What is a Transthoracic Echocardiogram?

A transthoracic echocardiogram is a noninvasive imaging test that utilizes sound waves to create detailed images of the heart's structure and function. During the procedure, a transducer is placed on the chest wall and emits high-frequency sound waves that bounce off the heart structures, producing real-time images of the heart chambers, valves, and blood flow patterns. This diagnostic tool is commonly used to assess various cardiac conditions, such as heart valve disorders, chamber size and function, and the presence of any abnormalities like congenital heart defects or tumors.

Transthoracic echocardiograms play a crucial role in the diagnosis, monitoring, and management of cardiovascular diseases. These tests provide valuable information to healthcare providers about the overall health of the heart, helping to guide treatment decisions and interventions. The procedure is safe, painless, and generally well-tolerated by patients, making it a preferred imaging modality for evaluating cardiac structure and function. By visualizing the heart in real time, transthoracic echocardiograms aid in identifying potential abnormalities early, facilitating timely interventions and improving patient outcomes.

In clinical practice, healthcare professionals interpret the echocardiogram results carefully to assess the presence of any cardiac abnormalities accurately. By combining the imaging findings with a patient's clinical history and symptoms, clinicians can make informed decisions regarding further diagnostic evaluations or treatment plans. Transthoracic echocardiograms are valuable tools not only in the diagnosis of heart conditions but also in the ongoing management and follow-up of patients with cardiovascular disorders.

What is a Transesophageal Echocardiogram?

A Transesophageal Echocardiogram (TEE) is a procedure used to obtain detailed images of the heart by inserting a specialized probe into the esophagus. This imaging technique provides clearer and more detailed images of the heart structures compared to a standard echocardiogram performed on the chest wall. Transesophageal echocardiograms are commonly used in clinical practice to evaluate heart function, diagnose structural abnormalities, assess blood flow patterns, and detect blood clots in the heart chambers.

During a TEE, the patient is usually sedated to minimize discomfort, and a thin, flexible probe is guided into the esophagus, located close to the heart. By emitting high-frequency sound waves and capturing the echoes that bounce back, the probe creates detailed real-time images of the heart's chambers, valves, and surrounding structures. This procedure allows healthcare providers to visualize specific areas of the heart more clearly and accurately, leading to a more precise diagnosis and treatment planning for various heart conditions.

In clinical settings, transesophageal echocardiograms are valuable tools for assessing conditions such as heart valve abnormalities, infective endocarditis, congenital heart defects, and sources of emboli in patients with strokes of unknown origin. The detailed images obtained through this procedure contribute to a comprehensive evaluation of the heart's function and structure, helping healthcare providers make informed decisions about the management of cardiovascular diseases and the implementation of appropriate interventions to improve patient outcomes.

Left Ventricle:

• Size: refers to the LV chamber cavity

• • Small: 
  • • The left ventricle may be underfilled (dehydrated or less blood volume)
    • The left ventricle may be hypertrophied (thickened), reducing the cavity space
  • Dilated/Enlarged: Due to cardiomyopathy (sick heart)

• Thickness

• • Left Ventricular Hypertrophy (LVH)
  • • Concentric: due to pumping against increased resistance or load (hypertension, obesity, aortic stenosis)
    • Eccentric: - preserved wall thickness, but enlarged cavity 
    • • athletic heart remodeling due to increased flow
      • Severe aortic regurgitation
  • “Mild basal septal hypertrophy”
  • • Common finding on Echo
    • • More common as we age
    • Typically benign
    • “Mild” means it’s not generally obstructing blood flow

• Systolic Function

• • Ejection Fraction (EF)
  • • Hyperdynamic: > 70% - usually due to adrenaline, dehydration
    • Normal (preserved): ≥ 50%
    • Mid-range: 40-50%
    • Moderately to severely reduced: 20-35%
    • Severely reduced: