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A transthoracic echocardiogram (TTE) is an ultrasound of the heart. The hearts size, structure and function of various cardiac components can be assessed.
The test is straightforward with a Cardiac Sonographer using a small handheld probe covered in water-soluble gel over the chest wall to generate real time images of the heart.
The test can take up to 30 minutes to complete depending on complexity.
You may be referred for an echocardiogram if your physician detects signs and symptoms of heart disease such as a valve murmur, shortness of breath, heart failure or a congenital birth defect such as a hole in the heart.
A stress echocardiogram is a functional ultrasound of the heart conducted before and soon after exercise. An ECG (electrical heart tracing) and cardiac ultrasound (on the chest) is performed at rest. After the resting images are taken, the patient is placed on a treadmill. The incline and speed of the treadmill is increased gradually increasing stress on the cardiovascular system. This is performed under full supervision and the test can be stopped at any time at the patient’s request.
During the test there is continuous monitoring of the ECG and serial blood pressure measurements are made. Once the treadmill component of the test is completed the patient is quickly transferred to the lying position and further ultrasound images are acquired to look at the motion of the heart muscle at peak heart rate. An abnormal test may indicate a problem with the coronary artery circulation.
If you are unable to walk on a treadmill, your doctor may request a Dobutamine Stress Echocardiogram, with this test you are giving a injection which will gradually increase your heart rate in place of the treadmill.
Your doctor may request a stress echocardiogram to assess the likelihood of significant coronary artery disease. Stress echocardiography can also be used to assess the impact of exercise on diastolic function (how well the heart fills with blood before it is expelled), myocardial reserve (the ability of the heart to respond to exercise with increased contraction of the heart muscle), and the effects of exercise on valvular heart disease.
Wear light loose clothing for the test with good quality walking shoes.
It is important to cease any Beta Blocking medication prior to this test. If you do not cease your medication, your test will need to be rebooked. If you have any queries about this, please contact us prior to your appointment date for clarification.
The test can take from 30 minutes to one hour depending on the complexity of the study.
After the images have been acquired a Cardiologist with a speciality in echocardiography will review your images and generate a formal report for the referring doctor. This will be sent direct to your doctor for their consideration. Your doctor will advise you of the results and determine what treatment – if any – is required. Showers are available onsite
A transesophageal echocardiogram (TOE) is an ultrasound of your heart. This test involves passing a very small ultrasound probe which is attached to a thin tube into the mouth and down into the oesophagus. As the oesophagus is close to the chambers of the heart very high-resolution images of the heart can be obtained.
Your doctor may request a TOE if they are concerned about;
In order to prepare for a TOE, you will be required to fast (nil by mouth / no food or fluids) for 6 hours prior to the test. Regular medication may be taken with a very small sip of water. If you are on warfarin, we will need a copy of your most recent INR level. If you have difficulty swallowing or have a known issue with your esophagus (web, stricture etc) please notify the doctor prior to the test commencing.
Local anaesthetic is sprayed onto the back of the throat to numb and suppress the gag reflex. A cannula is inserted into a vein in the arm and mild twilight sedative (Midazolam) is introduced. The ultrasound tube is then passed into the mouth and is swallowed into the esophagus. Detailed images of the heart are taken by a Cardiologist with a specialty in echocardiography and a full assessment of the clinical indication is undertaken. When finished, the probe is withdrawn, and the test is completed.
You will be required to recover onsite for at least an hour whilst the effects of the sedation and throat anaesthetic wear off. No food or fluids can be consumed during this period. After an hour, a sip test can be performed with a very small quantity of water to test that the swallowing action has returned to normal.
The cardiologist who has performed your test will generate a report for the referring doctor and the results can be discussed directly with your doctor.
Yes, medical ultrasound technology has been used for over 50 years and is a proven safe imaging technology that does not use ionising radiation. Very rarely damage to the esophagus can occur when passing the ultrasound probe into the esophagus. Discuss any concerns you have with the cardiologist prior to the test.
The test can take up to 60 minutes depending on the complexity of the study
All non-invasive diagnostics are performed on Level 8 at St Vincent’s Clinic in the Cardiac Investigations facility.