Clinical indications and triaging for adult transthoracic echocardiography - a statement by the British Society of Echocardiography

Sep 27, 2026

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Transthoracic echocardiography (TTE) is a widely used non-invasive imaging method across clinical practice, with demand continually increasing and creating delays for patients. The British Society of Echocardiography provides updated guidance on the clinical indications and triaging of adult TTE requests to standardize patient care, improve value for patients, and support a more sustainable TTE service. The guideline is intended for use across the United Kingdom and is based on evidence and clinical consensus.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

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Introduction

Abstract

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Bennett et al. Echo Research & Practice 2022, 9(1):5 [https://doi.org/10.1186/s44156-022-00003-8](https://doi.org/10.1186/s44156-022-00003-8) Echo Research & Practice GUIDELINE Open Access Clinical indications and triaging for adult transthoracic echocardiography: a statement by the British Society of Echocardiography Sadie Bennett1*, Martin Stout2, Thomas E. Ingram3, Keith Pearce2, Timothy Griffiths1, Simon Duckett 1, Grant Heatlie1, Patrick Thompson4, Judith Tweedie4, Jo Sopala5, Sarah Ritzmann6, Kelly Victor7, Judith Skipper8, Shaun Robinson9, Andrew Potter10, Daniel X. Augustine 11,12 and Claire L. Colebourn 13 Abstract Transthoracic echocardiography (TTE) is widely utilised within many aspects of clinical practice, as such the demand placed on echocardiography services is ever increasing. In an attempt to provide incremental value for patients and standardise patient care, the British Society of Echocardiography have devised updated guidance for the indicationsand triaging of adult TTE requests forTTE services to implement into clinical practice. Keywords Transthoracic echocardiography, Echocardiography, Indications, Triage Introduction Transthoracic echocardiography (TTE) is widely accepted as the first choice non-invasive imaging modality for the assessment of cardiac structure and function. TTE is versatile, widely available and low-cost as such it forms a crucial part for a patient’s pathway throughout *Correspondence: Sadie Bennett [Sadie.Bennett@uhnm.nhs.uk](Sadie.Bennett@uhnm.nhs.uk) 1 University Hospitals of North Midlands, Stoke‑on‑Trent ST4 6QG, UK 2 Manchester University NHS Foundation Trust, Manchester, UK 3 Shrewsbury and Telford Hospitals NHS Trust, Shrewsbury, UK 4 Southern Health and Social Care Trust, Craigavon Area Hospital, Portadown, UK 5 British Society of Echocardiography, London, UK 6 Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust Doncaster Royal Infirmary, Doncaster, UK 7 Cleveland Clinic, London, UK 8 Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK 9 North West Anglia Foundation Trust, Peterborough, UK 10 Whaddon Healthcare, Milton Keynes, UK 11 Royal United Hospitals Bath NHS Foundation Trust, Bath, UK 12 Department for Health, University of Bath, Bath, UK 13 Oxford University Hospitals NHS Foundation Trust, Oxford, UK clinical practice including initial diagnosis, management and follow-up of many cardiac [1, 2] but also non-cardiac conditions. The demand on TTE services continues to rise year upon year with data from National Health Service England indicating a ~ 3% increase in TTE activity for 2019 alone [3]. This continued increase in activity will invariably result in delays to patients accessing TTE’s services. As such, the British Society of Echocardiography (BSE) have written an update to the previous ‘Clinical Indications for Echocardiography’ [4] in an attempt to assist healthcare professionals in recognising when TTE is indicated and will provide incremental value to the management of a patient. This guide also provides guidance on the implementation of a standardised triaging system for TTE requests. It is thought that together this can achieve a more sustainable service for the benefit of our patients. This guideline is based on evidence from relevant clinical studies and/or general agreement from clinical practice. It is intended to be used by all BSE members throughout the United Kingdom. It will be regularly reviewed (5 yearly) and updated in accordance with changes as directed by publications and/or changes in © The Author(s) 2022, corrected publication 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence,

FAQs

What is the purpose of the guideline on adult transthoracic echocardiography requests?

To standardize clinical indications and triage for adult TTE requests, helping clinicians recognize when TTE is indicated and expected to provide incremental value.

Why is triaging guidance needed for TTE services?

TTE service demand is rising, which can lead to delays in patients accessing TTE, making a structured triaging approach necessary.

How is the guideline intended to be used and maintained?

It is intended for all BSE members across the United Kingdom and is planned to be regularly reviewed and updated in line with changes directed by publications and clinical practice.

Sep 27, 2026

Uploaded by SANS