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Transesophageal
echocardiogram (TEE)
Definition:
 |
| Illustration
of small transducer passed down throat , lying close to heart |
An echocardiogram
(often called "echo") is a graphic outline of the heart's movement,
valves and chambers.
During the transesophageal echocardiogram (TEE) 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
of the heart.
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 "food pipe" leading from your mouth
into your stomach) to provide a close look at your heart's valves and
chambers without interference from the ribs or lungs.
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.
Your doctor uses the
TEE to:
- Assess the overall
function of your heart's chambers and valves
- Determine the presence
of many types of heart disease (such as valvular heart disease, myocardial
disease, pericardial disease, cardiac masses and congenital heart disease)
- Evaluate the effectiveness
of medical or surgical treatments
- Evaluate abnormalities
of the left atrium
To prepare:
- You can wear whatever
you like. You will need to change into a hospital gown to wear during
the procedure. You
will be given a locker to store your belongings during the test. 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 of 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 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, dizziness and impairs your judgment, making it unsafe for
you to drive or operate machinery.
What
to expect:
- Before
the test, a cardiac sonographer, nurse or physician will explain the
procedure in detail, including possible complications and side effects.
They will be available to answer any questions you may have.
- You
will be given a hospital gown to wear.
- An
intravenous (IV) line will be inserted into a vein in your arm or hand
so medications can be delivered when necessary.
- The
nurse will connect you to several monitors:
- Electrocardiogram
(ECG): Three electrodes (small, flat, sticky patches) will be
placed on your chest. The electrodes are attached to an electrocardiograph
monitor (ECG) that charts your heart’s electrical activity.
- Blood pressure
monitor: A blood pressure cuff will be placed on your arm to
monitor your blood pressure intermittently throughout the test.
- Oximeter:
A small clip is placed on your finger. The device monitors the oxygen
level of your blood.
- You
will be given a solution to gargle that will numb your throat. The sonographer
will spray an anesthetic (pain-relieving medication) at the back of
your throat.
- The
doctor will put medication into your IV to help you relax and feel comfortable
as possible during the test. You may feel drowsy. If you feel discomfort
at any time during the test, tell your doctor, nurse, or sonographer.
- 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 any secretions.
- The
doctor will insert a thin, lubricated endoscope into your mouth and
down your throat (this part lasts a few seconds and might be a little
uncomfortable) into your 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.
- Your
heart rate, blood pressure and oxygen level of your blood will be closely
monitored during and immediately after the exam.
The TEE takes about
90 minutes.
After the procedure:
- After you have
recovered from the sedation, you may go home or to your other scheduled
appointments. You may NOT drive yourself home after the test.
- You may feel a
temporary soreness or numbness in your throat after the test.
- Wait at least one
hour after the test (or until the numbness in your throat is gone) before
eating or drinking. Start by drinking a cool liquid. If you have no
problems drinking cool liquids, eat and drink as you normally would.
- After the cardiologist reviews your
test, the results will go into your electronic medical record. Your
physician will have access to the results and will discuss them with
you.
Ask your doctor if
you have questions about the TEE.
Find
a Cleveland Clinic Heart Center doctor who performs this procedure |
