What is a transesophageal echocardiogram?

A transesophageal echocardiogram (TEE) is a test that uses sound waves (ultrasound) and a computer to look at your beating heart. For this test, a tiny probe called a transducer is attached to a flexible lighted tube and carefully placed through your mouth into your esophagus and down behind your heart. The esophagus is the tube that carries food from the throat to the stomach. The probe and computer use sound waves to create a moving picture of the heart valves, chambers, blood vessels, and the heart muscle itself.

When is it used?

TEE is used to see parts of the heart that cannot be seen with a transducer placed on the outside of the chest. Because the probe is much nearer your heart when it is inside you, the TEE gives very clear pictures.

TEE may be used to:

• Diagnose infections of the heart valves
• Check for small blood clots in the heart
• Find small holes in your heart that allow blood to pass between the two upper chambers of the heart
• Diagnose aortic dissection, which is a split or tear in the big blood vessel leading from your heart to the rest of your body

How do I prepare for the procedure?

• Arrange for someone to take you home after the test.
• You may or may not need to take your regular medicines the day of the procedure. Some medicines may keep your heart rate from increasing to the level needed for the test. Tell your healthcare provider about all medicines and supplements that you take. Ask your provider if you need to avoid taking any medicine or supplements before the procedure.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

The TEE may be done in your healthcare provider’s office or at the hospital. Your heartbeat and breathing will be checked. The back of your throat will be sprayed with local anesthetic, which will make your throat numb and keep you from gagging. You will be given medicines that make you feel relaxed, but you will stay awake. The healthcare provider will then pass the probe down your esophagus.

The procedure may be as short as a few minutes or last for a half hour or longer. The ultrasound waves from the probe are recorded for later review by your healthcare provider.

What happens after the procedure?

After the procedure, you can go home as soon as you are awake and alert enough to be driven home. Your provider may recommend that you not eat or drink anything until your throat is no longer numb, which may take several hours.

Ask your healthcare provider:

• How and when you will hear your test results
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks?

Every procedure or treatment has risks. Some possible risks of this test include:

• You may have problems with anesthesia.
• Your throat may be sore for a few hours afterward.
• You may have a small tear in the esophagus when the probe is passed. If this happens, the tear may heal by itself or it may need stitches.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.