transthoracic echocardiogram (TTE)
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Introduction
Also see echocardiography.
Indications
- initial diagnostic test for suspected or known structural heart disease
- heart failure
- cardiomyopathy
- valvular heart disease
- symptomatic patients
- asymptomatic patients with
- grade 3/6 or higher systolic murmur
- holosystolic murmer
- diastolic murmur or continuous murmur
- congenital heart disease
- pulmonary hypertension
- aortic disease
- pericardial disease
- rheumatic fever
Contraindications
- visualization of aortic arch
- cannot rule out aortic dissection[1]
Advantages
- identifies presence & severity of structural heart disease
- quantification of
- LV size & function
- RV size & function
- pulmonary artery pressures
- valvular stenosis, including mitral stenosis
- valvular insufficiency
- intracardiac shunts
- identifies pericardial disease
- good visualization of aortic root & proximal ascending aorta
- no known adverse effects
- widely available, portable, fast
Disadvantages
- operator-dependent data acquisition
- interpretation requires expertise
- variability in instrumentation
- image quality limits diagnosis in some patients*
* microbubble contrast may improve image quality[1]
Procedure
* video[4]
More general terms
More specific terms
References
- ↑ 1.0 1.1 1.2 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018.
- ↑ Matulevicius SA, Rohatgi A, Das SR et al Appropriate use and clinical impact of transthoracic echocardiography. JAMA Intern Med. 2013 Sep 23;173(17):1600-7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23877630
- ↑ FDA News Release. Feb 7, 2020 FDA Authorizes Marketing of First Cardiac Ultrasound Software That Uses Artificial Intelligence to Guide User https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-first-cardiac-ultrasound-software-uses-artificial-intelligence-guide-user
- ↑ 4.0 4.1 Hiraki N, Tanaka TD, Yoshimura M A Man With Left Ventricular Hypertrophy JAMA Cardiology. 2022;7(2):225-226. December 22, 2021 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34935854 https://jamanetwork.com/journals/jamacardiology/fullarticle/2787016
JN Learning JAMA Network (Video) https://edhub.ama-assn.org/jn-learning/video-player/18663312