Echocardiography Modalities
Short descriptions of specific modalities and guidelines regarding the length of
the exam.
Examples
Adult Transthoracic (TTE) study:
Multiple images and measurements of the heart are obtained from a variety of
imaging windows and stored digitally for reading. All images, Doppler, and
measurements are obtained through the chest wall. This is a noninvasive test.
A complete comprehensive study can take 30 to 45 minutes to complete
depending on the pathology seen.
Transesophageal Echo (TEE) study:
A specialized transesophageal probe is passed by the Cardiologist into the
client’s esophagus and the imaging is completed through the esophageal wall.
Many images and measurements are completed with 2D and 3D capabilities.
This is an invasive test that requires sedation, monitoring and additional staff
monitoring during recovery phase. Used for a more detailed examination of the
heart than obtained by TTE.
TEEs take 60 minutes from start to finish – 30 minutes of prep work, 20 – 30
minutes of imaging. There is an additional 45 – 60 minutes of recovery
depending on the sedation used.
Stress Echo – Dobutamine:
A specialized test that involves cardiac imaging, medication administration, 12lead ECG monitoring, vitals monitoring and additional staffing. An IV is started
and medication is administered that has inotropic and chronotropic effects on the
heart. The test determines how well blood and oxygen move through the
coronary arteries to the muscle of the heart.
This test takes 60 minutes from start to finish – 20 minutes of prep time and
resting image acquisition – 15 to 20 minutes of medication administration and
peak imaging – and 20 minutes for the heart to return to normal and post
imaging.
Stress Echo – Treadmill:
A combination test of cardiac imaging, treadmill walking, vitals monitoring and
12-lead ECG acquisitions. Resting images are taken, followed by the client
walking on the treadmill until one of the listed end points for the test occur. The
client is quickly returned to the bed for continuous capture of peak images and
recovery images.
This test takes 45 minutes to complete.
Stress Echo – Bicycle:
Specialized stress bed is required that has a bicycle attached. The client is
secured onto the bed and instructions are given. Resting images are taken with
the bed turned so the client is lying on their left side. The bed is returned to a
supine position and the client bicycles until an end point for the test has been
reached. The bed is returned to a left sided position while the client continues to
bicycle and peak images are taken.
This test takes approximately 45 minutes to complete.
Contrast and agitated saline
In addition to completing the above services 10 to 20 minutes can be added to
the time for additional imaging with a contrast agent or agitated saline study.
Contrast may be used for a variety of reasons but the most common is to
visualize the muscle of the heart. Difficult-to-image patients are common and
require an intravenous and contrast injection to improve the quality of the
assessment.
Agitated saline studies are added to a transthoracic or transesophageal study to
rule out shunt flow.