Transthoracic Echocardiogram (TTE)

What is a transthoracic echocardiogram (TTE)?

A transthoracic echocardiogram (TTE) is a non-invasive, safe and painless diagnostic test that uses ultrasound (high frequency) waves to record images of the heart and its various structures, including the heart chambers and valves. It shows the beating heart with blood circulating through it.

The images allow your doctor to find any heart abnormalities and assess the pumping function of your heart.

How it works

The procedure involves the following steps:

The sonographer spreads gel on the transducer.
The transducer is pressed firmly against your skin to aim an ultrasound beam through your chest into your heart.
The transducer records the sound waves that echo from your heart.
A computer converts the echoes into moving images on a monitor.

You may need a small amount of an enhancing agent injected through an intravenous (IV) line if your lungs or ribs block the view. The enhancing agent will allow your heart's structures to show up more clearly on a monitor. The agent is usually safe and well-tolerated.

Differences between a TTE and transoesophageal echocardiogram (TEE)

The TTE is more common than the transoesophageal echocardiogram (TEE), which is an invasive procedure. The differences are explained below.

Transthoracic echocardiogram (TTE)	Transoesophageal echocardiogram (TEE)
More commonly used	Less commonly used
Non-invasive	Invasive
Visualisation of the heart structure may be blocked by scarring, excess body tissue, or collapsed lung	Better visualisation of the heart structure
No preparation needed	Fasting is required 6 hours before the test
No anaesthetic required	A local anaesthetic will be used to numb your throat
No sedative required	A sedative will be given to help you relax
Usually takes less than an hour	Can take up to an hour and a half
Can resume your normal daily activities immediately after	Need to be kept under observation for a few hours before resuming normal daily activities

Your doctor will choose the type of echocardiogram you receive depending on the nature of your heart problem.

Why do you need a TTE?

The images produced by the TTE will allow your doctor to find, evaluate and monitor any functional and structural abnormalities of your heart, such as:

Damage to the heart muscle caused by a heart attack
Infection on or around the heart valves
Fluid around the heart
Hole in the heart
Heart murmur
Tumours

It also allows your doctor to assess if your heart is pumping blood properly and if the valves are working normally.

A TTE can also detect congenital heart disease (heart disease present at birth) and the source of a blood clot after a stroke.

What are the risks and complications of a TTE?

There are no risks involved in a standard transthoracic echocardiogram.

You may feel some discomfort from the transducer being pressed very firmly against your chest. This is necessary to produce the best images of your heart.

How do you prepare for a TTE?

No special preparations are required when you undergo a standard transthoracic echocardiogram. You can continue to eat, drink and take your usual medications.

What can you expect in a TTE?

A TTE is a safe procedure that does not require any anaesthetic or sedatives.

Estimated duration

Most echocardiograms take less than an hour.

During the procedure

You can expect to go through the following steps:

You will be asked to undress from the waist up and lie on an examination table or bed.
Your sonographer will attach sticky patches (electrodes) to your body to help detect and conduct your heart's electrical currents.
Your sonographer will apply a gel to the transducer to improve the conduction of sound waves.
Your sonographer will move the transducer back and forth over your chest to record images of sound-wave echoes from your heart. You may hear pulsing sounds, which are the ultrasound recordings of your blood flowing through your heart.
You may be asked to breathe in a certain way or to roll onto your left side.