What is an Echocardiogram: Transesophageal vs Transthoracic?


What is an Echocardiogram: Transesophageal vs Transthoracic?

An echocardiogram uses high-frequency sound waves (ultrasound) to produce images of your heart so that its functions may be viewed. This allows your doctor to determine your heart’s health and look for signs of heart disease or irregularities.

An echocardiogram involves minimal risk, and is the best way for your doctor to determine the pumping strength of your heart. It also allows your doctor to see if there are problems with your heart’s valves or chambers, and to see if heart problems are the cause of other conditions such as chest pains or shortness of breath. Fetal echocardiogram may also be used to detect heart problems in an unborn child before birth.

Why would I need an echo test?

Echocardiogram, or “echo test”, is commonly performed, and approximately 20% of Medicare patients have at least one per year. The percentage rises with age and levels off after around age 85. Use increases most dramatically after age 65, when the proportion of Medicare beneficiaries receiving echo tests goes from around 13% to more than 25%. African Americans have about a 1.9% higher occurrence of the test, and men receive it about 1.6% more often than women.

Doctors most often recommend an echo test for symptoms of heart disease, such as shortness of breath or swelling in the legs. Your doctor may also spot an abnormality such as a heart murmur during an exam, or suspect damage to your heart or problems with the valves and use echocardiogram to further investigate.

What are the different types of echocardiograms?

Your doctor may use one of five different echo tests depending on what information is needed:

Transthoracic echocardiogram

This is the most commonly performed echo test and is a standard, non-invasive procedure.

  • A conducting gel is applied to a device called a “transducer”
  • The transducer is placed firmly against your chest and an ultrasound beam is directed toward your heart
  • Sound waves are produced which echo your heart working, and a computer converts the waves into images on a screen
  • An intravenous-enhancing agent may be given so that your heart’s structure can be seen in the event your ribs or lungs are blocking the view of it

Transesophageal echocardiogram

If a clearer picture is needed or if your cardiologist can’t get an accurate enough image of your heart using a transthoracic echocardiogram, a transesophageal echo test may be administered.

  • A much smaller, more flexible transducer which fits down your throat is used
  • Your throat is first numbed and a sedative is given to help you relax
  • The transducer is then guided into your esophagus so that it can record sound waves echoing from your heart
  • A computer transforms the echoed sound waves into images for your doctor to view on a monitor

Stress echocardiogram

For symptoms which only show up under physical activity such as with coronary artery problems, your doctor may use a stress echo test.

  • A traditional transthoracic echocardiogram is used after exercise
  • Exercise is usually performed on a treadmill for the test
  • If you are unable to exercise, your doctor may instead use medication to stimulate your heart to beat as though exercising

Three-dimensional echocardiography

A three-dimensional (3-D) echocardiogram uses either a transthoracic or transesophageal procedure to produce a 3-D image of your heart.

  • Multiple images are taken from various angles
  • The images are combined to produce a 3-D rendering or “picture”
  • 3-D echocardiogram is used prior to heart valve surgery and to diagnose heart conditions in children

Fetal echocardiogram

Between weeks 18-22 of pregnancy, a fetal echo test may be used on the expectant mother to check for heart problems in the fetus.

  • The transducer is placed over the mother’s belly to view the heart function of the fetus
  • The test uses no radiation and is considered safe for the unborn child

How can I prepare for an echo test?

There are no special preparations involved in a transthoracic echocardiogram, but there are some minimal requirements for some other types.

  • If you are undergoing a transophageal echo test, you will be instructed not to eat or drink for several hours beforehand
  • It is likely you will need to arrange a ride after your transophageal test due to the sedative you will be given
  • For a stress test, you will need to wear shoes and clothing which are comfortable for exercise

What are the risks of taking an echo test?

Since all echo tests are non-radioactive and most are non-invasive, they are considered very safe. With Intermountain Health, this is further enhanced with our state-of-the-art facilities and a team of award-winning practitioners to ensure your care and safety come first.

That said, there are some potential minor risks and side effects to certain echo tests. For instance, with a transophageal echo test, you may experience a minor sore throat afterward, and you will likely feel drowsy afterward due to the sedative. In rare instances, the transducer may cause scraping or irritation in the throat. A stress test may also produce an irregular heartbeat, which your Intermountain Health specialist will carefully monitor.

Intermountain Health is here for you

With convenient clinics and providers located throughout Southern Nevada, Intermountain Health allows easy access to premium healthcare. This includes our network of over 310 primary care physicians and more than 1,700 specialists along with clinics specializing in primary care, specialty care, urgent care, and our senior-focused myGeneration Senior Clinics.

Whether you have symptoms of a heart condition or your doctor spots an abnormality in your heart, our expert cardiologists and advanced equipment are here to provide you with the best investigative medicine possible. This includes using the appropriate echocardiogram for your needs to ensure you are given the best cardiovascular care possible. To schedule an appointment, simply call (702) 997-1687, or you can go here for a convenient online appointment request.

Part of being well is being heard.