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Transesophageal Echocardiogram

Transesophageal Echocardiogram

A transesophageal echo (TEE) is a type of echo test in which a long, thin, flexible probe with an ultrasound transducer is guided down the patient’s throat into the esophagus (the "food pipe" leading from the mouth into the stomach).
The TEE test provides a close look at the heart’s valves and chambers, without interference from the ribs or lungs. TEE is often used when the results from standard echo tests are not sufficient, or when your cardiologist needs a closer look at your heart.

Why is this test performed?
The test is used to:

  • Assess the anatomy and 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 abnormalities of the left atrium

Before the test
When this test is recommended, please tell your doctor if you have any problems with your esophagus, such as a hiatal hernia, problems swallowing, or cancer.

Someone should come with you the day of the test to drive you home. You should not drive until the day after the procedure. The sedation given during the test causes drowsiness, dizziness and impairs your judgment, making it unsafe for you to drive or operate machinery.

Can I eat or drink on the day of the test?
DO NOT eat anything for at least 6 hours before the test. Small amounts of water only are OK up to 2 hours before the test.

Should I take my medications the day of the test?
Take all of your medications at the usual times, as prescribed by your doctor. If it is 4 hours before the test, please take your medications with only a small sip of water.

If you have diabetes and take medications to manage your blood glucose, please contact your doctor for specific instructions about taking your medication before the test.

What should I wear on the day of the test?
You should wear comfortable clothing. You will change into a hospital gown before the test.

What happens during the test?

  • Your test will take place at the EvergreenHealth and the test will be supervised by a cardiologist and registered nurse (RN) with a cardiac sonographer assisting in obtaining the ultrasound images of your heart.
  • The test will be explained in detail and informed consent will be obtained. You will have the opportunity to ask questions before we begin.
  • You will be given a hospital gown to wear.
  • The RN or sonographer will place three electrodes on your chest. The electrodes are attached to an EKG monitor to chart your heart’s electrical activity during the procedure.
  • A blood pressure cuff will be placed on your arm to monitor your blood pressure.
  • A small clip, attached to a pulse oximeter, will be placed on your finger to monitor the oxygen level of your blood.
  • Before beginning the test any family or friends that are accompanying you will be escorted to the waiting room. 
  • The cardiologist will spray an anesthetic (pain-relieving medication) at the back of your throat in order to numb your throat.
  • The RN will give you sedatives that will help you relax that may make you drowsy.
  • You will be asked to lie on your left side.
  • Once your throat is numb and you are comfortable, the cardiologist will insert the probe into your mouth.  Once it is in the back of your mouth, you may be asked to swallow in order to help pass the probe into your esophagus.  This part of the test lasts a few seconds and may be slightly uncomfortable.
  • Once the probe is in position, pictures of the heart are obtained at various angles (you will not feel this part of the test) and may actually drift off to sleep.
  • Your heart rate, blood pressure and oxygen level of your blood will be closely monitored during and immediately after the exam.

How will I feel during the test?
Because of the sedative, you may not be entirely awake for the test. We will keep you as comfortable as possible during the test. Tell the health care team if you feel uncomfortable at any time during the test. You may feel a temporary soreness or numbness in your throat after the test.

How long does the test take?
The test will usually take about 90 minutes. After you have recovered from the sedation, you may go home, but remember, you CANNOT drive after the test.

Can I eat after the test?
Wait at least one hour after the test (or until the numbness in your throat is gone) before eating or drinking. Start by drinking a cool liquid. If you don’t have any problems, you can eat and drink as you normally would.

How do I get the results of my test?
After the procedure the cardiologist will give you the results.  However due to the sedatives, often times patients don’t remember much of the test or the conversation with the Cardiologist afterwards. In most cases the cardiologist will try to discuss the results (if approved) with your attending family members. Otherwise you will be called at a later time with results.