Free TTE Guide & Scanning Tips
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Free TTE Guide & Scanning Tips
Transthoracic echocardiography (TTE) uses a phased array probe to transmit sound waves into the body and generate an image. Inside the probe, an electrical current vibrates piezoelectric crystals, which send sound waves into the body.
These crystals also detect the returning waves and send them to scan converters in the system. The resulting reflections, or “echoes,” are then used to create a diagnostic image. The speed of sound propagation is determined by the medium through which it travels, with sound waves moving slowest through air, gas, and adipose tissue.
The Ultimate 16-Page TTE Guide
Sharpen your transthoracic echocardiography imaging skills with this comprehensive guide.
We’re grateful to our readers around the world who support our mission to digitize echo education—making it simpler, clearer, and more accessible for everyone.
💡 Did You Know?
Echocardiography is a relatively young field—just about 70 years old. In 1953, Swedish cardiologist Dr. Inge Edler and physicist Carl Hellmuth Hertz borrowed a sonar device originally designed to detect cracks in metal. Their bold idea? Use sound waves to image the heart in real time. It worked—the first M-mode tracing of the mitral valve was recorded, and echocardiography was born.
Standard Views Overview
These are the most common transthoracic echocardiographic views, described in greater detail in the guide above. Remember that patient positioning and breathing techniques can significantly influence 2D image quality—along with the three optimization tips outlined below.
Parasternal long-axis (PLAX)
Parasternal short-axis (PSAX)
Apical four-chamber (A4C)
Subcostal (SC)
Suprasternal Notch (SSN)
3 Ways To Improve Image Quality
1. Optimize Frame Rate
The heart moves quickly, especially valves and walls, so higher frame rates improve temporal resolution. To increase frame rate, reduce image depth, minimize the number of focal zones, narrow the sector width, or use zoom strategically.
2. Adjust Sector Depth & Width
Avoid scanning more tissue than necessary. Excessive depth and wide sector angles force the system to process more data, lowering frame rates and image quality. Focus on the region of interest to keep the image sharp.
3. Fine-Tune Transducer Focus
Position the focal zone at or just below the structure of interest. This narrows the ultrasound beam at that depth, enhancing lateral resolution and producing a clearer, more detailed image.
Transducer Movements
Tilt – Keep the axis the same, but shift to a different imaging plane.
Sweep – Use multiple movements to capture a long video clip showing several structures.
Rotate – Hold the probe in place while turning the index marker to a new position.
Slide – Move the probe across the skin to a different location.
Rock – Within the same plane, adjust the probe toward or away from the marker.
Angle – Keep the probe in the same spot, but direct the beam to visualize a new structure.
You’ve just taken another step toward echo mastery. Our mission is to make echocardiography education simple, accessible, and effective—whether you’re preparing for boards or refining your clinical skills. Stay tuned for upcoming lessons, and don’t hesitate to share this resource with colleagues who might benefit.
Our next lesson drops Tuesday—and it features a rare case unlike anything we’ve encountered before. You won’t want to miss this one.
