This is the most commonly performed kind of echocardiogram – an ultrasound test of the heart, exactly the same technology used to look at the foetus in the womb, allowing doctors to see the heart in 3D and plan for surgery.
A TTE is most often performed in patients who have a heart murmur – an irregular flow of blood in the heart which causes a whooshing sound. It's an extremely useful test to look at heart function in patients with breathlessness and to diagnose heart failure. Increasingly it is used for assessing heart valves before cardiac surgery.
You will be asked to remove the clothing covering the top half of your body and to lie down on a bed. Several small sticky patches called electrodes will be attached to your chest and connected to a machine that monitors your heart rhythm.
You will be asked to move on to your left side. Cold jelly is placed on the chest to make a good contact between the ultrasound probe and the chest wall. It allows the doctor to examine the heart from different angles. All pictures are taken from the front of the chest.
A TTE is unsuitable for a small percentage of patients who are very large, for whom ultrasound does not offer a good image quality. Additionally, it may fail to show doctors a patient’s actual heart muscle characteristics, which are seen better on cardiac MRI. Small structures like tumours and infections of the heart could be missed or misinterpreted by a TTE. Finally, because of the way ultrasound behaves, the test is prone to artefacts - ie doctors see apparent abnormalities that are not really there.
There are no risks associated with a TTE.