What is Transesophageal Echocardiogram (TEE)?
A transesophageal echocardiogram (TEE) is a specialized ultrasound test that creates detailed images of your heart from inside your esophagus (the tube that connects your mouth to your stomach). Unlike a standard echocardiogram where the ultrasound probe is placed on your chest, a TEE uses a thin, flexible probe attached to an endoscope that's gently guided down your throat. Because your esophagus sits directly behind your heart, this approach provides exceptionally clear images without interference from your ribs or lungs. The test gives your cardiologist a close-up view of your heart's structures, particularly the valves and chambers.
Why is it Performed?
Your doctor may recommend a TEE when more detailed images are needed than a standard echocardiogram can provide. The test is commonly ordered to evaluate heart valve problems in detail, look for blood clots (especially before cardioversion for atrial fibrillation), assess congenital heart defects, examine the aorta for aneurysms or tears, investigate possible heart infections (endocarditis), or plan for heart surgery. TEE is particularly valuable for evaluating the mitral valve and detecting small blood clots in the left atrial appendage that standard echocardiograms might miss. The superior image quality often provides critical information for treatment decisions.
What to Expect
The TEE procedure is performed in a hospital or outpatient facility with specialized equipment. You'll receive sedation through an IV to help you relax and minimize discomfort, though you'll remain conscious enough to follow instructions. Your throat will be numbed with a spray or gel to suppress your gag reflex. Once you're comfortable, the doctor will gently guide the probe down your throat into your esophagus while you swallow. The probe remains in place for 10-20 minutes while images are captured from various angles. You won't be able to talk during the procedure, but you can communicate through hand signals. Afterward, you'll rest in a recovery area until the sedation wears off, typically 1-2 hours. The entire appointment takes about 2-3 hours.
Preparing for Your Test
Don't eat or drink anything for at least six hours before your TEE—this is crucial to prevent complications. Arrange for someone to drive you home, as you cannot drive for 24 hours after receiving sedation. Inform your doctor about all medications, especially blood thinners, and any allergies, particularly to anesthetics or latex. Wear comfortable, loose clothing. Remove dentures, contact lenses, and jewelry before the procedure. After the test, your throat may feel sore for a day or two. Don't eat or drink until the numbness in your throat completely wears off (usually 30-60 minutes after the procedure) to avoid choking.
Understanding Your Results
Your cardiologist will analyze the TEE images to evaluate heart valve function, chamber sizes, blood clots, structural abnormalities, and blood flow patterns. Normal results show properly functioning heart valves, no blood clots, normal chamber sizes, and no structural defects. Abnormal findings might reveal valve disease requiring repair or replacement, blood clots that need treatment with blood thinners, holes between heart chambers, vegetation from infection, or aortic disease. The detailed information from TEE often helps determine whether you need surgery, catheter-based procedures, medication adjustments, or simply continued monitoring. Your doctor will discuss findings and treatment recommendations with you once you're fully alert after the procedure.
Have questions about Transesophageal Echocardiograms? Our experienced cardiology team is here to help. Contact Advanced Cardiovascular Specialists & Primary Care at (203) 334-2100 to schedule your appointment or discuss any concerns.
