A transesophageal echocardiogram (TEE) is a diagnostic test that uses high-frequency sound waves (ultrasound) to produces images of the heart. The results of a TEE differ from those of a typical echocardiogram because the heart is accessed through the esophagus, an organ very near the upper chambers of the heart, rather than through the chest. Because of the proximity of the transducer to the heart, the ultrasound images produced by a TEE are extremely clear, showing details not otherwise visible.
Benefits of a Transesophageal Echocardiogram
When a physician requires more detailed images of a heart than those available through a standard echocardiogram, a TEE is used. Because sound waves do not have to penetrate any bony tissue, the heart and its chambers, muscle, valves, outer lining (pericardium) and connecting blood vessels are shown in detail and with great clarity. A TEE can help a physician see the following:
- The size of the heart, and the thickness of its walls
- How well the heart is pumping
- Whether abnormal tissue is present
- Whether there is regurgitation (backup) of blood
- Whether the heart valves are blocked (stenosis)
If a TEE shows evidence of abnormal tissue around the heart valves, it may be an indication of a viral, bacterial or fungal infection, or of a malignancy.
Reasons for a Transesophageal Echocardiogram
A patient undergoes a TEE to determine the extent of any heart damage. The test may be used to evaluate the function of the chambers and valves, or to check for the following:
- Blood clots (evidence of a possible stroke)
- Cardiomyopathy (congestive heart failure)
- Congenital heart defects
- Effectiveness of valve surgery
- Heart tumors
- Infective endocarditis
- Myocardial or pericardial disease
- Valve disease
A TEE is especially useful for a patient who has an unusually thick chest wall, is obese, has a bandaged chest, or is using a ventilator to help with breathing.
In addition to being used diagnostically, a TEE is used during several types of heart-repair surgeries so that a physician can visually monitor the operation in real time.
The Transesophageal Echocardiogram Procedure
A TEE is performed in a hospital or clinic, and takes about 30 to 60 minutes. A sedative is administered intravenously, and the throat is numbed with a medicated spray to prevent discomfort and to suppress the gag reflex. Small electrodes, applied to the chest, are attached to an electrocardiogram (EKG) machine to record heart rate.
As the patient swallows, a thin, flexible tube is inserted in his or her mouth, and run down the throat into the esophagus. The inserted probe has a transducer on its end that emits sound waves, which are sent to the heart and bounce back, creating the detailed images that show up on the computer screen.
Risks of a Transesophageal Echocardiogram
The only risks of a TEE involve the insertion of the tube into the throat and esophagus. A patient may have an urge to gag in spite of the medication, and have difficulty swallowing for a few hours after the procedure. A typical patient has a sore throat and hoarseness for a day or two; in rare instances, the esophagus may bleed.