Transthoracic Echocardiogram (TTE)
What is an echocardiogram (“echo”)?
This is a test that uses sound waves to look at the heart. It is a safe and painless
way to view the heart and its function.
How does it work?
A small device, called a transducer, is held against the chest. This sends sound
waves that bounce off the heart.
A computer uses the data from the transducer to create a picture of the heart. The
picture is shown on a TV screen. It can be saved on CD or printed on paper.
The echo consists of three techniques.
▪ M-mode echo – This is used to measure the exact size of the heart
chambers. It makes a picture that looks like a tracing of the heart.
▪ Two-dimensional echo – This shows the true shape and motion of the
different heart structures. These pictures represent “slices” of the heart in
▪ Doppler echo – This allows doctors to see how the blood flows though the
heart. The signals that represent blood flow are shown as a series of black-
and-white tracings. They can be seen as color pictures on the TV screen.
During a Doppler echo, you may hear a whooshing sound. This is not the
sound of your heart. It is a signal that the machine sends.
Why is the echo done?
The echo test gives doctors useful information about the heart.
Size of the heart. The echo is used to measure the size of the heart
chambers and thickness of the heart muscle.
Pumping strength. The test shows whether the heart is pumping at full
strength or if it is weakened. It can also tell whether all the parts of the heart
pump the same.
Valve problems. The echo shows the shape and motion of the heart valves.
It can help tell if a valve is narrowed or leaking.
Other uses. The test may be used to see if there is fluid around the heart,
blood clots, other problems inside the heart, or holes between heart
Before your echo
You do not need to do anything special to get ready for this test. You may eat and
go about your normal routines, unless you are told otherwise. Make sure you wear
a two-piece outfit. The echo may be done at the hospital or clinic.
What happens during the echo?
You will be asked to undress from the waist up and put on a short hospital gown.
Electrodes (small sticky patches) are placed on your chest and shoulders to record
You then lie on a special exam table. To take better pictures, a clear gel is applied
to the area where the transducer will be placed. This may feel cool and a bit moist.
The gel will be wiped off at the end of the test.
A technician moves the transducer over the chest to obtain many views of the
heart. They may ask you to change your position. Air in your lungs can affect the
echo pictures. You may be asked to exhale or hold your breath for a few seconds.
The pictures are recorded on videotape or printed on paper so the doctor can
review them later.
Bubble study with the echo
A bubble study may be done during a TTE. It allows doctors to learn more about
how blood flows through your heart, and your risk for stroke. For the study, a
small amount of air is injected into the IV. You will not feel any different. You
will be asked to “bear down” as if having a bowel movement (without emptying
bowels) during the test. The tech will let you know when and how to do this. Not
every echo includes a bubble study.
How long does the echo take?
An echo exam takes from 30 to 45 minutes. This depends on the number of views
and whether the Doppler echo is also used. Be sure to allow extra time to check in.
When the test is over, you may eat and return to your normal routine.
Is the echo safe?
The echo test is very safe. There are no known risks from the sound waves. The
test is painless. You may feel slight pressure when the transducer is held against
What are the benefits?
The echo test gives information about the heart’s structure and blood flow without
anything being put into your body.
The major drawback is that it is often hard to obtain good quality pictures in
patients that have a broad chest, are overweight, or have a chronic lung disease
such as emphysema.
Your test results
If a doctor is present during the test, you may be able to get the results before you
leave or your own doctor will discuss the test results with you during a future clinic
visit. The results of the echo test will help your doctor know how your heart is
working and to come up with a treatment plan that is best for you.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 6/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#6849.