Transthoracic echocardiogram (TTE) at Leeds Hospital

What is a transthoracic echocardiogram?

A transthoracic echocardiogram (TTE) is an ultrasound scan that uses sound waves to create moving pictures of your heart. It shows how well your heart is pumping and relaxing, and the condition of its chambers and valves, helping your doctor work out what might be causing your symptoms.

Why might I need a transthoracic echocardiogram?

This is one of the most commonly requested heart scans. It's often used to check how well the heart is pumping, especially when your symptoms suggest possible heart failure, but it can also assess your heart's valves, chambers, thickness, and the large blood vessels nearby.

You might be offered a TTE to help explain symptoms such as:

• breathlessness
• chest pain (angina)
• light-headedness or fainting
• heart palpitations, a fluttering or pounding feeling in your chest or neck
• a heart murmur picked up by your doctor
• rapid breathing or heartbeat
• swelling in your hands, feet, legs or abdomen
• extreme tiredness.

It's also used to screen for, diagnose or monitor conditions including heart failure, heart valve disease, cardiomyopathy, congenital heart conditions, blood clots, and problems with the aorta.

What are the benefits of a transthoracic echocardiogram?

A TTE gives your doctor detailed, moving images of your heart without needing surgery, radiation or sedation. In many cases, your consultant can get a good sense of how your heart is functioning on the same day as your scan, helping to speed up diagnosis.

Depending on what it shows, your consultant can recommend the most appropriate next steps, whether that's lifestyle changes, medication, or a referral for a procedure.

Are there different types of transthoracic echocardiogram?

A standard TTE is the most common and least invasive type of echocardiogram, with the probe used externally on your chest. A few variations exist for specific situations:

• contrast echocardiogram: a dye is injected into a vein to sharpen the images, making it easier to see how well your heart is pumping or to check for blood clots
• stress echocardiogram: images are taken while your heart is under stress, either from exercise or a medicine called dobutamine, to check for reduced blood flow to the heart muscle
• transoesophageal echocardiogram (TOE): a specialised probe is passed down your throat into your oesophagus instead of scanning through your chest. This is a different, more invasive test, usually only needed if a standard TTE doesn't give a clear enough picture.

How do I prepare for a transthoracic echocardiogram?

There's nothing special you need to do to prepare. You can eat, drink and take your usual medications as normal beforehand. The scan doesn't use X-rays, only harmless sound waves, so no other precautions are needed.

What happens during a transthoracic echocardiogram?

1. You'll be asked to undress from the waist up and put on a gown, left open at the front.
2. Small sticky sensors (electrodes) are attached to your chest to monitor your heart's rhythm during the scan.
3. You'll lie on a couch on your left side, often with your left arm above your head, which helps produce clearer images.
4. A gel is applied to your chest, and the sonographer presses a small handheld probe against your skin, moving it to different positions to capture your heart from different angles.
5. You may be asked to hold still, change position, or breathe in certain ways to get the clearest pictures.

The room is usually kept dim, and you'll hear sounds from the machine that represent blood flow through your heart. Sometimes a contrast dye is injected into a vein beforehand to make the images sharper.

You won't be sedated, since the test is non-invasive. How long it takes varies between services and depends on the complexity of your case: some report 10–20 minutes, others allow up to about an hour.

What happens after a transthoracic echocardiogram?

Once the scan is finished, the sensors and gel are removed and you can get dressed and go home right away. There are no restrictions on what you can do afterwards, including driving yourself home.

How soon you get your results varies. Your consultant may be able to tell you how your heart is functioning on the day of your scan, but a full written report can take anywhere from a day or two up to 48 hours, depending on the service. Your doctor will then discuss the results with you, along with any diagnosis and next steps.

What are the risks or side effects?

There are no significant risks associated with a transthoracic echocardiogram. It doesn't use radiation or electrical currents, and the scan itself is painless.

Some people find the pressure of the probe on their chest a little uncomfortable at times; let the sonographer know if this happens, as they can adjust their positioning. If a contrast dye is used, the only discomfort is usually a brief pinch from the injection.