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Transthoracic & Transoesophageal Echocardiography

The cardiology unit of Aster Hospitals is known for its excellent services. Of the several types of investigations available, transthoracic transesophageal echocardiogram is one of the most sought after services. Two types of echocardiograms are usually done: transthoracic echocardiogram and transesophageal echocardiogram. Out of the two, transthoracic echocardiogram is the most common one. A transthoracic echocardiogram is a test that involves using ultrasound waves to create images of the heart. This test helps the health provider to visualize the heart, its four chambers, heart valves, and the nearby blood vessels.

A transthoracic echocardiogram can assess cardiac health by checking the heart valves, determining how well the heart is pumping blood, measuring blood pressure, and measuring the size and shape of the chambers of the heart.

This test is also recommended in people who experience chest pain, edema, heart murmur, and breathlessness. The following conditions can be screened and diagnosed:

  • Aortic aneurysms
  • Blood clots
  • Changes in electrocardiogram
  • Congenital heart abnormalities
  • Heart failure
  • Heart valve diseases
  • Hypertrophic cardiomyopathy
  • Tumors of the heart

Echocardiography makes use of ultrasound waves to send high-frequency waves across the body. The sound waves bounce off the heart tissue and create "echoes." These echoes are used to create images representing the heart and how it looks while beating. Echocardiography uses Doppler ultrasound waves to show, measure, and assess blood flow through the heart chambers and valves.

A transesophageal echocardiogram is an echo test which sends sound waves into the body to create detailed images of the heart. A long, thin tube called an endoscope pushes the transducer down into the esophagus. The transducer is a device used to make sound waves. These soundwaves bounce off from different areas of the heart, creating echoes. The transducer transmits these echoes to a computer that converts them into pictures. These images show the function and structure of the heart very well.

A transesophageal echocardiogram is usually done to get a more detailed visualization of the heart. It is usually done in emergency and critical care when the healthcare provider wants a close view of the heart. One may need to get this procedure done if the healthcare provider wants to check for the presence of any blood clots. Not only this, a transesophageal echocardiogram may be done to assess if the procedure performed was successful or not.

A transesophageal echocardiogram may be done to examine the structures of the heart:

  • Left atrium: It includes the top left chamber of the heart.
  • Left atrial appendage: The small, ear-shaped sac present in the left atrium, where the formation of blood clots may take place.
  • Interatrial septum: The wall that separates both the upper chambers.
  • Thoracic aorta: The part of the aorta that passes through the chest.

A transesophageal echocardiogram may be used to assess the conditions in which there are problems with blood flow and blood pressure, low blood pressure, and hypoxia. It can perform specific procedures such as catheter ablation and electrical cardioversion. These procedures usually break free the blood clot, which travels through the bloodstream. Specific percutaneous procedures such as transcatheter aortic valve replacement, mitral valve repair, and tricuspid valve repair can be performed.

Health Conditions Treated

  • Aortic aneurysm
  • Blood clots
  • Cardiac tumors
  • Congenital heart diseases
  • Heart valve diseases
  • Infective endocarditis
  • Pericardial diseases


At Aster Hospitals we provide the highest quality of care and a transformative experience for all your healthcare needs. With our network of multi-speciality hospitals, specialised doctors, and world-class technology, we bring global standards of medical care to our patients.

Is a transesophageal echocardiogram done under anesthesia?

A transesophageal echocardiogram is an invasive procedure requiring a device to be put into the body. It might cause mild discomfort, but the risks involved are usually low. Transesophageal echocardiogram usually requires only local anesthesia and moderate sedation.

How is a transthoracic echocardiogram different from a transesophageal echocardiogram?

In a transesophageal echocardiogram, a probe is inserted into the esophagus. On the other hand, a transthoracic echocardiogram is performed by simply placing the probes against the skin. Both procedures use echoes from sound waves to create images.

Is transthoracic echocardiogram the same as an electrocardiogram?

Although both procedures have similar names, they are performed for different reasons. While an electrocardiogram is used to record the electrical signals of the heart, a transthoracic echocardiogram is used to visualize the structure of the heart. An echocardiogram can assess the chambers of the heart, the heart valves, and blood vessels. It can also assess the fluid accumulating around the heart.

What are the risks associated with transthoracic echocardiogram?

There are not many risks associated with transthoracic echocardiogram; this test does not use radiation or electric currents. This test usually does not cause any pain, except for a slight pinch from an IV injection of contrast.

Is one awake while a transesophageal echocardiogram is being done?

A moderate amount of sedation can make one feel drowsy but will allow one to tolerate the procedure without discomfort. The signs of discomfort are monitored before deciding the amount of sedation. Under general anesthesia, one needs a breathing machine. Because of deep sedation, the recovery is usually longer. The entire procedure of transesophageal echocardiogram takes around 15 minutes. However, the procedure may last as long as 90 minutes.

Which is better between transesophageal and transthoracic echocardiograms?

A transesophageal echocardiogram takes images from inside the body and, thus, shows the heart and its valves in a detailed manner. Hence this is a better diagnostic test.

What are the risks associated with transesophageal echocardiogram?

Some of the complications associated with transesophageal echocardiogram are:

  • Allergy to the medications
  • Aspiration pneumonia
  • Problems related to blood pressure and heart rhythms
  • Minor bleeding in the esophagus

What are the things that one should avoid before undergoing a transthoracic echocardiogram?

One should avoid drinking, smoking, or using any substance that contains nicotine. One should not drink coffee or consume any product that contains caffeine. Over-the-counter medications that contain caffeine should also be avoided.

Advanced Technology & Facilities

Transthoracic & Transoesophageal Echocardiography

A transesophageal echocardiogram can be done using one of the following methods:

  • M-mode echocardiography: It is the simplest type of echocardiography. It is used to measure heart structures, the pumping chambers, the heart's size, and the heart's walls' thickness.
  • Doppler echocardiography: It assesses blood flow through the heart's chambers and valves. The amount of blood coming out with each heartbeat indicates the heart functioning. Doppler can detect any abnormal blood flow within the heart.
  • Color Doppler: Color Doppler can be used to designate different colors to the direction of blood flow. This technique helps to interpret the results of Doppler echocardiography easily.
  • 2-D echocardiography: This technique helps to see the heart in motion.
  • 3-D echocardiography: This technique helps in a more accurate assessment of the heart's function. It is taken at the time the heart is beating.

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