When you visit a cardiologist with concerns about your heart, they may recommend tests to check how well your heart is working. You might hear about a transthoracic echocardiogram (TTE), an ECG, a stress test, or even a transoesophageal echocardiogram (TEE). But how do these tests differ, and when is a TTE the preferred choice?
Understanding what each test does can help you feel more informed and prepared when discussing your heart health with your doctor.
What Is a Transthoracic Echocardiogram (TTE)?
A TTE is a non-invasive ultrasound scan of the heart. It uses sound waves to create real-time images, allowing the cardiologist to see how your heart is pumping and whether there are any structural issues.
A probe is placed on the chest with some gel to help transmit sound waves, and the test is completely painless. It can provide detailed information about:
- How well your heart is pumping.
- Whether your heart valves are working properly.
- If there is fluid around the heart.
- Signs of heart disease or structural abnormalities.
A TTE is often one of the first imaging tests a cardiologist orders because it gives a clear and detailed picture of the heart’s function without requiring any invasive procedures.
How Does TTE Compare to Other Heart Tests?
A TTE isn’t the only way to check heart health. Depending on your symptoms and medical history, a cardiologist might choose another test or use multiple tests together. Here’s how a TTE compares to other common heart tests:
1. ECG (Electrocardiogram) – Checking the Heart’s Electrical Activity
An ECG records the electrical signals in your heart using small sticky patches (electrodes) placed on your chest, arms, and legs. It does not show images of the heart but instead provides a graph of its electrical activity.
When is an ECG used?
✔ To check for irregular heart rhythms (arrhythmias).
✔ To detect signs of a previous heart attack.
✔ To monitor heart rate and electrical function.
How is it different from a TTE?
- An ECG measures electrical signals, while a TTE shows moving images of the heart.
- A TTE can assess heart structure, while an ECG cannot.
2. Stress Test – Seeing How the Heart Responds to Activity
A stress test assesses how the heart functions when it’s working harder, usually during exercise. You may walk or run on a treadmill while wearing ECG electrodes to measure heart rate and rhythm. In some cases, imaging (like a TTE or nuclear scan) is added to see how blood flows through the heart during exertion.
When is a stress test used?
✔ To assess blood flow to the heart muscle.
✔ To check for signs of coronary artery disease.
✔ To evaluate exercise tolerance and heart function.
How is it different from a TTE?
- A stress test measures how the heart responds to physical effort, while a TTE provides detailed images of the heart at rest.
- A TTE does not involve exercise, making it suitable for those who cannot perform physical activity.
3. Transoesophageal Echocardiogram (TEE) – A Closer Look Inside the Heart
A TEE is similar to a TTE but involves a probe being inserted down the throat to get clearer images of certain parts of the heart. Since the oesophagus is located close to the heart, this test provides more detailed views of the heart’s valves and chambers.
When is a TEE used?
✔ When TTE images are unclear due to body structure or lung interference.
✔ To check for blood clots inside the heart (especially in patients with irregular heartbeats like atrial fibrillation).
✔ To examine heart valve infections or abnormalities.
How is it different from a TTE?
- A TEE provides sharper images of the heart’s internal structures, but it is slightly more invasive as it requires sedation.
- A TTE is more commonly used for initial heart assessments.
When Would a Cardiologist Recommend a TTE?
A TTE is often the first imaging test a cardiologist recommends because it is non-invasive, painless, and provides a clear picture of heart function. You may be advised to get a TTE if:
✔ You have unexplained shortness of breath, fatigue, chest pain, or swelling.
✔ A heart murmur or irregular heartbeat has been detected.
✔ You have a history of heart disease, high blood pressure, or other risk factors.
✔ Your doctor needs to assess heart valves, heart muscle function, or signs of fluid around the heart.
What to Do If You Need a Heart Test
If your doctor has recommended a TTE or another heart test, it’s normal to have questions. Understanding why a test is suggested and what it can reveal about your heart health can make the process less stressful. At The Heart Specialist, Dr Paul Ong can help you understand which test is right for you and what to expect during the process. If you’re experiencing heart symptoms or have concerns about your heart health, book a consultation with Dr Paul Ong at The Heart Specialist today. Early testing can provide important insights and help you take the right steps for your heart health.
