Echocardiogram (echo) is a procedure used to assess the heart's function and structures through the use of sound waves (ultrasound). Echocardiogram is obtained by applying a transducer to the front of the chest, also known as a transthoracic echo. A Transesophageal echocardiogram (TEE) test is a type of the echo test in which the ultrasound transducer, positioned on an endoscope, is guided through the throat and into the esophagus (the food tube that connects the mouth to the stomach).
- Transesophageal echocardiogram test is especially useful in cases in which conventional echocardiography cannot offer a good image.
-Transesophageal echocardiogram is used to evaluate the internal heart structures and path of blood flow in congenital (present at birth) heart defects.
-Transesophageal echocardiogram is also used during heart surgery to evaluate the effects of surgical intervention to the heart, such as repair of congenital heart defects. Further, certain conditions of the heart, such as mitral valve disease, blood clots or masses inside the heart, dissection (tear) of the lining of the aorta (the artery which carries oxygenated blood from the heart to the body), and implanted prosthetic (artificial) heart valves may be better visualized and assessed with a transesophageal echocardiogram than with regular echocardiogram.
- Transesophageal echocardiogram is also done to evaluate for blood clots in the heart prior to cardioversion or ablation procedures.
Transesophageal echocardiogram may be performed on an outpatient basis or as part of your stay in a hospital. You will be asked to to stop eating for at least 4-6 hours before the test. You will then be connected to an electrocardiogram monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes. The vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be monitored during the procedure. A sedative is given through an intravenous (IV) line to help with relaxation and the throat is sprayed with an anesthetic to "numb" it. A probe is passed through the mouth and into the esophagus. It is carefully moved until it is positioned directly next to the heart. Once the probe is in the right place, the images will be obtained. After the necessary images are obtained, the probe will be removed from the throat. The procedure generally lasts 30-45 minutes.
Please avoid all food and water for at least four hours before the test, including medication, unless directed to do otherwise by the doctor. Please bring a list of all medications that you are taking with you to the hospital on the day of the test.
After having transesophageal echocardiogram, your blood pressure, blood oxygen level, and other vital signs will be closely monitored. When your gag reflex has returned, your vital signs are stable, and you are more alert, the electrocardiogram electrode pads, the oxygen probe, and the intravenous will be removed. You can likely go home a few hours after having the test. If a sedative has been given, patients should not drive or operate heavy machinery for at least 10-12 hours. Eating and drinking should be avoided for at least 2 hours because the throat will still be numb and the food or drink can potentially be aspirated into the lungs. Your throat may be sore for a few days following the procedure due to the insertion of the transesophageal echocardiogram probe. It is unusual to experience bleeding, persistent pain or fever. If these symptoms persist, you should report to the physician.
Patients with known problems of the esophagus, such as esophageal varices, esophageal obstruction, or radiation therapy to the area of the esophagus should be evaluated carefully by the physician before having the procedure. Patients who are allergic to or sensitive to medications or latex should notify their physician. Possible risks associated with a transesophageal echocardiogram include, but are not limited to, the following: -Breathing problems -Heart rhythm problems -Bleeding and perforation of the esophagus -Aspiration -A rare risk of death
Why might I need a Transesophageal echocardiogram?
Transesophageal echocardiography may be done to evaluate signs and symptoms that may suggest:
-Atherosclerosis. This is a gradual clogging of the arteries by fatty materials and other substances in the blood.
-Cardiomyopathy. This is an enlargement of the heart due to thickening or weakening of the heart muscle.
-Congenital heart disease. These defects occur during formation of the fetus' heart. TEE can help assess and locate the abnormality as well as determine its effect on heart blood flow.
-Heart failure. A condition in which the heart muscle has become weakened to an extent that blood can’t be pumped efficiently. This can cause fluid buildup (congestion) in the blood vessels and lungs, as well as the feet, ankles, and other parts of the body.
-Aneurysm. This is a weakening and bulging of a part of the heart muscle or the aorta (the large artery that carries oxygenated blood out of the heart to the rest of the body).
-Heart valve disease. Malfunction of one or more of the heart valves that may block blood flow within the heart or result in blood leaking backwards (regurgitation).
-Cardiac tumors .A tumor of the heart may occur on the outside surface of the heart, within one or more chambers of the heart, or within the muscle tissue of the heart.
-Pericarditis. This is an inflammation or infection of the sac that surrounds the heart.
-Infective endocarditis. This is an infection of the heart, usually affecting the heart valves.
-Aortic dissection. This is a tear in the wall of the aorta.
-Blood clot and stroke. Blood clots can form inside the heart chambers, break free, and then flow to the brain or other areas of the body. This can cause a stroke or other problems. Most often these clots form with irregular heart rhythms or stagnant blood flow in the heart.
How will I feel during the test?
The sedative may make you drowsy. We will keep you as comfortable as possible. Please let us know if you feel uncomfortable at any time. Your throat may be sore or numb after the test. These feelings will go away.