Marquette General Heart Institute

 

Transesophageal Echocardiography (TEE)

 

There are several ways to create an image of the heart and how it functions. The TEE is one of these ways. It will show the heart structure and the blood flow through the heart. This procedure can detect heart problems such as blood clots, aneurysms, valve dysfunction, septal wall defects, backflow of the blood through the valves, infections of the heart valve and cardiac masses.

 

What exactly is a TEE?

Transesophageal echocardiography is a painless ultrasound imaging exam. The instrument used is inserted through the mouth and passed into the esophagus. Because the heart and esophagus are close together, and there are no bony structures between, TEE can provide a clear image of the heart.

 

The TEE probe is a long flexible instrument with an ultrasound sensor located at the tip. The probe is passed through the mouth, down the back of the throat, and into the esophagus and stomach. This allows the doctor to examine the heart and valves through ultrasound images. No biopsies (tissue samples) are taken from the heart during the TEE.

 

The exam is extremely well tolerated with little or no discomfort. The probe does not interfere with breathing. There is no risk of heart damage from the exam.

 

PREPARATION FOR A TEE

Do Not: eat or drink anything, including water, after midnight the day before your exam.

Do Not: smoke after midnight the day before your exam.

 

Do: take your heart and blood pressure medications the morning of your exam with

just a small sip of water.

 

Do: if you are an outpatient, bring a companion with you to the Cardiac Ultrasound Department in the Heart Institute where the examination will be performed.

 

You will be given medication to help you relax during the exam. These medications will make you drowsy, so you will need someone to take you home. You will not be allowed to drive for 24 hours after the exam. Even though you may not feel tired, your judgement and reflexes may not be normal.

 

THE PROCEDURE

Before the procedure you will be asked to sign a written consent form. A registered nurse will be with you during the whole procedure. The nurse will explain the TEE to you. You may ask questions or discuss the procedure with the nurse or doctor during this time.

 

In the procedure room you will be lying on a comfortable bed. Your nurse will check your blood pressure and pulse. A cardiac monitor will be used to watch your heartbeat. The ultrasound technician will also be present to set up the equipment. The technician will place another cardiac monitor on you to record a different image of your heartbeat. The nurse will place a finger clip on one of your fingers to monitor your oxygen levels. During the procedure you will be placed on oxygen to ensure optimum levels at all times. An intravenous (IV) solution will be inserted into a vein in your arm. You will receive a sedative through your IV. Your throat will be sprayed with a local anesthetic, which numbs your throat and allows you to swallow the TEE probe more readily.

 

The procedure. The doctor will ask you to lie on your left side. After the doctor places the probe in your mouth and asks you to swallow, he gently advances the probe into the esophagus.

A mouth guard will be provided for you to rest your teeth on and to protect the probe. You may hear some swishing noises during the exam. This happens when the doctor listens to the sound of blood pumping through the heart. The total exam lasts approximately 15-20 minutes.

After the procedure the probe is removed along with the mouth guard. A nurse will continue to monitor your heart, blood pressure, and oxygen levels for an hour or until the effects of the sedatives have worn off.

 

After the recovery period, if you are an outpatient, you will be discharged home with your escort. If you are an impatient, you will be taken back to your room.

 

For a day or two following the exam, you may experience some slight throat discomfort. You may also have localized irritation of the vein at the IV site.

 

The day of the exam, you might also experience slightly blurred vision and slower reaction times as a result of the medications.

 

OUTPATIENT INSTRUCTIONS

Do Not: Drive or operate nay motorized equipment for 24 hours after the exam.

Do Not: Drink alcoholic beverages for 24 hours after the exam.

 

After you are able to take a few sips of water without difficulty, usually one hour after the exam, you may resume your normal diet and normal activity. You should avoid very hot foods and liquids for approximately one hour after discharge.

 

Call your doctor immediately if you notice any of the following:

Unusual pain or difficulty swallowing.

Unusual abdominal or chest pain

Vomiting of blood.

Black or bloody stools

Temperature above 100.6F