When doctors suspect lung cancer, they are likely to recommend several tests, such as chest X-rays, computed tomography (CT) scans, biopsy, positron emission tomography (PET) scans, and echocardiograms. An echocardiogram isn’t used to detect lung cancer. It’s a test that can assess the impact of lung cancer on your heart, and it may be done to monitor your condition throughout your disease and in follow-up examinations.

Heart abnormalities can be caused by lung cancer as well as lung cancer treatments. Cardiovascular disease is also a common comorbidity (having two conditions at the same time) in people with lung cancer.

One MyLungCancerTeam member described the test they were getting: “ I just finished all testing — echocardiogram, pulmonary function test, another CT scan today. Now to be set up with the biopsy to get more answers.”

Tests for people with lung cancer can be stressful and exhausting, but they’re essential for evaluating your condition. An echocardiogram can provide crucial information that can be life-saving.

Here’s more about echocardiograms and lung cancer that you can discuss in depth with your doctor.

What Is an Echocardiogram?

An echocardiogram is an imaging test that uses ultrasound — or sound waves — to look at the anatomy of your heart and, in this case, how lung cancer may be affecting it. Different areas of the heart can be affected by lung cancer including:

• Heart chambers — Four hollow sections in the heart that regulate blood flow and heartbeat
• Aorta — A large blood vessel that moves blood from the heart to the rest of your body
• Heart valves — Four valves in the heart open and close to move blood in the right direction
• Wall motion — How the wall of the heart, including the heart muscle, moves as blood is circulated

The most common type of echocardiogram is a transthoracic echocardiogram, which is a standard echocardiogram, the type that is generally used for people with lung cancer.

How an Echocardiogram Is Performed

An echocardiogram is done in a medical facility. To start, a medical professional will attach electrodes (sticky pads with wires) to your chest so they can monitor your heart rhythm. This is a test known as an electrocardiogram, commonly called an ECG or EKG.

A standard echocardiogram — sometimes called a heart ultrasound, heart sonogram, or heart echo — is considered noninvasive, meaning it is painless and doesn’t require anything inserted into the body. However, in some cases, you may receive intravenous (IV) fluid with a dye, administered through a needle, to help make the heart more visible on images. Sometimes, an IV saline solution is given to look for holes in the heart.

During the echocardiogram, you will lie down on a table while a technician presses a transducer (“wand”) against your chest and moves it around your chest area. The ultrasound sends harmless sound waves into your body, which bounce off the heart to create images. Ultrasound in echocardiography is the same technology that is used to produce images of a fetus during pregnancy.

Images of your heart will be visible on a monitor during the procedure and recorded for review by a cardiologist. The test is usually done in about 30 minutes.

One MyLungCancerTeam member shared that they had a pulmonary function test (PFT) and an echocardiogram a day apart. “I had my first PFT yesterday and an echocardiogram just this morning. This whole thing is quite an adventure. Thankfully, neither of them required another needle stick,” they wrote.

Heart Complications That Can Be Detected in an Echocardiogram

If you have lung cancer, an echocardiogram can help ensure that, if you have heart disease, it’s treated promptly. Here are the most common heart complications that can occur with lung cancer.

Lung Cancer Spreading to the Heart

Lung cancer metastasizes (spreads) to the heart is detected in approximately 8 percent to 10 percent cases, making it a rare occurrence. But in autopsies, 15 percent to 35 percent of people with lung cancer were found to have cancerous tumors in their hearts.

Heart metastases tend to go undetected because they often show no early symptoms or because the symptoms may be masked by lung cancer symptoms. Echocardiography has helped improve earlier detection of lung cancer that has spread to the heart. Some research has indicated that a transesophageal echocardiogram may be more effective for detecting lung cancer metastases in the heart. This procedure is more invasive than a standard echocardiogram, requiring a small ultrasound device to be inserted through the esophagus.

Cardiac Toxicity From Lung Cancer Treatment

Some lung cancer treatments can be cardiotoxic (damaging to the heart). These include chemotherapy, immunotherapy, radiation, and targeted therapy drugs.

If your doctor recommends a treatment that has a risk of damaging your heart, you’ll likely be tested first with an echocardiogram. You’ll be monitored during and after treatment for heart problems. Early detection of heart complications can help ensure that your treatment plan is adjusted if necessary and that you get proper treatment for your heart.

Cardiotoxicity can increase the risk for many heart problems, including:

• Cardiomyopathy — Problems with the heart muscle that make it less able to pump blood
• Heart valve disease
• Heart failure
• Coronary artery disease and heart attack
• Hypertension (high blood pressure) or hypotension (low blood pressure)
• Irregular heartbeat

Symptoms of cardiotoxicity include:

• Chest pain
• Heart palpitations or racing heartbeat
• Shortness of breath
• Dizziness
• Swelling in the abdomen or legs

“I went today to have an echocardiogram on my heart after years of chemo, immunotherapy, and radiation,” a MyLungCancerTeam member wrote. “My heart has been beating fast the last six months, anywhere from 100 to 150 beats per minute. Next week, I will go see a cardiologist who specializes in people on chemotherapy and other cancer drugs.”

Pulmonary Hypertension

Lung cancer can cause pulmonary hypertension, which is high blood pressure in the lungs. Echocardiographic testing is used to diagnose this condition. Pulmonary hypertension can occur if a tumor is putting pressure on a blood vessel in the lung and obstructing blood flow. This in turn can cause the right side of the heart to work harder to pump blood and ultimately can result in heart failure.

Symptoms of pulmonary hypertension include:

• Shortness of breath
• Chest pain and pressure
• Fast heart rate or pounding heartbeat
• Swollen abdomen, ankles, or legs
• Fatigue

Blood Clots

People with lung cancer have an increased risk of blood clots, particularly with stage 3 (stage III) or stage 4 (stage IV) disease. (Roman numerals are sometimes used for stage numbers.) Some lung cancer medications can also raise the risk of blood clots. A blood clot forms when blood cells are packed together and form masses that can restrict blood flow. Blood clots can be life-threatening. However, with early detection with tests such as a CT pulmonary angiography, they can be treated.

Symptoms of blood clots include:

• Chest pain
• Irregular heartbeat
• Coughing up blood
• Fever or sweating
• Feelings of anxiety or panic

Echocardiogram Testing Can Be Vital

If you have lung cancer and your doctor recommends an echocardiogram, it’s essential to get this testing promptly. An echocardiogram can help you be sure that you’re being properly monitored for complications that can affect your heart. Let your doctor know if you think you’re having symptoms that may be related to your heart.

“I am going for an echocardiogram tomorrow. I am not short of breath and have no pain, but keep gaining weight and my swelling has not gone down,” a MyLungCancerTeam member shared.

Another member wrote, “In October, I started getting lightheaded and I was off. EKG is abnormal and blood pressure higher than normal. Referred to cardiology. They did an echocardiogram and EKG, both abnormal and show that the heart isn’t functioning properly. But with medication, it should fix itself in a couple of years.”

It’s important to always tell your doctor about any changes in your symptoms, even if they seem minor. Regularly talking with your doctor helps catch any problems early and manage your condition better.

Talk to Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 13,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Have you had an echocardiogram with lung cancer? Were any heart abnormalities detected? Share your experience in the comments below, or start a conversation by posting on your Activities page.