Transesophageal Echocardiogram (TEE)
What is a transesophageal echocardiogram?
A transesophageal echocardiogram (TEE) uses high frequency sound waves (ultrasound) that are bounced off the patient’s heart from inside the esophagus, creating a moving picture of the heart and blood vessels. The esophagus is the muscular tube that connects the throat to the stomach and is located directly behind the heart.
The test involves a long flexible tube, about the width of a pinky finger, inserted through the mouth into the esophagus. This probe, or endoscope, has a tiny device at its tip, called a transducer, which sends and records the soundwaves.
TEE is used to examine suspected problems with the valves or chambers of the heart, or issues with the heart’s ability to pump blood. An important purpose is to identify potential causes of stroke.
The test also is used to:
- Estimate the amount of blood pumped out of the left ventricle with each heartbeat
- Evaluate heart size and heart valve function
- Identify areas of poor blood flow in the heart and areas of heart muscle that are not contracting normally
- Examine previous injury to the heart muscle caused by impaired blood flow or evidence of congestive heart failure
What happens during this procedure?
The TEE begins with an anesthetic sprayed into the patient’s throat to numb it. The patient lies on an examination table and an IV is placed in their arm. Patients are given a mild sedative to help them remain calm throughout the procedure.
While connected to an electrocardiogram machine and a blood pressure cuff to monitor the patient’s vital signs, a physician will insert the tube through the mouth and down the throat. Patient’s may be asked to swallow to help move the probe down the throat into the esophagus.
The transducer sends sound waves into the chest and picks up echoes that bounce back from different parts of the heart. These soundwaves are converted into images on a television monitor and recorded.
The physician may move the probe around to get pictures of the heart from different angles.
How long will the test take?
The test takes about 30 minutes, and patients will then spend at least an hour recovering in the examination room. Those undergoing TEE on an outpatient basis should anticipate being at Cedars-Sinai for at least two hours.
What preparations are needed before a TEE?
Patients undergoing a TEE should prepare in the following ways:
- Do not eat or drink anything for three to four hours prior to the test.
- Wear comfortable, easy-to-remove clothing, because all patients must change into a hospital gown before undergoing the test.
- Be sure the doctor is aware of all medications the patient is taking before they come in for the test. He or she may ask that some be skipped prior to the TEE.
- Patients will need to remove dentures or any other oral prosthesis, because they may interfere with the test.
- If they are an outpatient, people undergoing TEE must have someone drive them home. Operating a vehicle is prohibited for 24 hours after sedation.
Does a TEE cause discomfort?
Although patients are given a sedative and their throats are numbed before insertion, they may still feel the probe as it is moved down the throat into the esophagus. This sensation is not painful, but it is quite common to feel the need to gag. This is normal.
What will happen after the test is complete?
After the test, patients remain in the examination room for 60 minutes to recover from the medication. It is OK to fall asleep during this time.
The patient should not eat or drink anything for an hour after being released, or until the throat is no longer numb.
Some patients have a sore throat or trouble swallowing after the procedure. This is normal. Patients should drink something cold or let a throat lozenge melt in their mouth to soothe any discomfort. This lasts about a day.
Patients who experience pain or bleeding, however, should report these symptoms to their doctor.
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