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More Than Just One Test: Types of Echocardiograms

Posted on 20. Jul, 2010 by Caitlin in Uncategorized

Part I of this article series featured a brief overview and history of echocardiography. This post provides a description of each of the four major types of cardiac sonography.

Transthoracic Echocardiogram (TTE)

The first test is known as the standard echocardiogram. It uses the same type of instrument as that used in a fetal ultrasound, the handheld transducer. The echo tech will first tape electrodes to the patient’s arms, legs and chest to record his or her heart rate during the test. Then the tech will place colorless gel on the chest, where the transducer will be placed. The transducer transmits high frequency sound waves (aka ultrasound), which bounce off the heart structures. The sound waves produce images and sounds that the physician can use to detect heart damage and disease.

Transesophageal Echocardiogram (TEE)

The transesophageal test differs from the TTE in the way the transducer is used. In the TEE, the echo tech will use a much

Results from a transesophageal echocardiogram.

smaller transducer that is hooked to an endoscope, a tube that is inserted down the throat into the esophagus (the tube you swallow with). This procedure is performed with anesthesia to make the patient as comfortable as possible.

Since the esophagus is located very close to the heart, the TEE provides clear images of the heart structures free of chest and lung interference. It is often combined with Doppler ultrasound and color Doppler techniques to evaluate blood flow across the heart’s valves.

Stress Echocardiogram

This is an echo performed while the patient exercises on a treadmill or stationary bicycle. It is used to examine the heart’s walls and pumping action when the heart is under stress. For a more in-depth explanation of the stress echo, check out our stress echocardiography page.

Dobutamine Stress Echocardiogram

Dobutamine replaces exercise in a dobutamine stress echocardiogram to stimulate the heart to see how it reacts under stress.

The dobutamine echo follows the same logic as the stress echo, but if the patient is unable to access a treadmill or stationary bicycle, the physician will administer dobutamine. Dobutamine is a drug that stimulates the heart, making it “think” that it is exercising. This test evaluates how a patient’s heart tolerates activity, the likelihood that the patient will develop coronary artery disease and the effectiveness of his or her current cardiac treatment plan.

Intravascular Ultrasound

The intravascular ultrasound is performed during a cardiac catherization. A catherization is a procedure during which the physician inserts a thin plastic tube into an artery or vein in the arm or leg. The tube is then advanced to the heart.

To conduct the ultrasound, a transducer is threaded into the heart’s blood vessel via the catheter. This test is often used to yield detailed information about atherosclerosis – a condition involving clot formation and narrowing of blood vessels.

The resulting image from an intravascular ultrasound.

For more information on echocardiography schools, resources, and jobs, visit www.echocardiographer.net/.