Chest Echocardiography (Transthoracic)

Woman lying on side on exam table with EKG leads on chest. Technician is holding ultrasound probe to woman's chest.

An echocardiogram (echo) is an imaging test.  A transthoracic echocardiogram is sometimes called by its abbreviation TTE. It may also be called surface echocardiogram because the images are non-invasive taken from the surface of the chest wall. It helps your healthcare provider evaluate your heart. A more invasive type of echocardiogram involves the ultrasound probe being passed into the esophagus to get images (transesophageal).


This test:

  • Is safe and generally painless

  • May cause discomfort from the echo probe being pressed against the bony areas of the chest. This is relieved once the probe is moved.

  • Can be done in a hospital, test center, or doctor’s office

  • Bounces harmless sound waves (ultrasound) off the heart using a transducer or probe (device that looks like a microphone)

  • Allows your healthcare provider to evaluate the size and shape of your heart, and the size, thickness and movement of your heart's walls, and the heart's pumping strength

  • Shows if the heart valves are working correctly, if blood is leaking backwards through your heart valves (regurgitation), or if the heart valves are to narrow (stenosis)

  • Shows if there is a tumor or infectious growth around your heart valves

  • Will help your healthcare provider find out if there are problems with the outer lining of your heart (pericardium)

  • Shows problems with the large blood vessels that enter and leave the heart

  • Demonstrates blood clots in the heart chambers

  • Shows abnormal holes between heart chambers

Before your echo

  • Discuss any questions or concerns you have with your healthcare provider.

  • Mention any over-the-counter or prescription medicines, herbs, or supplements you’re taking.

  • Allow extra time for checking in. Bring your insurance cards, identification, and any co-payments that are required for the test.

  • Wear a 2-piece outfit for the test. You may be asked to remove clothing and jewelry from the waist up. If so, you’ll be given a short hospital gown.

  • An IV (intravenous) catheter may be inserted into a vein in your arm or hand. Contrast or bubbles may be injected during the study.

During your echo

  • Small pads (electrodes) are placed on your chest to monitor your heartbeat.

  • A transducer coated with gel is moved firmly over your chest. This device creates the sound waves that make images of your heart. If you are overweight, the technician may have to apply more pressure to the chest wall to improve the quality of the images. This pressure can be uncomfortable over bony areas. Tell your technician if you are uncomfortable.

  • At times, you may be asked to exhale and hold your breath for a few seconds. Air in your lungs can affect the images.

  • The transducer may also be used to do a Doppler study. This test measures the direction and speed of blood flowing through the heart. During the test, you may hear a “whooshing” sound. This is the sound of blood flowing through the heart.

  • The technician may use IV contrast to improve the image quality or agitated saline may be used to follow blood flow through the chambers of the heart.

  • The images of your heart are stored electronically. This is so your healthcare provider can review them later.

After your echo

  • Return to normal activity unless your healthcare provider tells you otherwise.

  • Be sure to keep follow-up appointments.

Your test results

Your healthcare provider will discuss your test results with you during a future office visit. The test results help the healthcare provider plan your treatment and any other tests that are needed.