Transthoracic echocardiography (TTE) is a standard test conducted with an echocardiogram to get still or moving images of the heart’s internal parts through ultrasound. During this process, an ultrasonic transducer puts on the patient’s abdomen or chest to get various views about the patient’s heart. A transducer is similar to a microphone that sends sound waves into the chest and picks up certain kinds of echoes reflecting the different parts of the heart.
Purpose of Transthoracic Echocardiography (TTE):
Transthoracic echocardiography is a clinical technique used to evaluate the structure and functioning of the heart. It is a non-invasive assessment of the patient’s overall heart health, including the heart valve and the degree of relaxation and contraction. A particular image of the heart’s internal parts is shown on the monitor for real-time viewing, and after the test, it will be recorded for treatment. TTE will access all four chambers and four valves of the patient’s heart, but the quality or visibility of these structures differs from disease to disease and person to person.
Other structures that can be visible by Transthoracic Echocardiography are:
- Inferior vena cava
- Aorta
- Pleural effusion
- The pericardium
Disease detected by Transthoracic Echocardiography:
Transthoracic Echocardiography is used in the detection of the following disease:
- Heart Attack
- Pulmonary hypertension
- Thoracic ascending aortic aneurysm
- Septal defects, including ASD and VSD
- Endocarditis (sensitivity is higher with TEE)
- Enlargement of the heart
- Stenosis and regurgitation/insufficiency of valves
- Heart’s Hypertrophy
- Heart’s Infiltration from an irregular substance
- Pulmonary embolism
- Weakness of heart
- Evaluation of congenital disease, for example, tetralogy of Fallot and transposition.
- Septal defects, including ASD and VSD
- Cardiac tamponade
- Cardiomyopathy: dilated, restrictive, and hypertrophic
- Cardiac tumors
Transthoracic Echocardiography can diagnose some other diseases as well.
Indication for a Transthoracic Echocardiography
There are numerous indications for Transthoracic Echocardiography. Some of them are listed below:
- Symptoms of cardiac etiology such as fatigue, dyspnea
- Failure of heart
- Murmuring of the heart
- Congenital heart disease
- Endocarditis
- Pain in the chest due to wall motion abnormalities
- Hypoxemia for shunt evaluation
- Chemotherapy
Process of Transthoracic Echocardiography
- Before the Test:
There isn’t any special preparation required for the test of transthoracic echocardiography. So, you don’t have to worry about it. Fix your appointment and try to be on time. Following are the things that patient must know about the tests are:
- The patient will not feel any pain from an echocardiogram except when an intravenous needle is placed in the arm’s vein.
- No electricity can pass through the body during the test, so there is no longer danger of electric shock for the patient.
- Time required for test:
The average time taken during the transthoracic echocardiogram test is 30 to 60 minutes.
- During the Test:
- This test is either taken by a cardiac sonographer or by a cardiologist. It is a non-invasive test performed in various settings, such as clinic exam rooms, inpatient rooms, and exam rooms dedicated to echo imaging.
- The patient will lie on his back on a table or bed during the test.
- Then the technician will tap small metal discs on the patient’s legs and arms to record the heart rate.
- The technician will also rub a small amount of gel on the left side of the patient’s chest so they can easily pick sound waves in the body.
- Then a transducer is pressed and moves back and forth slowly against the patient’s chest in a specific direction.
- The echo produced from a transducer will transfer to a video monitor that records the picture and motion of the heart for further evaluation and treatment by doctors.
- The room usually darkens during the test because it will be helpful for the technician to observe the picture displayed on the monitor.
- During the test, the patient may be asked to stay still, lie on his left side, and hold his breath in and out very slowly.
- The technician may put the transducer on the different areas of the chest to get specific views of other heart parts.
- After the Test:
The gel is wiped off when the test is over, and the electrodes will be removed. The test reports will be further sent to the doctor within 24 hours. The doctor will follow up with you to discuss the outcomes of the test and recommend further testing and treatment. If a specific structure of the heart is needed to be explored in detail, in that case, the doctor may order a transesophageal echocardiogram (TEE) to diagnose it further and treat his patient.
Accuracy of Transthoracic Echocardiography
The weighted mean sensitivity and specificity for TTE were 46 percent to 99 percent, respectively.
Risks or complications
There isn’t any risk or chance of disease through transthoracic echocardiography. However, during the test, you may feel some pain or discomfort when the technician presses your chest hard with a transducer.
References:
- https://en.m.wikipedia.org/wiki/Transthoracic_echocardiogram#:~:text=A%20transthoracic%20echocardiogram%20(TTE)%20is,various%20views%20of%20the%20heart retrieved on April 23, 2022.
- https://www.aurorahealthcare.org/services/heart-vascular/services-treatments/testing-diagnosis/echocardiogram/transthoracic-echo retrieved on April 23, 2022.
https://my.clevelandclinic.org/health/diagnostics/13477-echocardiogram-transthoracic-tte retrieved on April 23, 2022
