The Different Types Of Echocardiograms

December 16, 2021

What is an echocardiogram and what can it detect?

An echocardiogram is a scan that uses sound waves to create images of the heart and its surrounding blood vessels. There are several different types of echocardiograms, and the one which is used will depend on the information the doctor requires.

There are two main types of standard echocardiograms:

  • Transesophageal echocardiogram
  • Transthoracic echocardiogram

Standard echocardiograms are used to check for heart problems, such as abnormalities with the heart’s chambers or valves. The scan can help doctors to ascertain whether heart problems are causing symptoms such as chest pain or breathing difficulty. It can also be used to detect congenital heart defects in a baby during pregnancy. This is known as a fetal echocardiogram.

What does an echocardiogram show?

Conditions and diseases that echocardiograms can be used to detect include:

  • Aneurysm
  • Atrial wall defects
  • Septal wall defects
  • Atherosclerosi
  • Cardiac tumor
  • Cardiomyopathy
  • Congenital heart disease
  • Heart failure
  • Heart valve disease
  • Pericarditis
  • Pericardial effusion

An echocardiogram uses a small probe that emits high-frequency sound waves. These sound waves create echoes that bounce off the body and are picked back up by the probe, before being turned into a moving image that is viewed on the monitor during a scan. From the images, the heart rhythm, as well as the blood flow to and from the heart, can be seen.

Normal vs abnormal echocardiogram

Depending on the results of the scan, an echocardiogram is described as normal or abnormal. The image that an echocardiogram produces can allow heart health, strength, and function to be monitored.

Atrial or septal walls that are 1.5cm thick or more can be considered abnormal and may indicate damaged valves or high blood pressure. If the walls are contracting more or less than they should, they may be pumping abnormally. The adult average for blood pumped per minute (known as the cardiac output) is 4.8 to 6.5 liters when the body is at rest.

An abnormal echocardiogram can show a low or high output outside this average bracket. Abnormal echocardiograms could also show the heart’s valves opening and closing improperly, or that there are defects such as passages in between blood vessels or openings in between the chambers of the heart.

Types of echocardiograms

The two main types of echocardiograms are a transesophageal echocardiogram and a transthoracic echocardiogram. Sometimes a technique called intracardiac echocardiogram will be used.

Rather than using sound waves to produce images of the heart, an intracardiac echocardiogram uses a probe at the tip of a catheter that is threaded to the heart via a blood vessel. The procedure can offer more detailed moving imagery and is used when the visualization of certain structures is required.

An intracardiac echocardiogram is only used on rare occasions, so in this section, we will focus mainly on the two main types of standard echocardiogram:

Transesophageal echocardiogram

A transesophageal echocardiogram is a scan that provides detailed images of the heart. The procedure begins with the numbing of the throat. Medications are usually given for relaxation. The probe is guided down the throat and into the esophagus. The probe records the sound wave echoes as they bounce back from the heart.

The computer will convert the echoes into moving images of the heart that can be viewed in real time. The ultrasound image is created by calculating the time the electrical pulse, sent out by the heart each time it beats, takes to travel around the body.

Transthoracic echocardiogram

A transthoracic echocardiogram is the most common form of echocardiogram. The procedure requires a technician to spread gel on a probe, before it is placed firmly against the skin. High-frequency sound waves are aimed at the heart through the chest, and the probe records the sound wave echoes as they bounce back. A computer then converts these echoes into moving imagery.

Imaging software for a transthoracic echocardiogram can be vital to efficiency when measuring clinical indications. Today’s most advanced echocardiography software, such as the Circle CVI LVivo Solution, offers automated tools that use AI to pre-select optimal views and significantly reduce report generation time.

Stress echocardiogram

A stress echocardiogram can be ordered when chest pain could indicate coronary artery disease or a heart attack. The procedure requires the patient to exercise on a stationary bike or treadmill until the heart reaches peak levels. The doctor will monitor your heart rhythm and blood pressure, and then take ultrasound images of the heart. This can show whether the heart muscles are receiving sufficient oxygen and blood during exercise.

Transthoracic echocardiogram vs transesophageal echocardiogram

A transthoracic echocardiogram is a more basic and less invasive version of a transesophageal echocardiogram. While a transesophageal echocardiogram involves the insertion of a probe into the esophagus, a transthoracic echocardiogram can be performed by simply placing the probe against the skin. Both procedures use echoes from sound waves to create imagery.

Are echocardiograms accurate?

A study into the accuracy of transthoracic echocardiogram for diagnosing bicuspid aortic valve found that the procedure “yields almost ideal diagnostic accuracy when ideal investigators examine an ideal patient” but that “TTE yields suboptimal diagnostic accuracy under routine conditions”. Other research found that the procedure “has a low sensitivity and extremely high specificity”, making it “an excellent rule in test for the detection of intracardiac RLS”.

Another study into the role of echocardiography in heart failure assessment concluded that “cardiac imaging is indispensable in the management of heart failure. Echocardiography is the most widely used test for this purpose and the most versatile in terms of providing clinically relevant information”.


Echocardiography has proven to be highly effective in the assessment of heart function. Supported by the latest imaging software, such as the Circle CVI LVivo Solution, echocardiography allows the detection and monitoring of a variety of heart problems and the measuring of clinical indications.

To understand more about the capabilities of Circle CVI’s echocardiography LVivo Solution, why not download a free 42 day trial of cvi42, the most powerful, multi-modality cardiovascular imaging tool on the market.