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Transesophageal Echocardiography (TEE)

What is transesophageal echocardiography?

Transesophageal echocardiography (TEE) is a test that makes pictures of your heart.

TEE uses sound waves (ultrasound) to create detailed images of your heart and the arteries that lead to and from it. The echo transducer for TEE is attached to a thin tube that passes through your mouth, down your throat, and into your esophagus. Because the esophagus is close to the upper chambers of the heart, TEE can produce very clear images of these heart structures and valves.

Why do people need TEE?

Health care professionals use TEE to find problems in your heart’s structure and function.

TEE can give clearer pictures than standard echocardiograms of:

  • The large artery leaving the heart (ascending aorta)
  • The upper chambers of the heart
  • Valves between the upper and lower chambers, including artificial valves
  • Possible small abnormal structures
  • A small opening between the two upper chambers of the heart

The detailed pictures from TEE can help your health care team see:

  • The size of your heart and the thickness of its walls
  • How well your heart is pumping
  • If there is abnormal tissue around your heart valves that could be bacterial, viral, or fungal infections—or cancer
  • Defects that can cause heart murmurs
  • If blood is leaking backward (regurgitation) or if valves are stiff, narrowed, or blocked (stenosis)
  • If blood clots are in the chambers of your heart (such as those caused by atrial fibrillation)

TEE is often used for information during surgery to repair heart valves, a tear in the aorta, or congenital heart lesions. It’s also used during treatment for endocarditis, a bacterial infection of the heart’s inner lining and valves.

What are the risks of TEE?

The main risks of TEE involve passing the probe from your mouth to your throat and esophagus.

Before the test, you will receive medications to help you stay calm and to numb your throat, but you may still feel like gagging.

Possible side effects include:

  • A sore throat for a day or two after the test
  • In less common cases:
    • An allergic reaction to medications
    • Minor bleeding in the esophagus
  • A risk of chest infection caused by inhaling something other than air into your lungs

How do I prepare for TEE?

Check with your health care professional. You may be told:

  • Not to have alcoholic drinks for a few days before the test
  • Not to eat or drink anything for a certain amount of time before the test

Because you may be given a sedative to help you stay calm, someone should drive you home after the test.

What happens during TEE?

  1. A heart doctor guides the scope into the esophagus and stomach.
  2. The doctor sprays your throat with medication to numb it and control the gag reflex. You will lie on a table.
  3. A nurse puts an IV in your arm and gives medication to help you stay calm.
  4. The technician places small pads (electrodes) on your chest. The electrodes are attached to a machine that records your electrocardiogram to track your heartbeat.
  5. Your blood pressure will be monitored with a blood pressure cuff on your arm.
  6. Your oxygen level will be watched with a pulse oximeter on your finger.
  7. A tube may be passed into your nose to provide oxygen.
  8. A thin, flexible tube (probe) is gently guided through your mouth and down your throat. You’ll need to swallow as it goes down.
  9. A transducer on the end of the probe sends sound waves to your heart and collects the echoes that bounce back. These echoes create pictures that appear on a video screen.

When the TEE is done, the probe, IV, and electrodes are removed. You will be monitored until you are fully awake. Then, you can usually get up, get dressed, and be taken home from the clinic or hospital.

What happens after TEE?

  • Your throat may be numb for a short time.
  • Don’t eat or drink anything until the numb feeling goes away—you could choke.
  • You may have trouble swallowing right after the test. This typically goes away within a few hours.
  • It’s common to have a sore throat for a day or two after the test.

Because you receive a sedative during the procedure, someone should drive you home from the test. You should be able to drive in 24 hours.

What should I watch for?

Call your health care professional if your sore throat gets worse or doesn’t go away after a few days.

Ready to talk with our team?

Contact Tennessee Heart to schedule your TEE and discuss whether it’s the right test for your heart health needs.