What is a Transesophageal Echocardiogram?

Transesophageal echocardiogram, usually abbreviated as TEE, is a type of echocardiogram that visualizes the heart from inside the esophagus instead of from outside of the chest and upper abdomen. It can have several advantages when it comes to getting a good view of the heart. One of these is that the Doppler is much closer to the heart and there are few obstructions to the sound waves that help to create the image of the heart. This isn’t always the case when performing standard echoes on especially adults or on children, where obstructions like excess body fat or abnormal position can make it difficult to get a good view.

Unlike the standard echocardiogram, the transesophageal echocardiogram usually is not performed when people are conscious. Since the Doppler is inserted through the mouth down to the esophagus, consciousness could make this extremely difficult. People would be likely to gag, even with special sprays that eliminate this to a certain degree. It could also be uncomfortable feeling the Doppler thread downwards and feeling its manipulations.

For this reason, transesophageal echocardiogram is typically performed when a person is unconscious or in a state of heavy sedation. Throat spray is used to prevent gagging, which might still happen in an unconscious or partially conscious state. For many people a simple TEE might be an outpatient procedure, and people could go home the same day after they recover from any anesthesia.

One of the indications for TEE is during actual surgeries where the heart is open. Even with an open-heart surgery, total visualization of the heart isn’t always possible. By using transesophageal echocardiogram, which doesn’t interfere with the surgical site, all structures of the heart can be visualized. This can help to determine success of surgical interventions before the chest is closed.

Not all cardiologists are expert at transesophageal echocardiogram, and it’s important to get a cardiologist with some experience in this field. Though rare, there can be damage to the throat or perforations in the esophagus, if this procedure is performed without the appropriate skill level. Some cardiologists will refer patients to experts if they think a TEE is warranted, and anyone who would undergo this procedure should consider inquiring the doctor’s background and experience with TEEs. Echocardiologists are generally most skilled in this area.

Unlike with the standard echo, there can usually be a few side effects after undergoing transesophageal echocardiogram. The most noted of these is a sore throat, which may be mildly bothersome to quite painful. The sore throat can last for several days, and if it appears to worsen, patients should consult their doctors.