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Echocardiograms: Transthoracic (TTE) & Transesophageal (TEE)

What is an echocardiogram?

An echocardiogram is one of the most common diagnostic tools cardiologists use to visualize the heart, aorta, and other blood vessels. An echocardiogram is essentially a Doppler ultrasound tool. The device emits sound waves, which bounce off the heart’s structures, creating an image of the heart and/or blood vessels under examination.

The image yielded by an echocardiogram is more detailed than an x-ray. Also, echocardiograms may be safer since they use sound waves instead of radiation. Another key benefit of an echocardiogram is that the test captures moving images of the heart, allowing the cardiologist to see how the heart pumps blood and how the valves function.

Who needs an echocardiogram?

An echocardiogram may be ordered for patients who have (or may have):

Your cardiologist at Phoenix Heart Center can discuss the potential benefits of having an echocardiogram with you at your cardiac consultation appointment.

How is an echocardiogram performed?

Generally speaking, there are two types of echocardiograms: transthoracic echocardiograms (TTE) and transesophageal echocardiograms (TEE). Both types of echocardiograms are available through Phoenix Heart Center. The difference between these two procedures is explained below.

Transthoracic Echocardiogram (TTE): How It Works

Transthoracic echocardiograms (TTE) are by far the more common of the two. This type of echocardiogram is noninvasive. Here’s how it works:

  1. A sonographer performs the test, and your cardiologist at Phoenix Heart Center interprets the results. (Cardiologists can also offer second opinions on echocardiograms performed elsewhere, if necessary.)
  2. Electrodes are placed on the chest. A special gel is applied in the areas where the transducer will be used.
  3. The sonographer places the transducer on your chest. This small tool emits sound waves and receives the echoes of those sound waves as they reflect off your body’s internal structures.
  4. Sound waves are converted into electrical impulses.
  5. The electrical impulses are converted into detailed moving images of the heart (or blood vessels).
  6. After the test is complete, the information is given to your cardiologist for review.

In some patients, body tissues or organs may block a clear view of the heart. The sonographer may inject a contrast dye to improve visualization. If this does not work, then a transesophageal echocardiogram may be necessary (see below).

Transesophageal Echocardiogram (TEE): How It Works

Transesophageal echocardiograms are much less common than TTEs. They are typically used when good visualization cannot be obtained via TTE. (Visualization may be blocked by scarring, excess body tissue, or collapsed lung.) Here’s how the procedure works:

  1. Eating or drinking is not allowed during the six hours leading up to the test. Only water is allowed until two hours before the test. If your physician’s instructions are different, follow his or her instructions.
  2. Electrodes are placed on your chest. These electrodes are connected to an electrocardiograph monitor. Blood pressure cuffs and a pulse oximeter will also be attached to your body.
  3. A local anesthetic will be used to numb your throat.
  4. An IV will be given for sedation. (You will remain awake.)
  5. While lying on your left side, a thin, flexible endoscope is passed down your throat. Though this may be uncomfortable, it should not hurt and will not interfere with breathing.
  6. Once in place, the transducer at the end of the endoscope is adjusted so that various images can be taken of your heart. The entire process takes between an hour and an hour and a half.
  7. After the test is complete, your cardiologist can interpret the results.
  8. Wait 30 to 60 minutes before eating or drinking. Start with water.

Because of the sedatives, you will not be able to drive home from your transesophageal echocardiogram. Arrange your transportation ahead of time. Most patients are fine to return to work and their normal daily activities within 24 hours of their TEE.

Schedule Your Appointment With a Cardiologist in Phoenix

To schedule your appointment with a board-certified, fellowship-trained cardiologist in Tempe, Mesa, or Phoenix, AZ, contact a Phoenix Heart Center location near you. You can also book your appointment online.

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