Transesophageal Echocardiogram (TEE)

Your doctor may order a TEE to help diagnose certain heart conditions. These include:

• congestive heart failure
• cardiomyopathy
• heart valve disease
• aneurysm
• pericarditis
• endocarditis
• blood clots

During a TEE, a medical professional places a flexible tube, called a probe, inside your esophagus. Your esophagus is also known as your food pipe.

Placing the probe in this area helps to provide more detailed pictures, due to its location behind the heart, according to Memorial Sloan Kettering Cancer Center.

A TEE allows a doctor to get a closer look at your heart’s:

• valves
• chambers
• blood vessels
• outer lining

Collectively, the images can show:

• the size of your heart
• whether there are any structural issues or clots
• how well your heart pumps blood

Here’s what you can expect during a TEE:

1. A nurse or technician will help you onto an exam table. Once you are on the table, they will connect you to equipment that monitors your blood pressure, heart rate, and breathing. They’ll also give you supplemental oxygen.
2. Your doctor will take additional steps to ease possible discomfort that can occur as a result of a TEE. For example, they may spray your throat with a numbing agent. They may also give you a protective mouth guard. (Note: If you have dentures or any false teeth, you’ll need to remove them before the procedure.)
3. A nurse or technician will then place electrodes on your chest. These small metal disks are attached to wires that connect to a machine. The machine monitors your heartbeat.
4. An anesthesiologist will help administer general anesthesia intravenously (via an IV) to help you fall asleep during the remainder of the procedure.
5. Once you’re under anesthesia, your doctor or technician will place a probe that contains a camera down your throat and inside your esophagus to take pictures of your heart. They may move the probe to get clearer pictures of your blood flow. In all, the procedure takes about 15 minutes.
6. The probe, electrodes, and IV are all removed once the doctor is done taking pictures during the TEE.
7. At the end of the TEE, medical staff will move you to a recovery room where a nurse will check your vitals. Once you’re fully awake and your vitals are satisfactory, they may allow you to go home.

Overall, the risks of TEE are minimal, according to the American Heart Association. Your throat may feel sore for a couple of days, and there’s a small chance of bleeding from possible tears in the esophagus.

There are also possible risks and side effects associated with general anesthesia.

The American Academy of Anesthesiologists suggested talking with your doctor about the following:

• underlying risk factors, such as high blood pressure, kidney disease, and sleep apnea
• mild and temporary side effects, such as nausea, vomiting, and confusion
• possibility of more severe side effects, such as hyperthermia, breathing problems, and cognitive dysfunction
• whether you smoke or drink alcohol, and whether these may increase your risk of anesthesia-related side effects

A doctor will review specific preparatory steps you should take before a TEE. These may include the following:

• Stop taking certain diabetes medications, such as metformin, a day before your TEE. Be sure you tell a doctor about all medications, supplements, and vitamins you currently take.
• Don’t drink any alcohol a few days before TEE.
• Don’t eat any food after midnight during the night before your procedure.
• You may drink water in small amounts after midnight, but you shouldn’t have any water 4 to 6 hours before your appointment time.
• Don’t wear cosmetics, perfumes, or lotions the morning of your procedure.
• Wear glasses instead of contacts on the day of your appointment.

You may typically go home the same day as your procedure. Due to the effects of anesthesia, you’ll need someone to help you get home.

Avoid eating or drinking anything until your throat is no longer numb. This can help reduce the risk of accidental choking. You should be able to swallow a few hours after the TEE.

During the first 1 to 2 days, you may experience a sore throat from the probe that was in your esophagus. Drinking plenty of fluids and sucking on popsicles or cough drops can help ease this discomfort. Call your doctor if your throat doesn’t feel better after a few days.

It’s also possible to cough up blood-tinged saliva or mucus. While this is typical within the first 24 hours, you should call your doctor if the blood is excessive or if you cough up blood for more than a day.

Also, if your doctor prescribes antibiotics, be sure to take these as directed to help prevent infection.

You should be able to resume regular activities, including work and school, after 24 hours. Your doctor will notify you of the TEE results within a few days.

Is TEE painful?

A TEE itself isn’t painful due to the use of numbing agents and anesthesia. However, you may experience some discomfort for a few days after the procedure, including a sore throat.

Is TEE invasive?

Doctors consider TEE a minimally invasive procedure. It involves more preparation than other imaging tests, but there are no incisions. Invasive surgeries, on the other hand, do include incisions.

Will I be under anesthesia during TEE?

Yes. General anesthesia makes the procedure more comfortable for you. It also makes it easier for a doctor to move the probe around your esophagus for the clearest heart images possible.

While numerous diagnostic imaging exams are available, a doctor may specifically order a TEE to better determine the presence of certain heart diseases. In children, a TEE may also help detect congenital heart conditions.

TEE is minimally invasive, and it doesn’t cause many side effects. It’s still important to discuss all the preparatory steps and possible risks with your doctor well before the procedure.