There are several types of echoes, each used based on the patient’s condition and the test’s purpose. Below are some types and the steps for each:

• Transthoracic Echo (TTE): This is the most common and widely used type. During this exam, a handheld device called a transducer is used to send ultrasound waves to the patient’s chest, capturing several images of the heart. No specific preparations, such as fasting or medication adjustments, are required for this test unless instructed by your doctor.
• Transesophageal Echo (TEE): This type is used when more detailed and accurate images are needed. A transducer is inserted through the esophagus to get clearer heart images, especially if there are difficulties in imaging through the chest. Before the test, you should inform your doctor if you have sleep apnea, swallowing problems, esophageal issues such as a hiatal hernia, or if you’re taking medications for anxiety, sleep disorders, or pain relief. Avoid eating or drinking for at least 6 hours before the test.
• Stress Echo: A stress echo is performed before and after exercise in a hospital or clinic to assess how the heart responds to physical activity. If the patient is unable to exercise, medication is administered to make the heart work harder, simulating the effects of exercise. 

Here are some guidelines to follow before the test:

1. Avoid eating or drinking, except for water, for at least 4 hours before the test.
2. Avoid smoking on the day of the test.
3. Avoid caffeine for 24 hours before the test, including decaffeinated drinks and some over-the-counter pain relievers.
4. Inform your doctor about all medications you’re taking; they may recommend stopping certain heart medications and adjusting diabetes medication doses on the day of the test.
5. Wear comfortable clothing and athletic shoes.