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Transesophageal Echocardiography

Transesophageal echocardiography (TEE) is a test that uses high-frequency sound waves (ultrasound) to make detailed pictures of your heart and the arteries around it.

Unlike a standard echocardiogram, the transducer that produces the sound waves for TEE is attached to a thin tube that passes down your throat and into your esophagus. Because the esophagus is so close to the heart's upper chambers, TEE can capture very clear images of those heart structures and valves.

The detailed pictures that TEE provides can help doctors see:

  • How well your heart is pumping.

  • The size of your heart and how thick its walls are.

  • If there is abnormal tissue around your heart valves that could indicate bacterial, viral, or fungal infections or cancer.

  • If blood is leaking backward through your heart valves (regurgitation) or if your valves are narrowed or blocked (stenosis).

  • If blood clots are in the chambers of your heart, in particular the upper chamber, for example, after a stroke.

Who is eligible for a transesophageal echocardiography (TEE)?

Doctors may want to use TEE if you have a thick chest wall, have lung disease, are obese, or have bandages on your chest that prevent electrodes from being placed there.

What conditions can be diagnosed by a transesophageal echocardiography (TEE)?

Examples of the conditions TEE may diagnose include:

  • Aneurysm: This is a weakening and bulging of a part of the heart muscle or the aorta (the artery that carries oxygenated blood from the heart to the rest of the body).

  • Aortic dissection: This is a tear in the wall of the aorta.

  • Atherosclerosis: This is when your arteries are blocked or narrowed by fat and other substances in the blood.

  • Blood clot and stroke: Blood clots can form inside the heart and then flow to the brain and cause a stroke.

  • Cardiac tumor: A tumor may form on the outside surface of the heart, within the heart chambers, or within the muscle tissue of the heart.

  • Cardiomyopathy: This is an enlargement of the heart due to thickening or weakening of the heart muscle.

  • Congenital heart disease: These defects occur during fetal formation.

  • Endocarditis: This is an infection of the heart that usually affects the heart valves.

  • Heart failure: This is a condition in which the heart has weakened to an extent that blood can’t be pumped efficiently.

  • Heart valve disease: This is a malfunction of the heart valves that may block blood flow within the heart or result in blood leaking backwards (regurgitation).

  • Pericarditis: This is an inflammation or infection of the sac that surrounds the heart.

How do I prepare for a transesophageal echocardiography?

Your doctor may ask you not to have alcoholic drinks for a few days before the test, and not to eat or drink anything for at least four to six hours before TEE. Because you may be given a sedative before the test to help you stay calm, someone should drive you home after.

What should I expect during my transesophageal echocardiography?

TEE usually lasts 30 to 60 minutes.

  • You will lie on a table. A nurse will put an IV (intravenous line) in your arm and give you a mild sedative (medicine) to help you stay calm.

  • The technician may place small metal disks (electrodes) on your chest. He or she attaches the electrodes by wires to an electrocardiogram (EKG) to track your heartbeat.

  • A technician sprays your throat with medicine to numb it and stop you from gagging. The doctor then gently guides a thin, flexible tube (probe) through your mouth and down your throat and asks you to swallow as it goes down.

  • A transducer on the end of the probe sends sound waves to your heart and collects the echoes that bounce back. These echoes become pictures that show up on a video screen. This part of the test takes 10 to 15 minutes.

  • When the doctor is finished taking pictures, the probe, IV, and electrodes are removed, and nurses watch you until you are fully awake. Then you can usually get up, get dressed, and leave the clinic or hospital.

Your throat may be numb for a short time. Don’t eat or drink anything until the numb feeling goes away—you could choke. Because of the sedative, you get during the procedure, don’t drink alcohol for a day or two.

Why choose Presbyterian for transesophageal echocardiography?

Presbyterian’s Heart and Vascular team has many different options to help you manage your heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans for your heart health needs. Depending on the type of heart condition you have and its underlying cause, the team can recommend a wide variety of treatment options, including lifestyle modifications, medications, and procedures. Our cardiologists and cardiovascular surgeons work closely together for cases in which surgery is the best treatment option. We also offer a customized cardiac rehabilitation program at our Healthplex, where clinically appropriate, which can improve your endurance and exercise tolerance, as well as improve heart-related symptoms. Your cardiologist will work with the rehabilitation team to create a plan that will be tailored to your individual health needs.