TRANSESOPHAGEAL ECHOCARDIOGRAMS |
A transesophageal echocardiogram (TEE) uses the same sound wave technology that a regular echocardiogram uses but the pictures are taken by inserting a special probe into the esophagus (the food tube that connects the mouth with the stomach) rather than by placing it on the patient's chest wall.
This test is done for several reasons:
In some people, a regular echocardiogram cannot get good pictures of the heart due to the anatomy of their chest. Taking the picture from the esophagus circumvents that problem.
In some people, the part of the cardiovascular system the physician is interested in taking pictures of is not accessible by a regular echocardiogram.
Sometimes the regular echocardiogram shows something that is only suggestive of abnormality. To find out for sure, a transesophageal echocardiogram is required.
The most common uses of TEE include searching for an abnormality in the heart or major blood vessels that could be responsible for causing a stroke, looking for infections on the heart valves and evaluating the aorta (the main blood vessel in the body) for a tear in its wall. It is also frequently used to monitor the heart during cardiac and noncardiac surgery.
Anywhere from 2% to 5% of all people having a regular echocardiogram may have a TEE recommended for them.
The test is most commonly done in the hospital but can be done in a doctor's office as well. An overnight fast is required before this test. The test is only performed by a physician, often with the assistance of an echo technician and a nurse.
A local anesthetic spray is administered to the back of the mouth to numb that area and prevent gagging. Very commonly, intravenous sedation is given to make the patient relaxed and drowsy but not completely asleep.
The probe is a long, flexible tube, similar to what gastroenterologists use to look into people's stomachs. It is about the width of an adult male's index finger.The tip of the probe is placed into the back of the mouth and the patient is asked to swallow. This carries the tip of the probe into the esophagus where the pictures are taken and simultaneously recorded on videotape for later analysis. The probe is in place for anywhere from 10 to 20 minutes.
During the test, the patient is unable to swallow their saliva. The nurse uses a suction device similar to what dentists use to remove the saliva that accumulates. The patient may feel the probe pressing against the back of their throat and may feel it moving up and down inside their chest. However, it is not normally a painful procedure. The probe does not enter the windpipe and does not normally affect the breathing.
After the test, the patient may not take anything by mouth for another hour because they might gag. After one hour, it is okay to eat normally. If sedatives were given, the patient may not drive for the rest of the day and must arrange for someone else to take them home. About 4% of people experience a sore throat for 24 hours following the procedure.
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