TRANESOPHAGEAL ECHO (TEE)

WHAT IS A TRANESOPHAGEAL ECHO (TEE)?

A transesophageal echo (TEE) is a test where sound waves are used to study the structures and function of the heart using a probe that is passed down the throat into the esophagus (food pipe)and stomach just like an endoscope.

In a routine 2D echo test, the ultrasound probe is placed on the chest. This is called a transthoracic echocardiogram. Being overweight or having certain lung diseases can interfere with images of the heart when the transducer is placed on the chest wall. By inserting the ultrasound probe in the oesophagus, a clearer image of the heart is available because the sound waves do not have to pass through skin, muscle, or bone tissue. In fact, the TEE probe is much closer to the heart since the esophagus and heart are right next to each other. This is useful in better identification in certain disease conditions like diseases of the heart valves, aorta, left atrium, etc

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who needs a TEE?

Patients with strokes or mini strokes to look for cause of clots
Patients with valve diseases to identify the reason and severity of the problem and plan treatment
Patients with holes in their heart to decide whether holes can be plugged by devices or surgery
Patients with fever where an infection of the valve (endocarditis) is suspected
Those who have cardiac masses on a transthoracic 2D echo
Patients who have undergone heart valve surgery (prosthetic valves)
To look for clots in left atrium before electrical cardioversion for atrial fibrillation
Patients in whom a tear in the lining of the aorta (aortic dissection) is suspected

what happens during a TEE?

A written and informed consent will be taken before the procedure
You will be asked to remove any dentures or any oral prosthesis before the insertion of the TEE probe
You will be given a gown to wear and asked to empty your bladder before the procedure
An intravenous (IV) line will be started in your hand to inject of medicine and to give IV fluids, if needed.
You will lie on a bed, positioned on your left side. A pillow or wedge may be placed behind your back for support
You will be connected to an ECG monitor that records the electrical and vital signs (heart rate, blood pressure, breathing rate, and oxygen level) will be monitored during the procedure.
A local anesthetic spray will be applied to the back of the throat. This will numb the back of your throat to make passing the TEE probe more comfortable
A bite protector will be placed in your mouth.
You may receive a sedative before the procedure to help you relax.
The lubricated TEE probe will be passed through your mouth and down your throat. You may be asked to swallow to help pass the probe. This portion of the test could be a little uncomfortable
Once the probe is in the right place, the images are taken
After the images are taken, the probe will be removed from your throat.
The sedative may make you drowsy. Your throat may be sore or numb after the test. These feelings will go away. You may have cold liquids after one hour. if you are comfortable with cold liquids, you may move on to taking semisolid food. Avoid hot beverages.

how to prepare for a TEE?

You may need certain blood tests like viral markers, a hemogram, etc prior
You will need to fast overnight, usually for around 8-10 hours before the procedure. You should refrain from taking water for at least 6 hrs as well.
Please carry a list of your medicines and other medical doucments
Let us know if you are allergic to or sensitive to medicines, local anesthesia, or latex.
If you have a history of bleeding disorders or if you are taking any blood thinners, you may be told to stop some of these medicines before the procedure.

are there any risks?

Possible risks of TEE include:

Breathing problems
Heart rhythm problems
Bleeding
Injury to the teeth, mouth, throat or esophagus

If you have known problems of the esophagus, such as esophageal varices, esophageal obstruction or stricture, or radiation therapy to the area of the esophagus, you may not be able to have a TEE. Your doctor will evaluate you carefully before having the procedure.

There may be other risks depending on your specific medical condition.