Transesophageal echocardiogram

Transesophageal echocardiogram (TEE): During this test, an ultrasound transducer (which produces high-frequency sound waves) provides pictures of the heart's valves and chambers and helps the physician evaluate the pumping action. The ultrasound transducer is positioned on an endoscope (a long, thin, flexible instrument about 1/2 inch in diameter). The endoscope is placed into your mouth and passed into your esophagus (the tube from your mouth to your stomach) to provide a close look at your heart's valves and chambers without interference from the ribs or lungs.

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TEE is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves. TEE is often used when the results from standard echo studies were not sufficient or when your doctor wants a closer look at your heart.

To prepare:

• You can wear whatever you like. You will change into a hospital gown for the procedure. Do not bring valuables.
• Do not eat or drink anything for at least six hours before the test. Take your medications with only a small sip of water.
• Take all your medications at the usual times, as prescribed by your doctor.
• If you have diabetes and take medications to manage your blood sugar, ask your physician how to adjust your medications the day of your test.
• Tell your doctor if you have any problems with your esophagus (tube connecting mouth to the stomach), such as hiatal hernia, problems swallowing, or cancer.
• Bring someone with you to drive you home after the test. You should not drive until the day after the procedure. Sedation given during the procedure causes drowsiness and dizziness and impairs your judgment, making it unsafe for you to drive or operate machinery.

What to expect:

An intravenous (IV) line will be inserted into a vein in your arm or hand so medications can be delivered when necessary. You will be connected to several monitors. An EKG monitor will chart your heart's electrical activity during the test; a blood pressure cuff will be placed on your arm to monitor your blood pressure, and an oximeter will monitor the oxygen level of your blood by means of a clip placed on one finger.

You will be given a solution to gargle that will numb your throat. Anesthetic will then be sprayed at the back of your throat. Medication will be injected into the IV line to help you relax during the test. You may feel drowsy.

You will be asked to lie on your left side on an exam table. A dental suction tip will be placed in your mouth to remove secretions. The doctor will insert a thin, lubricated endoscope into your mouth and down your throat (this part lasts a few seconds and might feel uncomfortable) into the esophagus. The tube does not interfere with your breathing. You may be asked to swallow at certain times to help pass the tube.

Once the probe is in position, pictures of the heart are obtained at various angles (you will not feel this part of the test). Because of the sedative, you may not be entirely awake for the test.

The TEE takes about 90 minutes.