What is a transthoracic echocardiogram?
A transthoracic echocardiogram, usually just called an echo, is an ultrasound scan of the heart taken from the surface of the chest. A small probe with gel on it is placed between the ribs and sends harmless sound waves into the chest; the echoes that bounce back are turned into moving pictures of your beating heart. It shows the size of the chambers, the thickness and strength of the muscle, how well each of the four valves opens and closes, the pressure in the lung arteries and whether there is fluid around the heart. There is no radiation and nothing is injected.
Why is it done?
An echo is the single most useful test for looking at the structure and function of the heart. It is requested for breathlessness, swollen ankles, chest pain, palpitations, a murmur, high blood pressure, a previous heart attack, before and after heart surgery, and to monitor treatment for heart failure, valve disease or cardiomyopathy. It is safe to repeat as often as needed, which makes it ideal for following a condition over time.
What happens on the day?
No preparation is required: you may eat, drink and take your medication as usual. You undress to the waist and are given a gown or sheet, and you lie on a couch on your left side. Three sticky dots may be placed on the chest to record the ECG at the same time. Warm gel is applied and the sonographer or cardiologist moves the probe over different parts of the chest and the upper abdomen, sometimes at the base of the neck, pressing firmly at times and asking you to hold your breath briefly or roll further onto your side. You will hear whooshing sounds, which are simply the blood flowing. The study usually takes twenty to forty minutes.
What to expect afterwards
The gel is wiped off, you dress, and you may drive, eat and continue your day immediately; there are no restrictions or after-effects at all. Your cardiologist reviews the images and normally discusses the findings with you at the same visit, explaining what they mean and what, if anything, should be done next. Occasionally the pictures from the chest surface are not detailed enough, and a scan through the gullet or another form of imaging is recommended to answer the question fully.
Possible complications
An echocardiogram is one of the safest tests in medicine. Diagnostic ultrasound has no known harmful effects, and no needles, dye or radiation are involved. The only discomfort is from the cool gel, from firm pressure of the probe between the ribs, from lying on your side for a while, or from mild redness where the ECG dots were attached. If a contrast agent is used to improve the pictures in a small number of patients, it is given through a drip and can very rarely cause an allergic reaction, which is why you are monitored while it is given.
This information does not replace a consultation. Please discuss your own risks and options with your cardiologist.