A transesophageal echocardiogram (TEE) is a different type of echocardiogram. Echocardiograms are diagnostic tests that use crystals to generate high-frequency sound waves. As these sound waves are aimed at the valves and tissues of the heart, they are reflected (echoed) back to a machine that analyzes them and generates an image of your heart on a computer monitor. Echocardiograms allow physicians to view the chambers of your heart while it is pumping, and help physicians determine whether your valves, pericardium (the external covering of the heart), and arteries are functioning properly.
An echocardiogram is used to diagnose a number of heart problems:
- Valve disease
- Coronary artery disease
- Weak heart muscles
- Holes between heart chambers
- Fluid around the heart
- Aortic abnormalities
- Congenital heart defects
- Emboli (small blood clot fragments)
A transthoracic echocardiogram (TTE) is performed while you lay on your back, a technician moves a small device, called a transducer, over your chest. A transesophageal echo (TEE) is performed by having a cardiologist insert a probe into your esophagus instead of placing the transducer on the outside of your chest. (You will receive a mild intravenous sedative and an anesthetic spray for your throat). Your esophagus is directly behind the heart, so viewing your heart from this angle provides very clear and detailed images. A TEE can help physicians get a better view of blood clots, for example, that they might not see clearly in a regular transthoracic echocardiogram exam. It also visualizes areas not always seen on a transthoracic echo.
Preparing for the Test
A transesophageal echo (TEE) is more involved than a transthoracic echocardiogram (TTE). You will need to abstain from food or drink for 6 hours prior to the test and for at least one hour after the test is completed. If performed as an outpatient procedure, you will need someone to drive you home.
What is the doctor looking for?
The test will evaluate the flow of blood through the chambers of the heart; evaluate the function of the heart valves, and assess the condition of the great vessels in the heart. It also is used to access for blood clots, pump action, and possible shunting between chambers.
What is the test?
The TEE test involves a probe being placed into your esophagus (the “tube” through which food reaches your stomach). The probe then uses sound waves to obtain multiple images of the heart and it's function. The images are recorded on video tape and are of high quality with superior detail. Our physician uses this information to determine the best treatment plan for you.
During the Procedure
The staff will start an intravenous (IV) feeding in your arm so that medications can be easily administered during the test. You will be connected to equipment that will monitor your heart rate and blood pressure. Another device, a pulse oximeter, which is like a bandaid, will be connected to your finger, to monitor oxygen levels in your blood. You will be given some medications to help you relax. Your throat will be sprayed to make it numb before the T.E.E. probe is inserted. A special device will be placed in your mouth to prevent you from accidentally biting the probe. This mouthpiece restricts the motion of the tongue, making it very difficult to speak. (The device does not interfere with your breathing.) During this time - which lasts about 15 minutes - the doctor and nurse will ask you questions, which you will be able to answer with “yes” or “no.” Do not talk, just gently nod or shake your head.
After the Procedure
After the probe and mouthpiece are removed, you will be taken to a recovery area. You will remain there until the numbing spray and other medications wear off (usually one or two hours). The nurses in the recovery area will take care of you and check on you frequently. When the medications wear off the nurses will inform you that you can return home. It is important to have a family member or friend take you home since lingering effects of the medications may interfere with your ability to drive safely.
Where are the tests done?
Your TEE exam will take place in the hospital or Endoscopy Unit. At Mercy St. Vincent Medical Center, it is located on the ground floor of the Ambulatory Care Center (ACC). Park in the Medical Office Building (MOB) Garage, follow the main floor hallway to the ACC building and take the elevators to the ground floor. At Mercy St. Charles Mercy, a TEE is done in endoscopy which is located within the surgery department. The patient enters in the back of the hospital through the outpatient surgery area. At Mercy St. Anne Hospital, a TEE is done in endoscopy which is located within the surgery department.
May I eat or drink?
Do not eat or drink anything for 6 hours before your test.
What about medications?
Check with your doctor about any medications you are taking. If you are diabetic, ask your doctor about diet changes and/or altered doses of diabetic medications.
Will I have an IV?
Do I need special clothing?
What should I bring to the test?
A list of your current prescribed medications. If you wear eyeglasses, please bring them to read the consent form.
How long does the test take?
The probe is in the esophagus for about 15 minutes, but you will probably be here for about 2.5 hours.
When will the results be ready?
The physician knows immediately and will report to you and the family. A written report will follow within 24-48 hours.
Tell your doctor/nurse if you have …
Any symptoms or are experiencing any discomfort or anything wrong with your esophagus.
Will the test make me sick or sleepy?
You may experience a gagging reflex. The test will probably give you a sore throat. You will probably be sleepy from medication given for sedation. This will usually wear off within 1 hour. The patient cannot drive home from the test, they must have someone take them home.
Will I receive any radiation during the procedure?
What if I am pregnant or breast-feeding?
There are no risks if you are pregnant or breast-feeding.