Transesophageal Echocardiography (TEE)

Like other types of echocardiograms, this test uses sound waves bounced off your heart to create an image. In transesophageal echocardiography, a long, flexible tube (a probe) about the width of a little finger is inserted into your mouth and esophagus. (The esophagus is the muscular tube that connects the throat to the stomach.) A tiny transducer at the tip of the probe sends and records the sound waves.

With transesophageal echocardiography, the sound waves that echo back pictures of your heart come from inside your esophagus rather than through your chest wall. These images are sometimes clearer than those produced by a regular echocardiogram. The probe is closer to the heart, where some structures are better visualized. The sound waves that echo back from striking the surfaces of the heart are turned into images that can be seen on a television screen and recorded on videotape and CD.

Transesophageal scans done in the operating room provide real-time feedback to the surgeon about the health and functioning of the heart and its valves, so that appropriate choice of surgery required may be made at the time of cardiac surgery.

Transesophageal echocardiography is done to:

  • Detect blood clots or masses inside the heart
  • Assess the heart valves
  • Assess how artificial valves are working
  • Detect holes between the chambers of the heart
  • Diagnose a dissection or tear in the lining of the aorta
  • Detect vegetations or infections of the heart valves

The test begins with your throat being sprayed with an anesthetic to make it numb. You then lie down on an examination table. An intravenous (IV) catheter will be placed in the vein in your arm. You will be given a drug to relax you during the test. You will be connected to an electrocardiogram machine that will monitor your heart during the test and will be wearing a blood pressure cuff. Oxygen will be delivered into your nose by way of a tubing called a cannula.

Then, a small flexible tube will be put down your throat. The doctor will ask you to swallow. This causes the probe will gently move down your throat. You may be able to feel it move, but this sensation is usually not painful. It is quite common to feel the need to gag. Don't worry if this happens. Once the tube is in place, you should not feel any pain.

On the end of the tube is the transducer, which takes ultrasonic images of your heart and projects them into the echo machine. The doctor can move the probe to get pictures of your heart from different angles.

The procedure usually takes about 30 minutes. After the test, you will remain in examining room 60 minutes to recover from the medication. You may feel sleepy during this time. Do not eat or drink anything for an hour or until your throat is no longer numb.

You may find that you have a sore throat or trouble swallowing after the procedure. Having something cold or letting a throat lozenge melt in your mouth will help soothe it. These side effects usually go away after a day or so. If you feel pain or have bleeding, report these symptoms to your doctor.

The For Patients section has instructions for preparing for transesophageal echocardiography.