Difference Between Echocardiogram and Transthoracic Echocardiogram
An echocardiogram (echo) is also known as a heart ultrasound and is often used interchangeably with a transthoracic echocardiogram (TTE). However, the term 'echo' is broad and encompasses several types; TTE is one of them.
When an echo is advised to a patient, a doctor refers to a TTE unless specified otherwise. In this blog, we will explore the differences between the two.
What is an echocardiogram?
An echocardiogram is a non-invasive, painless test that enables doctors to assess the heart's shape, size, movement, and function in real-time. Whether you are experiencing chest pain, shortness of breath, or palpitations, or undergoing a routine checkup, an echocardiogram provides information about your heart health.
An echocardiogram creates dynamic images of the heart using high-frequency sound waves, above 20,000 Hz (a range higher than what a human can hear). These sound waves bounce off the heart structures and return to the probe, which then sends them to the machine, where they are converted into the images on the screen.
Types of echocardiograms?
- A transthoracic echocardiogram, also known as a TTE, is a standard echocardiogram that provides a non-invasive method for assessing blood flow and heart structure. It creates images of the heart from outside the body.
- A transesophageal echocardiogram is also referred to as a TEE. If TEE is unable to provide a detailed account of the heart's structure, then TEE may be required. It takes pictures of the heart from inside the body.
- A fetal echocardiogram is done during pregnancy, usually in the second trimester, to check the baby’s heart. It is a safe procedure that allows the unborn baby’s heart to be seen without surgery or X-ray.
- A stress echocardiogram is performed right before and after exercise. It evaluates how your heart responds to physical activity.
What is a Transthoracic echocardiogram?
It is a superficial procedure that uses a probe moved across the chest in the heart region. TTE uses ultrasound, which bounces off the heart tissues and creates pictures on the computer using these echoes to form images that represent the heart as it beats. It may even use Doppler ultrasound to measure and assess blood flow.
You should be comfortably dressed in loose-fitting clothes, as you will be asked to remove clothing above the waist or wear a gown.
It takes 30 to 45 minutes to complete the test, and since it is non-invasive and painless, you can leave for home soon.
It helps detect structural abnormalities, such as valve defects, cardiomyopathy, and heart failure.
It does not require sedating a patient.
Key differences between the echocardiogram and TTE:-
Echo is a broad term that includes several other types of procedures. TTE is a prominent subtype.
Echo uses many approaches. It can be done superficially using a transducer on the chest or by inserting it into the esophagus. TTE is specifically a superficial procedure that uses a transducer moving across the chest.
Echo may or may not require sedation, but TTE is essentially a procedure that does not require sedation.
Echo, when done using invasive techniques, gives clear images of the heart. When TTE fails to yield the desired results, alternative techniques are employed.
Where are echocardiograms and transthoracic echocardiograms used?
Echocardiograms are used to evaluate heart murmurs, heart failure, valve problems, congenital disabilities, and heart attacks. They help assess the heart’s pumping strength, detect blood clots, and identify infections or fluid around the heart.
TTE is often sufficient for evaluating various cardiac conditions when a patient is stable, and the suspected issue can be assessed through the chest.
Conclusion
Understanding the difference allows patients to be better informed about the diagnostic tests they will undergo, and they feel confident discussing their heart health with their doctor. Whether it is a basic TTE or a more specialized echo, such as a TEE or stress echocardiogram, these tests play a vital role in diagnosing and monitoring heart conditions.
Here to answer all your questions
TTE is used to screen, diagnose, and follow up medical conditions such as:-
- Blood clots
- Aortic aneurysm
- Congenital heart conditions
- Heart failure
- Heart valve disease
- Cardiomyopathy
- Tumors
Five cardiac ultrasound views are important for cardiac assessment. All five views (parasternal long-axis view, parasternal short-axis view, apical four-chamber view, subxiphoid view, and inferior vena cava view) help assess diffusion contractility and relative chamber size. The five views are critical in assessing Effusion, Ejection, Equality, Exit, and Entrance.
- Effusion assesses for effusion and tamponade.
- Ejection assesses left ventricular ejection fraction.
- Equality assesses for a normal right ventricular to left ventricular size ratio, which is around 0.6:1. An equal 1:1 ratio could indicate right heart strain.
- Exit evaluates the aorta for abnormal enlargement of the aortic root
The entrance evaluates the Inferior vena cava (IVC), a large vein that brings blood to the heart from the lower body. High IVC collapsibility occurs in hypovolemia (less fluid in the body). If the IVC looks full and does not collapse, it is a sign of IVC plethora present in congestive heart failure and obstructive conditions.
Echocardiograms reveal changes in heart size, weakened or damaged heart walls, high blood pressure, or other diseases that can cause thickened walls or enlarged heart chambers.
A normal echo is a good sign, indicating that the heart’s structure and pumping functions are healthy. However, this is not a universal rule, so you may require additional tests, such as stress tests or angiography, to assess the coronary arteries for blockages. An echo does not reveal the problems associated with the heart's arteries.
Five cardiac ultrasound views are important for cardiac assessment. All five views (parasternal long-axis view, parasternal short-axis view, apical four-chamber view, subxiphoid view, and inferior vena cava view) help assess diffusion contractility and relative chamber size. The five views are critical in assessing Effusion, Ejection, Equality, Exit, and Entrance.
- Effusion assesses for effusion and tamponade.
- Ejection assesses left ventricular ejection fraction.
- Equality assesses for a normal right ventricular to left ventricular size ratio, which is around 0.6:1. An equal 1:1 ratio could indicate right heart strain.
- Exit evaluates the aorta for abnormal enlargement of the aortic root
The entrance evaluates the Inferior vena cava (IVC), a large vein that brings blood to the heart from the lower body. High IVC collapsibility occurs in hypovolemia (less fluid in the body). If the IVC looks full and does not collapse, it is a sign of IVC plethora present in congestive heart failure and obstructive conditions.
Echo is used in imaging internal organs of the human body, such as the liver, stomach, and intestines. Such imaging is called ultrasound.
