A complete transthoracic echocardiogram is a common, non-invasive medical procedure that uses sound waves to create moving images of the heart. This examination is essentially an ultrasound of the heart, allowing clinicians to visualize the organ’s structure and function in real-time. The term “transthoracic” indicates that the ultrasound probe, called a transducer, is placed on the chest wall to direct sound waves toward the heart. These sound waves bounce off the heart’s structures, producing echoes that the machine translates into a detailed picture displayed on a screen. This painless technique provides a dynamic view of how the heart is beating without the need for radiation exposure.
Why This Test Is Ordered
Physicians order this comprehensive ultrasound test to investigate symptoms and diagnose a range of heart conditions. The procedure offers detailed views necessary to evaluate the heart’s pumping ability, which is formally measured by the left ventricular ejection fraction (LVEF). A low LVEF is a common indicator of heart muscle weakness that can lead to heart failure. The study also provides precise measurements of the size and thickness of the heart’s four chambers, helping to identify enlargement or muscle overgrowth, known as hypertrophy.
The test is routinely used to assess the function of the heart’s four valves: the mitral, aortic, tricuspid, and pulmonary valves. It can detect valvular heart disease, such as stenosis (a narrowing that restricts blood flow) or regurgitation (a leaky valve that allows blood to flow backward). Using Doppler technology, the ultrasound measures the speed and direction of blood flow through these valves and chambers to quantify the severity of any leaks or blockages. The echocardiogram can also help identify congenital heart defects and detect fluid accumulation around the heart, a condition called pericardial effusion.
What Happens During the Procedure
Preparation for this non-invasive test is minimal, typically requiring no fasting or changes to daily medications. Patients are usually asked to wear a two-piece outfit since they will need to undress from the waist up and put on a gown. Once in the examination room, which is often kept dimly lit, the cardiac sonographer will explain the process and help the patient onto the exam table.
To monitor the heart’s rhythm throughout the examination, small, sticky patches called electrodes are placed on the chest to connect the patient to an electrocardiogram (ECG) machine. The sonographer then applies a water-soluble gel to the chest, which helps eliminate air pockets and ensures the sound waves travel efficiently from the transducer to the heart. The transducer is pressed firmly against the skin and moved to various positions, which can sometimes cause a sensation of pressure.
The patient will be asked to lie in different positions, most commonly on their left side, to bring the heart closer to the chest wall for clearer images. They may also be asked to hold their breath briefly or breathe slowly to move the lungs out of the way of the sound waves. The machine will emit whooshing sounds as it measures blood flow, which is a normal part of the Doppler process. The entire examination usually takes 30 to 60 minutes, depending on the complexity of the views needed.
Interpreting the Complete Report
The designation of a study as “complete” signifies that the sonographer has systematically captured all standard imaging planes and measurements required for a comprehensive assessment. This is distinct from a “limited” or focused study, which might only focus on one specific aspect, such as checking for fluid around the heart. A complete report details the structural integrity and functional performance of all four heart chambers, the four valves, and the major blood vessels connecting to the heart.
The report will include specific, quantitative measurements, providing objective data on heart function. One of the most important measurements is the left ventricular ejection fraction (LVEF), typically expressed as a percentage, which quantifies the amount of blood pumped out of the main chamber with each beat. The physician will also review detailed notes on any observed structural abnormalities, such as the location and size of any masses or blood clots. The final interpretation integrates all this data to determine the most appropriate treatment or follow-up plan.