Cochin Cardiac Club

Health Blog by Dr.Uday Nair


Transesophageal echocardiography (TEE) uses sound waves to produce an image of the heart and to see how it is functioning. But unlike standard echocardiography, the sound waves travel through a tube-like device put in the mouth and passed down the throat into the esophagus. (The esophagus is the tube that connects the throat to the stomach).TEE offers superior visualization of posterior cardiac structures because of close proximity of the esophagus to the posteromedial heart with lack of intervening lung and bone. This proximity permits use of high-frequency imaging transducers that afford superior spatial resolution 

Why is this test performed?

The test is used to:
Assess the overall function of your heart’s valves and chambers
Determine the presence of many types of heart disease, such as valve disease, myocardial disease, pericardial disease, infective endocarditis, cardiac masses and congenital heart disease
Evaluate the effectiveness of valve surgery
Evaluate abnormalities of the left atrium


Upon arrival, you will change into a patient gown and an IV (intravenous) will be started in your arm.  Several electrodes (small sticky patches) will be placed on your chest.  A blood pressure cuff and an oxygen saturation clip will also be in place to monitor you throughout the TEE.  You will be asked to remove any dental appliances and to identify any caps or any loose or missing teeth.  The Cardiologist will spray the back of your throat with a numbing medicine and then place a small plastic bite block in your mouth to protect your teeth and the probe.  You will be positioned comfortably on your left side.  Sedation medications will be given to you through the IV (intravenous) during the procedure.  You may become sleepy, but you will not be "knocked out".
The lubricated end of the ultrasound probe is then passed through the bite block and gently advanced down the esophagus and then toward the stomach.
The Cardiologist will ask you to swallow several times to advance the probe/scope.
This probe is then gently positioned to obtain the necessary pictures/information. 
The procedure takes approximately 15 to 20 minutes.  When the examination is complete, the Cardiologist will withdraw the probe and the bite block. 
You will continue to be monitored for an additional 1 to 2 hours and then you will be discharged home with a responsible adult. 
You may not drive for 24 hours.

Risks of TEE.

If you have a transesophageal echocardiogram, your throat may be sore for a few hours afterward. Rarely, the tube may scrape the inside of your throat. Your oxygen level will be monitored during the exam to check for any breathing problems caused by sedation medication.

Who Needs TEE?

Doctors may recommend transesophageal echocardiography (TEE) to help diagnose a heart or blood vessel disease or condition. TEE can be used for adults and children.

Doctors also may use TEE to assist with cardiac catheterization or to help prepare for surgery or assess a patient's status during and/or after surgery.
Complications of TEE.

The application of transesophageal echocardiography (TEE) has been continuously increasing over past several decades. It is usually considered a very safe diagnostic and monitoring device. Though the complications are rare, but these complications must be known to the operators performing TEE.The complications are primarily related to gastrointestinal, cardiovascular and respiratory systems along with some miscellaneous problems related to probe insertion, drugs and inexperience of the operator.

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