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Chest Echocardiography (Transthoracic)

Woman lying on side on exam table with EKG leads on chest. Technician is holding ultrasound probe to woman's chest.
During an echo, images of your heart appear on a monitor.

An echocardiogram (echo) is an imaging test that uses ultrasound. It helps your healthcare provider look for symptoms that may be related how well your heart works.  A transthoracic echocardiogram is sometimes called TTE. It may also be called surface echocardiogram. This is because the images are taken from the surface of the chest wall. It helps your provider assess your heart. A more invasive type of echocardiogram involves the ultrasound probe being passed into the esophagus to get images (transesophageal).

This test:

  • Is safe and generally painless

  • May cause discomfort from the echo probe being pressed against the bony areas of the chest. This goes away once the probe is moved.

  • Can be done in a hospital, test center, or doctor’s office

  • Bounces harmless sound waves (ultrasound) off the heart using a device that looks like a microphone (transducer or probe)

  • Allows your healthcare provider to look at the size and shape of your heart. The provider can also see the size, thickness, and movement of your heart's walls, and the heart's pumping strength.

  • Shows if the heart valves are working correctly. It can also show if blood is leaking backward through your heart valves (regurgitation), or if the heart valves are too narrow (stenosis).

  • Shows if you have a tumor or infectious growth around your heart valves

  • Will help your healthcare provider find out if there are problems with the outer lining of your heart (pericardium)

  • Shows problems with the large blood vessels that enter and leave the heart

  • Shows blood clots in the heart chambers

  • Shows abnormal holes between heart chambers

Before your echo

  • Discuss any questions or concerns you have with your healthcare provider.

  • Mention any over-the-counter or prescription medicines, herbs, or supplements you’re taking.

  • Allow extra time for checking in. Bring your insurance cards and ID.

  • Wear a 2-piece outfit for the test. You may be asked to remove clothing and jewelry from the waist up. If so, you’ll be given a short hospital gown.

  • An IV (intravenous) catheter may be put into a vein in your arm or hand. This will be done if contrast or bubbles will be injected during the study.

During your echo

  • Small pads (electrodes) are placed on your chest to monitor your heartbeat.

  • A transducer coated with gel is moved firmly over your chest. This device creates the sound waves that make images of your heart. If you are overweight, the technician may have to apply more pressure to the chest wall to improve the quality of the images. This pressure can be uncomfortable over bony areas. Tell your technician if you are uncomfortable.

  • At times, you may be asked to exhale and hold your breath for a few seconds. Air in your lungs can affect the images.

  • The transducer may also be used to do a Doppler study. This test measures the direction and speed of blood flowing through the heart. During the test, you may hear a “whooshing” sound. This is the sound of blood flowing through the heart.

  • The technician may use IV contrast to improve the image quality. Or they may use agitated saline to follow blood flow through the chambers of the heart.

  • The images of your heart are stored electronically. This is so your healthcare provider can review them later.

After your echo

  • Return to normal activity unless your healthcare provider tells you otherwise.

  • Keep any follow-up appointments.

Your test results

Your healthcare provider will discuss your test results with you during a future office visit. The test results help the healthcare provider plan your treatment and any other tests you need.

Online Medical Reviewer: Lu Cunningham
Online Medical Reviewer: Mandy Snyder APRN
Online Medical Reviewer: Steven Kang MD
Date Last Reviewed: 4/1/2019
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