Your Child's Echocardiography
Transthoracic echocardiography (TTE) is an imaging test that uses sound waves (ultrasound) to form pictures of the heart. The test can show problems with heart structure or heart function. This includes showing blood flow, how well the heart pumps, or if the heart is enlarged.
Transesophageal echocardiography (TEE) is similar to a TTE, but it’s done from inside the esophagus (food pipe). Because the esophagus lies just behind the heart, a TEE gives clearer pictures than a TTE taken from outside the chest.
Before TTE or TEE
You’ll be told whether to keep your child from eating or drinking anything for a certain amount of time before the test. Follow these instructions carefully.
Let the technologist or doctor know if your child:
During TTE or TEE
TTE or TEE is performed by a technologist or a specially trained cardiologist. A cardiologist is a doctor who can diagnose and treat heart problems. The tests take place in a hospital. TTE lasts about 30 minutes. TEE lasts about 60 minutes.
With a TTE, a transducer is moved across your child’s chest to take pictures of the heart.
Ask your child’s healthcare provider if you can stay with your child during the test.
For both tests, your child lies on an exam table with his or her shirt off.
If your child is having a TEE, he or she is given a pain reliever and a sedative (medication that makes your child relax or sleep). This is done by mouth or an intravenous (IV) line. Or, your child is given anesthesia (medication that makes your child sleep and not feel pain). This is done by facemask or IV. If your child is having a TTE, these medications are rarely used.
A breathing tube may be placed in your child’s trachea (windpipe). Special equipment monitors your child’s heart rate, blood pressure, and blood oxygen levels.
During a TTE, clear, non-greasy gel is applied to your child’s skin. Then the doctor moves a transducer (small probe) across the chest. This device creates the sound waves that form pictures of your child’s heart. The pictures are seen on a video screen.
During a TEE, a long, flexible wand with a transducer (probe) on the end is used to take pictures of your child’s heart. First, your child’s throat is numbed. The wand is lubricated to allow it to slide easily. Then it is guided down the throat into the esophagus. The doctor moves the wand up, down, and sideways to look at your child’s heart from different angles. As with a TTE, images of your child’s heart are viewed on a screen.
Risks and Possible Complications of TTE or TEE
Reaction to sedative or anesthesia
Sore throat or problems swallowing (only with TEE)
Injury to teeth, mouth, esophagus, or stomach (rare, and only with TEE)
After TTE or TEE
If a sedative or anesthesia was given, your child is taken to a recovery room. It may take 1–2 hours for medications to wear off.
Unless told not to, your child can return to his or her normal routine and diet right away.
After TEE, your child’s throat may be sore. If the throat was numbed, your child will need to be careful when eating for a few hours.
The doctor may discuss early results with you right after the test. You’ll receive complete results when they’re ready.
After TTE or TEE, call the doctor if your child has any of the following:
How to Help Your Child Prepare
You can help your child by preparing him or her in advance. How you do this depends on your child’s needs.
Explain the test to your child in brief and simple terms. Younger children have shorter attention spans, so do this shortly before the test. Older children can be given more time to understand the test in advance.
Make sure your child understands which body part(s) will be involved in the test.
As best you can, describe how the test will feel. An IV may be inserted into the arm or hand to give medications. This may cause a brief sting. Your child won’t feel any discomfort once the medications take effect.
Allow your child to ask questions and answer these questions truthfully. Your child may feel nervous or afraid. He or she may even cry. Let your child know that you’ll be in the room or nearby during the test.
Many hospitals have a child life specialist. This person is specially trained to help children understand what to expect during their time in the hospital. Books, videos, dolls, and toys may be used to help explain the procedure to your child. Be sure to ask your child’s doctor about the resources available at your hospital.