Transthoracic Echocardiogram

What is a transthoracic echocardiogram?

  • A transthoracic echocardiogram (TTE) is an ultrasound test that uses sound waves to show pictures of your heart. Your heart is a large muscle in your chest that pumps blood and oxygen to your body. Your heart has four chambers (spaces), including two atria (upper chambers) and two ventricles (lower chambers). You have heart valves (doors) between each atrium and ventricle, and between each ventricle and its connecting blood vessels. These valves help control the blood flowing into, through, and out of the heart.

  • During a TTE, pictures of your heart are taken as your heart beats. The sound waves make echoes that create pictures of your moving heart. A transducer (hand-held device) is used to send the pictures of your heart to a TV-like screen. A TTE can show the movement and thickness of your heart wall. The TTE can also show the size of your heart chambers. A Doppler device may be used during your TTE to show the blood flow through your heart. Color Doppler shows your blood as different colors, depending on the speed and direction of the blood flow. A stress TTE may also be done to see how your heart functions when it has to work harder than normal.

Why might I need a transthoracic echocardiogram?

If you play competitive sports, you may need a TTE as part of a normal exam. You may need a TTE if you have symptoms of a heart problem. These symptoms include trouble breathing, abnormal heartbeats, and tightness, heaviness, pressure, or pain in your chest. You may have a TTE to check your heart when you have known heart disease. A TTE can show how well your heart is pumping blood to the rest of your body. You may also need a TTE for the following reasons:

  • To look for heart problems and heart disease: You may need a TTE if a chest x-ray shows you have an enlarged heart. A TTE can show if you have abnormal heart function or cardiac tamponade. Cardiac tamponade is when blood pools around your heart, making it hard for your heart to beat. If you have high blood pressure, a TTE can show if it is causing heart damage. A TTE may be used to look for an infection in the lining of your heart. If you have a known heart defect, a TTE can be used to monitor for problems. A TTE can also show how bad a heart problem is, and if your heart is failing.

  • To check for problems with your heart valves: A TTE can show how well blood is pumping through your heart valves and chambers. Caregivers can see damaged, narrowed, or blocked heart valves with a TTE. A TTE will also show if your blood is flowing in the wrong direction through a heart valve. Ask your caregiver for more information about heart valve disease.

  • To check your heart after a myocardial infarction: If you have a myocardial infarction (heart attack), a TTE may be done to look for heart damage. This damage can include ischemia (tissue death), heart muscle rupture (tear), or a ventricular septal rupture. A ventricular septal rupture occurs when the wall between your two ventricles tears.

  • To look for a mass in your heart: A TTE may show if you have a mass (growth) in or near your heart. A mass can be a tumor (abnormal tissue growth), thrombus (blood clot), or an aneurysm (bulging blood vessel wall).

  • To guide your caregiver during a heart procedure: A TTE allows your caregiver to see your heart while a heart procedure is occurring. A TTE may be used during a myocardial biopsy (taking a tissue sample from your heart) or a heart valve repair. A TTE can also be used during pericardiocentesis, and when closing a heart defect, such as a hole in the heart. Pericardiocentesis is the removal of excess blood from around your heart with a needle. A TTE allows your caregiver to watch for problems during the procedure. Your caregiver can also see the results of the procedure when it is complete. Ask your caregiver for more information about TTE guided heart procedures.

  • To check your heart after a procedure or treatment: You may need a TTE to check your heart after having a heart procedure or surgery. The TTE can show if the procedure or surgery caused any problems with your heart function. You may need a TTE after a heart defect repair, or the repair or replacement of a heart valve. A TTE may be done to check blood flow after surgery to open blocked blood vessels leading to your heart.

What happens during a transthoracic echocardiogram?

  • You will lie on your back or left side on a table or bed. Gel is put on the left side of your chest to help the transducer pick up the sound waves. Your caregiver will move the transducer back and forth on your chest. Pictures of your moving heart will be seen on the screen. During the test, you need to lie very still. You may be told to hold your breath at times, or to breathe slowly. Your caregiver may put a contrast agent (dye) into your IV. The dye will help the pictures of your heart show up better.

  • If you are having a stress TTE, you may need to run on a treadmill or ride an exercise bike. If you cannot exercise, you may be given medicine in your IV that causes your heart to work harder. During a stress TTE, caregivers check your heart at rest and while your heart is under stress. Caregivers will look for changes in your heart function as your heart beats faster and harder. Caregivers wipe the gel off your chest once they have all of the information they need.

What happens after a transthoracic echocardiogram?

You may be able to go home after your test. If you are staying in the hospital, you may be taken back to your room. Ask your caregiver when you will get the results of your test.

What are the risks of having a transthoracic echocardiogram?

  • During a TTE, the pictures of your heart may not be clear. The pictures may be hard to read if you are overweight, or if your lungs make it hard to see your heart. Shadows or reflections may be seen as heart problems when your heart is normal. If this occurs, you may get treatments or have other tests that are not needed. With a TTE, some areas of your heart may be hard to see, and you may need other tests.

  • If you do not have a TTE, you may not learn the cause of your symptoms. You may not get proper treatment for a heart problem. Some heart problems can lead to heart failure, and you may die.

What can I do to keep my heart healthy?

  • Eat a healthy diet: Changing the way you eat can help control your symptoms, or decrease your risk for heart problems. You should eat a variety of healthy foods from each food group every day. Your diet should include fruits, vegetables, breads, dairy products, and protein (such as chicken, fish, and beans). Eating healthy foods may help you feel better and have more energy.

  • Exercise: Your caregiver may suggest an exercise program to help improve your heart health. It is best to start slowly, and do more as you get stronger. Rest when you need to. Do not start an exercise program without talking with your caregiver. Together you can plan the best exercise program for you.

  • Keep a healthy weight: Keep a healthy weight so your heart does not have to work so hard. If you are overweight, ask your caregiver about a healthy weight-loss plan.

  • Manage your medical conditions: High blood pressure, high blood cholesterol (fat), and diabetes (high blood sugar) can lead to heart problems. Work with your caregiver to manage your medical conditions and decrease your risk for heart problems.

  • Quit smoking: If you smoke, it is never too late to quit. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

Where can I find more information?

Contact the following:

  • American Heart Association
    7272 Greenville Avenue
    Dallas , TX 75231-4596
    Phone: 1- 800 - 242-8721
    Web Address:

When should I call my caregiver?

Call your caregiver if:

  • You have chest pain or trouble breathing that is getting worse over time.

  • You have questions or concerns about having a TTE.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You have any of the following signs of a heart attack:

    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns

    • Discomfort or pain in your back, neck, jaw, stomach, or arm

    • Trouble breathing

    • Nausea or vomiting

    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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