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Cardiac Imaging

TTE      TOE

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Transthoracic Echocardiogram (TTE) 

An echocardiogram or “echo” is a type of ultrasound. In terms of a transthoracic echo (TTE), the test is non-invasive and uses sound waves to produce a moving image of your heart. The cardiac sonographer will use a device known as a transducer to press against gel applied to the skin of your chest, and direct sound waves to your heart. These sound waves generate images of the tissues and spaces in your heart, and allows a doctor to see any abnormalities in the cardiac structure or blood flow.

Your doctors may refer you for an echocardiogram to gather information about how your heart is built, and how it is positioned within your chest.


By creating an ultrasound image, we can view the size and thickness of your heart chambers, valves, and the sac that holds your heart muscles and assess how well they function, as well as evaluate your risk of having blocked arteries, also known as coronary artery disease.

During an Echocardiogram, you will be asked by the cardiac sonographer to remove your top clothing and lie on the exam couch. The lights will be dimmed so that the cardiac sonographer can see the black and white images as clearly as possible. You may be asked to roll on your side or hold your breath, so the heart is at its most visible through the chest wall. The sonographer may press firmly with the transducer which can cause some discomfort, but it is tolerable and often only for a few seconds. The entire test should take no more than 30 minutes, and you are able to return to normal activities as soon as you have completed the procedure. There are also no known risks associated with an Echocardiogram, with no radiation used in the test, and no invasive measures used.


For the test you should wear comfortable clothing with tops that are easily removed. Smoking should be avoided for 4 hours before the test, and caffeine products such as coffee, cola, or tea for 2 hours before the test. There will be no down time after the procedure and you can return to normal activity immediately.

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Transoesophageal Echocardiogram (TOE) 

An echocardiogram or 'echo' is a type of ultrasound. Ultrasound waves are used to create a moving image of your heart, which allows your doctor to assess the tissues and spaces in your heart. There are cases in which a transthoracic echocardiogram cannot obtain a sufficient image of difficult to access areas of your heart, due to the ribs and lungs interfering with the sound waves. In these situations, or when there are concerns of infections, growths, or tumours in hidden parts of the heart, a transoesophageal echo (TOE) is required.

At Australian Cardiology, we maintain great networks within private and public hospitals in Melbourne which allows your doctor greater flexibility when  arranging a TOE for you. Our staff will organise for you to attend one of these hospitals, and under a sedation or general anaesthetic, a thin scope will be inserted through your mouth, into the throat and oesophagus. By producing the sound waves from this vantage point, the heart can be visualised very closely and in further detail than the standard TTE.

At the time of your TOE, an intravenous line will be inserted to allow for administration of sedation or anaesthetic. You will be given a  numbing spray and gargle, and you will be asked to lie on your left side on the exam table. You will be given a plastic guard to protect your teeth and the scope during the procedure. The scope will pass into your mouth and throat, and swallowing may be required to ease the positioning in the oesophagus. Once the scope is in place, there should be no discomfort, and the process should take between 30 – 90 minutes.

Once the procedure is complete, you will be required to wait until the sedation and numbness has worn off, and invited to drink some cool fluids. As long as there are no issues with this, the nursing staff will offer you something to eat, and encourage you towards discharge. Your accompanying person is then able to transport you home.

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