoms and rhythm or blood-flow changes under effort | Needs ability to exercise; less detailed than stress echo |
| CT or invasive coronary angiography | Showing narrowings in the coronary arteries | Radiation and contrast dye; invasive version carries procedural risk |
Is there any recovery after echocardiography, and how long should you stay?
After a standard or contrast scan you can dress, eat and carry on normally, and there is no recovery period. After a stress echo you may feel tired for an hour or so. After a transoesophageal study the throat can be sore for a day, and sedation means no driving, alcohol or important decisions until the next morning. Most people can have the scan and receive the report on the same day, so a stay of one or two nights is enough if the echo is combined with a consultation; add time if further tests are requested. Take the images and report home so your own doctor can compare them.
How do you read an echocardiogram report?
The report lists measurements that look technical but follow a pattern. The ejection fraction is the share of blood pumped out of the left ventricle with each beat; a normal value is usually in the mid-50s to 70 per cent range, and lower figures suggest weakened pumping. Wall thickness and chamber size indicate whether the heart has been strained. Valve findings are graded from trivial or mild to moderate and severe, for leaks (regurgitation) and narrowing (stenosis); mild changes are common and often only need follow-up.
A severe valve problem may lead to a discussion about surgery, for example replacement of the aortic valve. Findings in the veins and circulation are assessed separately, for instance with sclerotherapy for varicose veins when leg veins are the problem. Always ask the cardiologist to explain the report in plain language and to say what, if anything, should change.
Risks and safety of echocardiography
Standard transthoracic echocardiography is considered very safe, uses no ionising radiation and has no known harmful effects; the NHS describes only mild discomfort from the probe. Contrast agents can rarely cause an allergic reaction, and the team should ask about previous reactions. Stress echo carries a small risk of chest pain, abnormal heart rhythm or, very rarely, a heart attack, which is why it is done with a cardiologist and resuscitation equipment present. Transoesophageal echo can cause a sore throat and, rarely, injury to the gullet, bleeding or sedation-related breathing problems, and it is not suitable for people with oesophageal disease. Tell the team about swallowing problems, bleeding disorders, blood thinners and allergies beforehand.
How to choose a clinic, red flags and questions to ask
Choose a hospital where a cardiologist, not only a technician, reviews and signs the report, where the machine is a modern cardiac ultrasound system with Doppler, and where resuscitation equipment is on site for stress and transoesophageal studies. Red flags include a quote that does not state which type of echo is included, pressure to add a long list of unrelated tests, no written report, and promises that the scan will "find everything". Read how our process works and send your details through the free quote page to receive a written plan and price.
Useful questions to ask the clinic:
- Which type of echocardiography is included, and is contrast or a stress test extra?
- Who performs the scan and who signs the report?
- Will I receive the images and a report in English?
- Is a cardiology consultation and ECG included in the price?
- What happens if the scan shows something that needs treatment?
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
Echocardiography is an ultrasound scan of the heart. Sound waves from a probe create moving pictures that show the heart's size, pumping strength, valves and blood flow without radiation or needles in the standard version.
A standard scan is roughly €40 to €200 in Turkey, against about €180 to €500 in the UK. Stress and transoesophageal studies cost more. The hospital confirms its price in a written quote and states which type of echo is included.
A standard scan is not painful, although pressure from the probe over the ribs can be uncomfortable. A transoesophageal study involves throat numbing and light sedation, and the throat may feel sore for a day afterwards.
A standard scan takes about 20 to 45 minutes. A stress echo takes around an hour including exercise, and a transoesophageal study takes longer because of preparation and recovery from sedation.
For a standard scan you usually need no preparation and can eat and take your medicines normally. For a transoesophageal study you fast for about six hours and need someone to take you home.
It can show weak pumping, leaking or narrowed valves, fluid around the heart, enlarged chambers, congenital defects and clots. It does not show the coronary arteries directly, so a normal result does not rule out every heart problem.
Standard echocardiography is very safe and uses no radiation. Contrast, stress and transoesophageal versions carry small extra risks, which the cardiologist should explain and monitor for during the test.
An ECG records the heart's electrical activity and rhythm, while an echocardiogram uses ultrasound to image the heart's structure and movement. Doctors often use both because they answer different questions.
The scan and report can usually be done in a day. One or two nights are enough if you add a cardiology consultation or ECG, and longer if the results lead to further tests.
Ejection fraction is the share of blood the left ventricle pumps out each beat. A value around 55 per cent or higher is generally regarded as normal, but a cardiologist interprets it together with your symptoms and other findings.
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