What is it?

A Transesophageal Echocardiogram (TEE) is a special type of echocardiogram, or ultrasound of the heart, that allows us to obtain very detailed images of the structures of the heart. We pass a small ultrasound probe down the esophagus (swallowing tube) and take pictures of the heart from inside your body.

What are the indications?

This test is performed to evaluate the valves of the heart, the pumping function of your heart, and to look for any blood clots or birth defects of the heart. We would recommend a TEE if we suspect valve leakage or narrowing, infection in the heart, or if you have a stroke without a clear cause. We sometimes perform this test prior to a cardioversion, or electrical shock of the heart, to look for blood clots in your heart that could lead to a stroke.

How is it done?

We admit you to the hospital as an outpatient and a nurse will prepare you for the test by asking you questions, having you change into a gown and starting an IV. We’ll ask you to remove any dentures or partial plates in your mouth. We will give you light sedation but you will be awake for the TEE. We numb the back of your throat with an anesthetic spray and pass the ultrasound probe into your swallowing tube with you lying on your side or sitting in the upright position. Once the probe is in position we quickly take the pictures we need and generally finish within 10-15 minutes. We pull out the probe and monitor you for 1-2 hours. The numbing spray inhibits your ability to swallow normally for a short while and we can let you eat once sensation returns. We can generally give you the results of the study before you leave the hospital.

How do you prepare for it?

We ask that you have nothing to eat or drink after midnight the night before your TEE. We do not want you to vomit on any food or drink which could cause you to choke and possibly develop pneumonia. You may take your usual morning medications with a sip of water when you wake up in the morning; however, we ask that you not take any insulin or diabetic medications as you will not have anything to eat for several hours. We do not want your blood sugar to drop and make you sick. You must have someone drive you home after the procedure since you will receive sedation medication. It is not safe for you to drive or operate machinery until the next day.

What are the risks?

Risks involved are vomiting, choking, aspiration pneumonia, breathing problems, abnormal or slow heart rhythm, reaction to the conscious sedation and minor bleeding. A rare but serious risk is perforation or tear of the esophagus.