Transesophogeal Echocardiography - TEE

What is a Transesophageal Echocardiography (TEE)?

Transesophageal echocardiography (TEE) is a test that produces pictures of your heart. TEE uses high-frequency sound waves (ultrasound) to make detailed pictures of your heart and the internal structures of the heart (valves).  Unlike a standard echocardiogram the echo transducer that produces the sound waves for TEE is attached to a thin tube that passes through your mouth, down your throat and into your esophagus. Because the esophagus is so close to the upper chambers of the heart, very clear images of those heart structures and valves can be obtained.

Why do I need a TEE?
Doctors use TEE to identify problems in the heart’s structure and function. TEE can give clearer pictures of the upper chambers of the heart, and the valves between the upper and lower chambers of the heart, than standard echocardiograms. Doctors may also use TEE if a patient has a thick chest wall, are obese, or are using a ventilator to help you breathe. 

The detailed pictures provided by TEE can help doctors see:

  • The size of your heart and how thick its walls are.
  • How well your heart is pumping.
  • 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 or if another procedure us unable to rule out blood clots in the heart.
  • TEE is often used to provide information during surgery to repair heart valves, a tear in the aorta or congenital heart lesions. It’s also used during surgical treatment for endocarditis, a bacterial infection of the inner lining of the heart and valves.

 What are the risks of TEE?

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Difficulty breathing
  • Bleeding or damage to the mouth, throat, or esophagus

What should I expect during a TEE?

A doctor will perform your TEE test with the help of a nurse or technician and personnel from the anesthesia department.  You will be connected to machines that monitor your blood pressure, heart rate, and oxygen levels during the test. You will be given a mild sedative by an intravenous line (IV) to help you relax. You’ll remain somewhat alert so you can cooperate with the doctor and staff.   If the TEE is being done in conjunction with other electrophysiology procedures you may be given general anesthesia. 

The TEE test may cause some mild throat discomfort, but it should not be painful. The back of your throat will be numbed with an anesthetic spray. Your throat will feel cool, and you may get a bitter taste in your mouth. You will need to remove any full or partial dentures. To protect your teeth, a plastic mouth guard will be placed in your mouth. You’ll need to press your lips around the guard.

The doctor then will insert the scope into the back of your mouth and advance the scope into your esophagus. The transducer will take a pictures of your heart.

What should I expect after the TEE?

You cannot eat or drink for at least 1 hour after the test. The numbing effect of the anesthetic takes this long to wear off

You may have a mild sore throat for up to 24 hours after the test. This is normal.

The physician will speak with you after the procedure to discuss the results.


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