What Is a Transesophageal Echocardiogram?

Medically Reviewed By Angela Ryan Lee, MD, FACC
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A transesophageal echocardiogram (TEE) is an imaging test that allows your doctor to examine your heart and the arteries connected to it. It uses ultrasound to take pictures of your heart via a thin tube that passes through your mouth and into your esophagus. Your doctor may order a TEE if they suspect your heart is not working as it should. In some people, a TEE can provide more detailed information than a traditional echocardiogram.

A TEE can also help healthcare professionals monitor the heart during surgery.

Read on to find out more about transesophageal echocardiography. This guide includes information on what happens during the test, when you might need it, and more.

What happens during a transesophageal echocardiogram?

There is an LED heart sign against a purple background.
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Transesophageal echocardiograms (TEEs) are performed by specially trained doctors in a hospital or clinic. You can expect the whole test to last around 30–60 minutes, according to the American Heart Association.

Before the TEE, the technician will spray your throat with a medication to numb it and suppress your gag reflex. You may then intravenously receive a mild sedative.

Your doctor will monitor your heart with electrodes. If they feel that tracheal intubation is necessary, they will carry this out while you are lying down, explain researchers in a 2022 overview. Tracheal intubation is when a healthcare professional inserts a thin tube into the trachea or windpipe to keep the airways open.

Your doctor will then insert a thin, flexible probe through your mouth, down your throat, and into your esophagus. At the end of the probe is a transducer.

The transducer sends ultrasound waves to your heart. It turns the echoes that bounce back into pictures. Your doctor can view these pictures on a monitor.

The time it takes for your doctor to take the pictures can vary, but this part of the test should last around 10–15 minutes.

Are you awake during a transesophageal echocardiogram?

In some cases, you may be asleep during the TEE, according to the Memorial Sloan Kettering Cancer Center. You may receive anesthetic through an intravenous catheter during the procedure to help you sleep.

However, per the Ohio State University Wexner Medical Center, you may receive only a mild sedative to keep you calm instead. In this case, you will then be awake enough to swallow when your doctor inserts the probe if necessary.

Why do doctors perform a transesophageal echocardiogram?

Your doctor may perform a transesophageal echocardiogram (TEE) if they suspect that there is an issue with your heart.

It allows them to clearly examine the upper chambers of your heart and the valves between the upper and lower chambers more effectively than they can with a standard echocardiogram. This is particularly true if a person has chest bandages after recent cardiac surgery, has obesity, or uses a ventilator to help them to breathe, according to the American Heart Association (AHA).

The TEE allows doctors to examine:

  • the size of your heart
  • the thickness of your heart’s walls
  • how well your heart is pumping
  • heart valves
  • issues with blood flow
  • blood clots in the heart

Your doctor may also perform a TEE during surgery for:

  • endocarditis
  • heart valve repair
  • repair of a tear in the aorta
  • congenital heart lesions

What conditions can a transesophageal echocardiogram help to diagnose?

A transesophageal echocardiogram (TEE) is useful for assisting in the diagnosis of a range of conditions affecting the heart.

According to the AHA, it allows your doctor to examine your heart for signs of:

  • bacterial or fungal infection
  • stenosis, which is when the valves become narrow or blocked
  • regurgitation, which is when blood leaks backward through your heart valves
  • blood clots
  • cardiomyopathy
  • cancer

Learn more about heart conditions.

How do I prepare for a transesophageal echocardiogram?

Your doctor will be able to inform you about anything special you need to do before your transesophageal echocardiogram (TEE).

It is possible that they will ask you to avoid drinking alcohol for a few days before the test. You may also not be able to eat or drink anything for at least 4–6 hours before the TEE.

It is important to ask your doctor any questions you may have before the test. Being as informed as possible about what to expect before, during, and after the TEE can help to put you more at ease.

What happens after a transesophageal echocardiogram?

Straight after your transesophageal echocardiogram, you will spend time in a recovery room. A nurse will monitor your vital signs until you are ready to go home.

You may find that your throat still feels numb from the medication. It is important to not have anything to eat or drink until the numbness goes away, otherwise you are at risk of choking.

You may experience difficulties swallowing for a few hours after the test. Some people also have a sore throat for 1–2 days afterward.

It is important to avoid drinking alcohol for 1–2 days after the test, as the sedative needs time to leave your system.

Your doctor will be able to advise you on how soon after your test they expect to look at your results.

What do my transesophageal echocardiogram results mean?

Your doctor will be able to explain your test results to you following the transesophageal echocardiogram (TEE). The length of time it takes for them to analyze your results can depend on the findings during the TEE.

If your doctor identifies any concerns with your heart, such as unusual tissue or issues with blood flow, they will explain what this means and advise you on any further tests they recommend.

If they are able to confirm a diagnosis with the TEE, they will discuss with you what that diagnosis means and any treatments they recommend.

It is important to ask any questions you have about your test results, diagnosis, and any additional tests or procedures your doctor recommends.

What are the risks of a transesophageal echocardiogram?

The main risk of a transesophageal echocardiogram (TEE) occurs when the probe passes through your throat to your esophagus, the AHA explains.

In rare cases, tracheal intubation and TEE can cause bleeding and esophageal injury, according to 2017 research.

When should I contact a doctor?

You should contact your doctor if you have scheduled a transesophageal echocardiogram and you have questions about the test. They will be able to provide you with information about what to expect from the test and anything special you need to do before and after.

You should also contact your doctor if you experience a sore throat for more than a few days after the test. It is common for a person to have a sore throat for 1–2 days, but it should not last for much longer than this.

Summary

A transesophageal echocardiogram (TEE) is a type of imaging test. During the procedure, your doctor will insert a thin, flexible probe into your mouth and down your throat to your esophagus. The transducer on the end of the probe sends ultrasound waves to the heart, which return as pictures.

Your doctor may order a TEE to assist with diagnosing a condition of the heart. In particular, TEE can be useful in cases where a traditional echocardiogram does not provide enough information.

Contact your doctor if you are booked in for a TEE and have questions about the test. They will be able to answer any questions you may have and advise you on anything specific you need to do to prepare for the test.

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Medical Reviewer: Angela Ryan Lee, MD, FACC
Last Review Date: 2022 Sep 30
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