Patient education: Transesophageal echocardiogram (The Basics)

What is a transesophageal echocardiogram? — A transesophageal echocardiogram ("TEE") is a type of echocardiogram (figure 1).

An echocardiogram (also called an "echo") is an imaging test that creates pictures of the heart as it beats. During an echo, a doctor, nurse, or technician uses a thick wand, called a "transducer," to send sound waves into the heart. The sound waves create images that show the size of the heart chambers, how well the heart pumps, and how well the heart valves work (figure 2).

"Transesophageal" means that the doctor puts a tube with the transducer down the throat and into the esophagus. The esophagus is the tube that carries food from the mouth to the stomach.

Why might my doctor do a TEE? — Your doctor might do a TEE to:

●Look for a problem in your heart or in the blood vessels around your heart

●Check on a known heart problem or condition

How do I prepare for a TEE? — The doctor or nurse will tell you how to prepare.

Before your procedure, your doctor will do an exam and ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, and some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

●Any substances you use – These include alcohol and other legal or illegal drugs. This information is important because these substances might affect how well medicines used for the TEE work.

●If you have trouble swallowing food or liquids

●If you have trouble moving your neck

●If you have dentures, dental appliances, or loose teeth

In some cases, your doctor might decide that you shouldn't have a TEE based on your health history or exam. If this is the case, they will talk to you about your other options.

If you can have a TEE, you will also get information about:

●Fasting – This means not eating or drinking anything for a period of time. Ask your doctor or nurse about your fasting schedule. For example, they might ask you not to eat or drink anything (other than clear liquids) for at least 6 hours before the procedure, and to stop clear liquids at least 3 hours before the procedure.

●Taking medicines before your TEE – If you normally take medicines, ask your doctor or nurse if you can take them as usual before your TEE. You should also ask if it is OK to take them with a small sip of water.

●What help you will need after the TEE, if you are going home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

What happens during a TEE? — When it is time for the procedure:

●If you have dentures or other removable appliances in your mouth, they will be taken out.

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●In most cases, you will get anesthesia medicines called "sedatives." These will make you relax and feel sleepy. You might be awake for some parts of the procedure, but you might not remember it.

●You might also get something called "contrast." This is injected through your IV. It can improve the images of the heart.

●You might get a mouth spray or gargle to numb your throat.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will put a thin tube with a transducer on the end down your throat and into your esophagus (figure 1). They will move the transducer to certain places in your esophagus and stomach to take pictures of your heart.

What happens after a TEE? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●Your throat might be sore from the transducer.

●The staff will help you get out of bed and start moving around when you are ready.

●When the numbness in your throat wears off and you feel ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of a TEE? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Injury to the esophagus

●Bleeding in your digestive tract

●Methemoglobinemia – This is a blood disorder that makes it difficult for your cells to get enough oxygen.

What else should I know? — If you had sedatives, you will not be able to drive or do certain other activities right away after your procedure. Ask your doctor when you can drive again and return to your regular activities, including work. Rest if you are tired after the procedure.

Your doctor will schedule a follow-up appointment to go over your TEE results with you.

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Patient education: Echocardiogram (The Basics)