Transthoracic Echocardiogram (TTE) with 2D Colour Doppler Imaging

An echocardiogram is a cardiac ultrasound that uses sound waves to assess the condition, structure, function, and size of the heart chambers. When combined with cardiac Doppler, it can also detect abnormalities in blood flow within the heart.

Clinical Indications for Transthoracic Echocardiogram

• Arrhythmias (e.g., symptomatic arrhythmia, asymptomatic frequent APB, paroxysmal or permanent A-Fib or A-Flutter, frequent VPB, non-sustained VT, sustained VT, LBBB, high-grade AV blocks, WPW)

• Syncope, palpitations

• Chest pain (or ischemic equivalent syndrome) and CAD (coronary artery disease)

• Dyspnea, edema, cardiomyopathy

• Heart murmurs (evaluation and re-evaluation of known disease)

• Hypertension

• Thoracic aortic disease (e.g., dilation of the aortic root or ascending aorta, Marfan syndrome, or other connective tissue disorders)

• Valvular stenosis (assessment and re-assessment of known disease)

• Valvular regurgitation (assessment and re-assessment of known disease)

• Known or suspected mitral valve prolapse (assessment and re-assessment of known disease)

• Suspected structural heart disease

• Congenital or inherited structural heart disease (e.g., bicuspid aortic valve, Marfan syndrome, atrial septal defect (ASD), ventricular septal defect (VSD), Ehlers-Danlos syndrome—assessment and re-assessment of known structural disease)

• Prosthetic heart valves

• Infective endocarditis

• Pericardial disease

• Cardiac masses

• Pulmonary diseases (assessment and re-assessment)

• Neurologic or other possible embolic events (e.g., stroke or TIA)

(Source: Standards for Provision of Echocardiography in Ontario, 2021)

Limitations of Transthoracic Echocardiogram

Due to the limitations of echocardiography, approximately 20% of patients have heart images that may not be clearly visible. To improve image clarity, we use contrast echocardiography with a contrast agent called Definity, which enhances the visualization of heart structures and blood flow.

For comprehensive information about contrast echocardiography, indications, and additional details about Definity, please visit our "For Doctors: Contrast Echocardiography" section.

Report Processing

The echocardiography report is meticulously analyzed by a cardiologist. A detailed report, including conclusions and clinical recommendations, is sent directly to the referring physician. This ensures that patients receive timely and accurate follow-up care.

Next Steps

To refer a patient for echocardiography or other diagnostic modalities, please download the Requisition Form and fax it to our Requisition Processing Centre at 647-351-6648.