Transthoracic echocardiogram (TTE) is a type of non-invasive ultrasound technique used to evaluate the heart and surrounding structures. With this diagnostic tool, high frequency sound waves or ultrasound are delivered by a transducer, a hand-held device applied over the chest, particularly on the breast bone and the left side of the chest. Ultrasound creates images that are viewed from a monitor, and captures changes in the heart muscle and the heart valves while they are in motion. It is non-invasive, meaning it does not penetrate the body, unlike the transesophageal echocardiogram which is inserted through the mouth into the esophagus.
How Is a TTE Done?
TTE is a painless procedure done by a sonographer, a radiologist or a cardiologist while the patient lies on his left side. There are no special preparations or precautions to be observed before the test, and the patient does not need to fast or alter his medications before and after it is done.
The patient will be asked to undress from the waist up, and to wear a hospital gown. Three electrodes (sticky patches) are applied over the chest wall, which in turn are connected to an electrocardiogram or ECG machine. This records the heart’s electrical activity.
The patient then lies on his left side and the sonographer moves a transducer that looks like a wand or microphone, covered with gel over the chest. Sound waves emitted are not heard or felt, but the movement of the transducer over the skin may be felt as a firm but painless pressure. Images are created and seen on a video monitor which can be immediately evaluated by the cardiologist. The procedure takes about 40 minutes, after which the patient may return to his normal activities.
TTE is a safe diagnostic procedure which entails no risks.
Why Is a TTE Done?
Transthoracic echocardiogram or cardiac echocardiogram is an imaging device used to:
- Watch the heart’s motion
- Picture the inner and outer walls of the heart, including the chambers
- Observe the opening and closing of the heart valves, including artificial heart valves if present
- Measure the thickness of the walls and the size and shape of the chambers
- Assess the overall function of the heart and cardiac performance
How Does TTE Help as a Diagnostic Tool?
A cardiac echogram can help diagnose the following conditions through the images produced:
- Congenital heart defects
- Enlargement of the heart and its possible causes
- Presence of blood clots and tumors in the heart
- Pericardial effusion or fluid around the heart
- Thickening of the outer lining of the heart
- Thickening and abnormalities in the motion of the heart muscles
- Abnormalities in the movement of heart valves and muscles
Transthoracic echocardiogram is an accurate and simple tool to diagnose the possible causes of heart failure, heart murmurs (abnormal heart sounds), chest pains, shortness of breath, easy fatigability, and irregular heartbeats. In addition, heart attacks may be monitored, as well as observation for proper functioning of artificially implanted heart valves.
TTE is not the only form of echocardiogram used to evaluate the heart and its function. It can be done in conjunction with a Doppler echocardiogram which is used to observe the blood flowing through the blood vessels of the heart. If images obtained from the transthoracic route are not clear enough since the heart may be obscured by the thick chest wall, the breasts and the lungs, the transesophageal route may be chosen to obtain a closer view.
Cleveland Clinic: Transthoracic Echocardiogram
Massachusetts General Hospital: Transthoracic Echocardiogram