Overview
Transthoracic Echocardiogram (TTE)
An ultrasound machine uses a device called a transducer that sends sound waves through the body that are then reflected back, creating an image on a computer screen of internal body structures.
An echocardiogram is often referred to as a transthoracic echocardiogram or TTE because the sound waves are sent through the chest wall and lungs to view an image of the heart.
How TTE Is Used
A physician may choose to request a TTE to determine if the patient is suffering from different types of heart disease, stiffness of ventricle walls due to long-term high blood pressure or enlargement of the ventricles due to heart failure.
A TTE can also help the doctor observe the pumping function of the heart and function of the heart valves, including mitral valve prolapse, as well as diagnose fluid in the area surrounding the heart.
Preparation
No special preparation is necessary for a TTE.
To perform at TTE, you will remove the clothing from your upper body, but you will be covered by a gown or sheet.
The TTE Procedure
You will lie on an exam table or bed, and electrodes will be attached to our chest and shoulders. These electrodes record an electrocardiogram, also known as an EKG, during your TTE test. The EKG helps show the timing of cardiac events like filling and emptying of the heart’s chambers.
A clear gel will be applied to the chest, and the transducer will be moved around on the chest to get several images of the heart. You may be asked to move into different positions or to hold your breath.
During the exam, the technologist will watch the monitor, and the results will be recorded for the physician to review later.
Safety & Time
TTE is a very safe procedure, and there are no known risks. A TTE can take as little as 15-20 minutes or as long as an hour.
Follow Up
Your physician may be present during the test or review your results before you leave the office, or he or she may review the results later and contact you within a few days.
Transesophageal Echocardiogram (TEE)
An echocardiogram is often used to get an image of the heart by sending ultrasound beams through the chest wall and lungs.
In some cases, however, a patient may require a Transesophageal echocardiogram (or TEE) instead because of issue like obesity or emphysema that make it hard for the beams to reach the heart.
How TEE Is Used
A TEE can detect blood clots, masses and tumors inside the heart.
It can determine the severity of some heart valve problems and help detect infection, some congenital heart diseases and aorta tears.
TEE also helps evaluate patients who have had strokes due to blood clots.
Preparation
To prepare for a TEE, avoid eating or drinking for six hours to reduce the risk of vomiting.
If you are not told otherwise, take your prescription medications with small sips of water.
If your TEE is performed on an outpatient basis, you will need someone to drive you home afterward.
If you wear dentures, remove them.
Be sure to tell your doctor or nurse about any allergies you may have as well as any swallowing difficulties or mouth, esophagus or stomach problems.
The TEE Procedure
To perform a TEE, you will lie on your left side and will receive a sedative through an IV line. The sedative will help you relax, and your throat will be sprayed with anesthetic.
You will swallow a small transducer that will be attached to a flexible tube. A TEE usually causes no pain, and the sedative helps minimize discomfort.
The transducer will be placed in the esophagus, right behind the heart. The physician can then examine the heart from different angles.
Your heart rate, blood pressure and breathing will be monitored throughout the procedure, and you will be given oxygen as a preventive measure.
What to Expect After a TEE
After the procedure, you will not be allowed to drive for 12 hours due to the sedative you received.
You should avoid eating or drinking until the numbness has worn off in your throat. Hot foods and drinks should be avoided for 24 hours after your TEE.
Soreness in your throat is common, and you may use throat lozenges starting two hours after your procedure.
Call Your Doctor if...
Bleeding, persistent pain and fever are NOT common, and you should tell your physician if you experience any of these.
Safety & Time
The procedure itself will take 10 to 30 minutes, but expect to be in the cardiac lab for about two hours due to preparation and observation time.
While a TEE is relatively common and fairly safe, some patients may experience problems with breathing, abnormal or slow heart rhythm, reaction to the sedative or minor bleeding. Perforations and tears of the esophagus are extremely rare.
Follow Up
Your physician may provide you with results immediately after your TEE. But if you are drowsy from the sedative, he or she may choose to discuss your results later.