What is a Transesophageal Echo (TEE)?

A Transesophageal echocardiogram (often called TEE) uses sound waves to produce an image of the heart's movement.  During a TEE, ultrasound (high-frequency sound waves) is used to provide pictures of the heart's valves and chambers. The ultrasound transducer is positioned on an endoscope (a long, thin, flexible instrument about 1/2 inch in diameter). The endoscope is placed into your mouth and passed into your esophagus (the "food pipe" leading from your mouth into your stomach) to provide a close look at your heart's valves and chambers without interference from the ribs or lungs.
TEE also uses Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves. TEE is often used when the results from standard echo studies were not sufficient or when your doctor wants a closer look at your heart.

What is a TEE used for?

• To assess the heart’s function
• Determine the presence of:
  • disease of the heart muscle, valves and pericardium,
  • blood clots within the heart,
  • heart tumors
  • congenital heart disease
• Evaluate the effectiveness of medical or surgical treatments

What can I Expect?

• You can wear comfortable clothes. You will be given a hospital gown to wear. If you wear dentures, you will be asked to remove them prior to the test.
• You may NOT eat or drink anything for at least 8 hours before the test
• Take all of your medications at the usual times, as prescribed by your doctor with a sip of water
• If you have diabetes and take medications to manage your blood sugar, ask your physician how to adjust your medications the day of your test
• Tell your doctor if you have:
  • any problems with your esophagus (tube connecting mouth to the stomach), such as hiatal hernia, problems swallowing, varices, or cancer
  • a history of stomach ulcers
  • sleep apnea
• Bring someone with you to drive you home after the test. You should not drive until the day after the procedure. Sedation given during the procedure causes drowsiness, dizziness and impairs your judgment, making it unsafe for you to drive or operate machinery
• Before the test the procedure will be explained in detail, including possible complications and side effects. They will be available to answer any questions you may have
• An intravenous (IV) line will be inserted into a vein in your arm or hand so medications can be delivered.
• The nurse will connect you to several monitors:
  • Electrocardiogram (ECG): The sonographer will gently rub ten small areas of your chest, and place small sticky electrode patches to these areas. The electrodes are attached to an electrocardiograph (ECG) monitor, which charts your heart's electrical activity during the test
  • Blood pressure monitor: A blood pressure cuff will be placed on your arm to monitor your blood pressure intermittently throughout the test.
  • Oximeter: A small clip is placed on your finger. The device monitors the oxygen level of your blood.
• An anesthetic spray (pain-relieving medication) will be used at the back of your throat, and you will be given a solution to gargle that will numb your throat.
• The doctor will put medication into your IV to help you relax and feel comfortable as possible during the test. You may feel drowsy. If you feel discomfort at any time during the test, tell your doctor, nurse, or sonographer.
• You will be asked to lie on your left side on an exam table.
• A suction catheter will be used to remove any secretions from your mouth.
• The doctor will insert a thin, lubricated endoscope into your mouth and down your throat into your esophagus. The tube does not interfere with your breathing. You may be asked to swallow at certain times to help pass the tube.
• Once the probe is in position, pictures of the heart are obtained at various angles (you will not feel this part of the test). Because of the sedative, you may not be entirely awake for the test.
• Your heart rate, blood pressure and oxygen level of your blood will be closely monitored during and immediately after the exam.
• The TEE takes about 60 to 90 minutes.

After the Procedure:

• After you have recovered from the sedation, you may go home or to your other scheduled appointments. You may NOT drive yourself home after the test.
• You may feel a temporary soreness or numbness in your throat after the test.
• Wait at least two hours after the test (or until the numbness in your throat is gone) before eating or drinking. Start by drinking a cool liquid. If you have no problems drinking cool liquids, eat and drink as you normally would.
• After the cardiologist reviews your test, the results will go into your electronic medical record. Your physician will have access to the results and will discuss them with you.

Ask you doctor if you have any questions about the transesophageal echocardiogram.