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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
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