Transesophageal Echocardiography (TEE) is a medical imaging procedure that employs high-frequency sound waves (ultrasound) to create detailed visualizations of the heart and its surrounding arteries. Unlike conventional echocardiograms, TEE involves the insertion of a thin tube equipped with an echo transducer through the mouth and into the esophagus, enabling exceptionally clear imaging of the heart's upper chambers and valves.

Indications for TEE

TEE is performed for a variety of purposes to assess heart structure and function. This procedure is particularly valuable because it provides clearer images of certain heart structures compared to standard echocardiograms.

Here are some primary reasons for performing TEE

  • Evaluating Cardiac Structure and Size
  • Assessing Cardiac Function
  • Diagnosing Heart Defects
  • Assessing Heart Valve
  • Identification of Blood Clots
  • Guiding Surgery

What TEE Can Reveal

During a TEE, healthcare professionals can obtain detailed images of various heart structures and conditions, including

  • Heart size and wall thickness
  • Cardiac function and pumping efficiency
  • Presence of abnormal tissue around heart valves
  • Defects causing heart murmurs
  • Valve conditions (regurgitation, stenosis, blockages)
  • Blood clots in heart chambers, especially in the upper chamber (atrial fibrillation-related clots)

The TEE Procedure

The TEE procedure involves several sequential steps

Preparation

Patients may be instructed to abstain from alcohol and undergo fasting before the procedure. A designated driver should be arranged as patients receive a sedative.

Throat Numbing

A numbing spray is applied to the throat to suppress the gag reflex.

Patient Positioning

Patients lie on their side on a table with a supportive pillow or wedge.

Monitoring

Electrodes are placed on the chest for electrocardiogram (ECG) monitoring. An intravenous (IV) line may be established for medication administration and fluid delivery.

Probe Insertion

A thin, flexible tube (probe) is inserted through the mouth and down the throat. Patients may be asked to swallow to facilitate probe placement.

Image Acquisition

Equipped with a transducer, the probe emits sound waves toward the heart, capturing echoes that generate real-time images displayed on a monitor.

Post-Tee Procedure

After undergoing TEE, patients can expect

Temporary Throat Numbness

Throat numbness may persist briefly; patients should avoid consuming food or beverages until the numbness subsides.

Mild Swallowing Difficulty

Some patients might experience temporary difficulty swallowing, typically resolving within a few hours.

Sore Throat

A sore throat is common for a day or two following the procedure.

Sedation Effects

Due to the sedative, patients should have someone drive them home, and they may feel groggy for the remainder of the day.

Generally, patients can return to their normal activities within 24 hours, and specific post-procedure care instructions, if any, will be provided by their healthcare physician.