Transesophageal Echocardiogram (TEE)

What is a Transesophageal Echocardiogram?

This is an ultrasound test that allows the cardiologist to clearly visualize the anatomy of your heart and the function of your heart valves from inside the esophagus (the tube leading from the mouth to the stomach). Usually performed on an outpatient basis, a TEE involves the insertion of a small probe into your mouth and the esophagus and requires giving you some mild sedation.

Why did the doctor order the exam?

There are many reasons that a cardiologist would want to see the structures of your heart. A few examples:

• To detect blood clots or masses inside the heart
• To assess the severity of some heart valve defects
• To examine prosthetic (artificial) heart valves
• To evaluate holes between heart chambers
• To detect infection of the heart valves
• To diagnose a dissection (a tear) in the lining of the aorta (the body's main artery)
• When the standard echocardiogram is of poor quality or inadequate (such as in people who are obese or have chronic lung disease)

What can I expect before the exam?

You will not be allowed to eat or drink anything after midnight the night before the exam.

If you are having the test down in the short stay unit as an outpatient, you must have someone else drive you home from the hospital. You will not be allowed to drive for 24 hours due to the sedation that you will be given.

Be sure to tell the doctor or nurse if you have a problem swallowing or if you have any condition involving your esophagus or stomach.

Be sure to tell the doctor or nurse if you have any allergies to medications.

Before the test is performed, you will meet the cardiologist, who will explain the procedure, potential benefits and possible risks. Please feel free to ask questions or share concerns that you may have. You will then be asked to sign an informed consent form.

If you wear dentures, you will need to remove them.

An intravenous (IV) line will be inserted into a vein in your arm, to allow the injection of medications.

What can I expect during the exam?

When you arrive for the test, you will change into a hospital gown.

The nurse assisting the doctor will apply some electrodes to monitor your heart rhythm during the procedure.

An automatic blood pressure cuff will be placed on your arm. This will automatically inflate every few minutes to allow close monitoring of your vital signs.

A probe will be placed on your finger to monitor your oxygen level throughout the procedure.

A nasal cannula will be placed in your nose to give you additional oxygen during the procedure.

After the doctor arrives, you will have your throat sprayed by an anesthetic to numb it.

You will be given a low dose of a sedation to help you relax.

You will be asked to turn onto your left side.

Once you are relaxed, the doctor will ask you swallow a small, thin probe. You may gag when you first feel the probe enter the esophagus but you will be able to swallow it. You may feel the probe moving slightly, but the procedure is generally not painful.

There will be no interference with your breathing.

How long does the TEE take?

The procedure itself will take approximately 30 minutes.

You will be asked to arrive 90 minutes before the scheduled procedure time so that all of the preliminary work can be completed.

You will be monitored for approximately 60-90 minutes following the procedure to make sure that the sedation wears off completely.

What can I expect after the TEE?

You will be allowed to get dressed and leave.

YOU WILL NOT BE ALLOWED TO LEAVE ALONE. YOU MUST HAVE SOMEONE ELSE WITH YOU.

Do not eat or drink anything for about an hour or so, until you can feel your throat.

After the test, you throat may be slightly sore. Please notify the physician if this is a continued problem.

The cardiologist will discuss the results of the test with you and your family.

The cardiologist will forward the results to your physician, who will then discuss them with you.