In some cases, an echocardiogram doesn’t show us enough detailed information about your heart, so we perform a special type of echocardiogram, a transesophageal echocardiogram.
Here’s what’s involved with these tests.
What is a transesophageal echocardiogram?
Echocardiograms use high-frequency sound waves (ultrasound) to examine the structures of your heart. A transesophageal echocardiogram (TEE) uses the same ultrasound energy to generate the picture, but it does so not from outside the chest, as with an echocardiogram, but from your esophagus. Because your esophagus is so close to the upper chambers of the heart, TEEs can create very clear images of the structures and valves.
Why should I have a transesophageal echocardiogram done?
Your CVAM doctor could recommend you have this test to better look into potential problems with your heart’s structure and function. Because the transducer is so close to your heart, it can provide clearer pictures of the upper chambers and the valves between the upper and lower chambers than are possible with standard echocardiograms. TEEs may also be necessary in patients who have thick chest walls, are obese, have bandages on their chest, or need to use a ventilator to help with breathing.
What can a transesophageal echocardiogram detect that are not seen well on a standard echo?
Thanks to their detail, TEEs help our doctors see these things:
- Blood clots in the heart, especially the left atrial appendage which can be associated with strokes
- Details of the heart valves and what problem is causing them to not open well or leak, including planning for MitraClip procedure.
- Size of the left atrial appendage to assess candidacy for device closure, including Watchman implant
- Small holes in the wall separating the upper chambers of the heart that are associated with strokes and heart failure
Transesophageal echocardiogram Procedure
We perform TEEs in our Mesa location. The tests usually take between 30 and 60 minutes. To get you ready, we place a series of small metal electrodes on your chest. These metal discs are attached with light adhesive so they stay in place. The electrodes are attached to a machine that will record your electrocardiogram (ECG) to track your heart rate. We also connect you to an automated blood pressure machine and a pulse oxymeter so that we can monitor your blood pressure and oxygen saturation during and after the procedure.
Next, we spray your throat with a numbing anesthetic to suppress your gag reflex and then we provide a mild sedative intravenously.
Your CVAM doctor then gently guides a thin, flexible tube through your mouth and down your throat. You’ll be asked to swallow as the probe is advanced. At the end of the probe is the ultrasound transducer. The transducer is used to create pictures of the heart onto a video screen adjacent to your table. The process of inserting the probe and transducer and then producing the images takes about 10-15 minutes.
Once the images are obtained the probe is removed; once you are awake you will be moved to a recovery room. Your blood pressure, heart rate and oxygen level is monitored until the numbness has resolved with your throat. When you no longer feel groggy, the IV and electrodes are removed and you are ready to have someone drive you home.
What happens after my transesophageal echocardiogram?
Your throat will still be numb for a half hour or so after your TEE, but you must not eat or drink anything, as this could lead to possible choking. Once the numbness passes, you can eat and drink normally.
It’s common to have a slight sore throat for a day or two after the test, due to the probe being in your throat. You may also be slightly hoarse for a day or so.
When will I know the results of my transesophageal echocardiogram?
The pictures of your heart generated during your TEE are available immediately after the procedure. Your CVAM cardiologist will review the results with you and your family immediately following the procedure and after your have woken from the sedation.
risks Of transesophageal echocardiogram
This is a very low-risk procedure. Your CVAM team ensures your throat is adequately numbed prior to inserting the probe and transducer. There is a sense at first that you want to gag, but this passes as you relax. The throat-numbing anesthesia helps calm your gag reflex. This test only uses ultrasound energy, which has no adverse effects on the body. There is a slight chance the probe could cause bleeding in your esophagus, but this is very rare.