A transthoracic echocardiogram (TTE), often called a cardiac echo or cardiac ultrasound, is a non-invasive ultrasound imaging test used to monitor the movement of the heart. In particular, echo is considered the best way to visualize the movement and function of the heart muscle and heart valves. You may need cardiac echoes if you have heart valve disease , abnormal heart rhythms, or heart muscle diseases such as dilated cardiomyopathy or hypertrophic cardiomyopathy .
The purpose of the test
Cardiac echoes are used to detect abnormalities in the structure and function of the heart. The test emits sound waves that bounce off your heart and create a moving image on the screen. This allows your doctor to view the anatomy of your heart from different angles and monitor your heart rate.
If you have symptoms of fatigue, shortness of breath, or fainting, you may need cardiac echoes, especially if heart sounds or an electrocardiogram (ECG) (a test that records the electrical activity of your heart) suggests that you have a structural heart problem. .
Cardiac echo allows your doctor to watch your heart as it beats so that specific areas of concern can be identified. For instance:
- Heart valve problems, such as mitral valve prolapse , can be detected because the test can visualize the movement of the heart valves.
- During the test, you can use a special microphone called a Doppler microphone to measure the velocity (velocity) of blood flow in different areas of the heart. It is useful for measuring altered blood flow in conditions such as aortic stenosis .
- Echo also helps evaluate congenital heart defects. For example, tetralogy of Fallot and atrial septal defect are congenital conditions in which the heart does not have the correct anatomical structure.
- Echo is often used to measure the left ventricular ejection fraction to assess the effectiveness of various cardiac procedures in conditions such as heart failure .
- If you have cardiac arrhythmia, which is an irregular rhythm, the echo can evaluate the movement of your heart, which can help determine the exact cause and the best treatment.
Echocardiograms are also sometimes used in conjunction with stress tests to assess cardiac performance. The echo test is performed at rest and then repeated during exercise to detect changes in heart muscle function during periods of stress. Deterioration of muscle function during exercise can be a sign of coronary heart disease .
Although an echocardiogram provides a lot of information about the anatomy of the heart, it does not allow visualization of the coronary arteries or blockage of the coronary arteries. If imaging of the coronary arteries is required, a cardiac catheterization is usually performed.
Certain physical abnormalities, such as a thick chest or emphysema, can interfere with the visualization of your heart during an echocardiogram. If you have one of these conditions and need an echo, you may need an invasive ultrasound of the heart, known as a transesophageal echocardiogram (TEE).
Risks and contraindications.
Regardless of your health, you can safely perform a transthoracic echo. During the test, you may be asked to hold your breath for a few seconds and no test-related side effects are expected.
Before the test
If you have an echo, you don't need to do anything special to prepare for it, and you don't need to do any screening tests before the echo appears.
In general, you can expect the test to take about an hour. As with all diagnostic tests, you must also arrive at least 15-30 minutes in advance to be able to log in and complete all required forms.
Most doctor's offices will recommend that you have an ultrasound at the nearest cardiac testing center. If you have health insurance, your provider may request that you travel to an approved location.
What to wear
You will need to wear an exam gown for the test itself, so there is nothing special you need to wear prior to the test.
Food and drink
Before the transthoracic echo, there are no food and drink restrictions. However, depending on the reason for the test, your doctor may ask you to refrain from caffeine for 6 to 10 hours before the test because it can increase your heart rate.
Cost and health insurance
Your health insurance may require a prior authorization for diagnostic echoes. You may also be responsible for a surcharge. You can talk to your health insurance provider or the cardiac testing service to have both of them answer your questions about these questions.
If you pay for the test yourself, it will likely cost you several thousand dollars, including service fees, technical fees, equipment fees, and professional fees. These costs can vary widely, and your doctor and other healthcare providers are likely to be unaware of the cost of the echo. You can ask the agency what the total cost is and also itemize the fees.
You must bring your test order (if it has not already been submitted electronically), your insurance card, identification form, and method of payment.
During the exam
The echo will be performed by a technician or doctor. Often a technician will perform some or all of the tests, but a doctor, usually a cardiologist, will look at images of your heart while receiving an echo and can adjust the transducer to generate additional images as needed. Your own doctor may attend your ultrasound test or another cardiologist.
You will be asked to change into an exam gown prior to the exam.
During the exam
At the beginning of the test, you will lie on the exam table and the technician will apply some gel to your chest and then the transducer, a small device shaped like a microphone.
The transducer sends sound waves to your heart. Like a sonar in a submarine, the waves are reflected off the structures of the heart and return to the transducer, where they are collected. They are then processed by the computer and displayed on the screen, providing an image of your beating heart.
The technician moves the transducer to view your heart from different angles. During the test, you may be asked to lie on your side or hold your breath for a few seconds. In general, the transthoracic echo usually takes 30 to 60 minutes.
After completing the test, you may be given a small towel or pad to clean the gel, you can get dressed again and go out. Results are usually not immediately available because the doctor may want to review the test and take a closer look at some of the images before preparing the report.
You don't need to adjust your activity and there are no side effects after the echo.
interpretation of results
The results of your ultrasound will be prepared as a report in which your doctor will describe the anatomy of the heart, the movements of the heart, and any defects found during the test. The receipt of the report can take from several days to several weeks. Often times, because the results are so detailed, your doctor may schedule an appointment with you to discuss the results and next steps.
The report must include:
- Heart rate: the normal range is 60 to 100 beats per minute.
- Estimation of the size of your heart: The expansion of the chambers means that your heart is enlarged.
- A description of the pericardium, which is the protective tissue that surrounds your heart, including its appearance and a description of any abnormalities.
- An estimate of the thickness of your heart based on your age, size, and gender.
- A report on the function of your ventricles with details of any abnormalities.
- Evaluation of the shape and movement of the heart valves and the presence of regurgitation (loss of blood).
- A comment on whether your heart had blood clots.
- Description of any anatomical or birth defects or unexpected discoveries.
Your report may also include a comment on the quality of the images in case there are any difficulties with clarity, which would make the results less reliable.
Cardiac echoes are used to evaluate many different conditions. Therefore, the recommendations for additional actions vary greatly and depend on the results. Over time, you may need an echo again if you have chronic heart disease, but regular follow-up echocardiograms are not typical.
Generally, follow-up after the echo is aimed at treating your heart condition. For example, if the test is used to diagnose a congenital heart defect, the next steps could include surgery. If used to evaluate heart failure, medication adjustments may be required. If used to evaluate arrhythmias, medications, surgery, or a pacemaker may be required.
In some cases, after verifying the results of a transthoracic echo, a PVE may be ordered, especially if your doctors are concerned that you have an undetected heart problem. TEE examines the heart by placing an ultrasound device in the esophagus, not outside the chest. Both tests have pros and cons, the most significant difference being that TEE is invasive and requires sedation. TEE can also be used for surgical planning .
Get the word of drug information
If you or your loved one needs a cardiac echo, you can be sure that it is a safe and hassle-free test. There are many different reasons for testing, as well as many possible outcomes. In most cases, problems identified by the echo can be treated with medication. Sometimes heart surgery is required to fix the problem, which works very well. If you are not clear about what all aspects of your results mean, talk to your doctor.