A Transthoracic Echocardiogram (TTE), often called an “echo,” is a widely used, non-invasive imaging test that provides a detailed look at the heart. The procedure uses high-frequency sound waves, similar to a pregnancy ultrasound, to create real-time, moving images of the heart’s internal structures. By placing a small device on the chest wall, the TTE captures how the heart beats and pumps blood without the need for surgery or injections. It is the most common form of heart ultrasound used for evaluating overall cardiac health.
What the Test Reveals
The images produced by the TTE provide physicians with specific, measurable information about the heart’s anatomy and function. The test allows for the precise measurement of the size and thickness of the four heart chambers, which can indicate if the heart muscle has enlarged or if a chamber is dilated. The TTE also assesses the motion of the heart walls to determine how effectively the muscle contracts during a heartbeat.
A primary measurement is the Ejection Fraction (EF), which calculates the percentage of blood pumped out of the heart’s main chamber, the left ventricle, with each contraction. A normal EF typically ranges between 50% and 70%; a lower number suggests the heart is not pumping strongly. The TTE also uses Doppler technology to evaluate the function of the four heart valves, checking for conditions such as stenosis (a narrowing of a valve) or regurgitation (blood leaking backward). Doppler technology also measures the speed and direction of blood flow through the heart and major vessels.
Preparing for and Undergoing the Procedure
The TTE generally requires no special preparation, such as fasting, allowing you to eat, drink, and take your usual medications beforehand. Wearing a loose-fitting top is recommended, as you will need to undress from the waist up and may be given a gown. The procedure typically takes between 40 to 60 minutes to complete.
The test begins with a cardiac sonographer attaching small adhesive patches, called electrodes, to your chest to monitor the heart’s electrical activity throughout the exam. You will then be asked to lie on an examination table, often turning onto your left side. This positioning brings the heart closer to the chest wall, allowing the sonographer to capture clearer images. A lubricating gel is then applied to your chest to ensure the smooth transmission of sound waves from the transducer.
The sonographer presses the transducer, a wand-like device, firmly against your chest and moves it to several locations to visualize different sections of the heart. You may feel slight pressure from the wand. During the exam, the machine may produce a swishing sound, which is the Doppler technology picking up the noise of blood flowing through your heart. The sonographer may ask you to hold your breath briefly or change position slightly to optimize the image quality.
Safety and Understanding Your Findings
The Transthoracic Echocardiogram is a safe procedure that is non-invasive and uses no ionizing radiation. Once the images are captured by the sonographer, they are sent to a cardiologist, a physician specializing in heart health, for detailed interpretation. The cardiologist reviews the measurements, structure, and motion patterns of the heart to generate a comprehensive report.
The results are usually finalized and sent to your ordering physician within 24 to 48 hours. Your doctor will then discuss the findings with you, explaining what the measurements mean for your health and determining any necessary next steps for treatment or further testing.