TEE (Trans-Esophageal Echocardiogram)
The TEE test takes a detailed picture of your heart and its major blood vessels. This test helps to detect heart valve disease, heart tumors, and blood clots inside the heart. It also helps detect an aneurysm (AN-your-izm), which is a swelling, like a balloon, in a blood vessel. TEE stands for trans-esophageal (trans-ee-SOFF-uh-jee-ul) echocardiogram (ek-oh-CAR-dee-oh-gram).
How does a TEE work?
The TEE test combines several procedures. It makes a picture by using sound waves that pass through skin and tissue without being heard or felt. This is called ultrasound (UL-truh-sound). The special instrument that sends and receives the sound waves is called a transducer (trans-DOO-sir).
A tiny transducer is attached to the end of a flexible tube with a light. The tube is called an endoscope (EN-doh-skope). The scope is passed into your mouth, through your esophagus (food pipe), and down behind your heart. The word “trans-esophageal” means “through the esophagus.”
The transducer sends sound waves into your heart and blood vessels and then receives the signals that bounce back, or “echo.” The signals are converted into pictures that show on a screen. This part of the test is called an echocardiogram.
How do I prepare for the test?
- Do not eat or drink anything, not even water, for 6 hours before the test. If your doctor says so, you may take your medicine with a very small sip of water.
- Remove any full or partial dentures.
- Tell your doctor or nurse before the test if any of your teeth are loose.
- You will need to sign a consent form.
What happens during the test?
A doctor will perform your TEE test with the help of a nurse or technician. The technician will help you onto a bed and ask you to lie on your left side. You will be connected to machines that monitor your blood pressure, heart rate, and oxygen levels during the test. You will be given a mild sedative by an intravenous line (IV) to help you relax. You’ll remain somewhat alert so you can cooperate with the doctor and staff.
The TEE test may cause some mild discomfort, but it should not be painful. The back of your throat will be numbed with an anesthetic spray. Your throat will feel cool, and you may get a bitter taste in your mouth. You will need to remove any full or partial dentures. To protect your teeth, a plastic mouth guard will be placed in your mouth. You’ll need to press your lips around the guard.
The doctor then will insert the scope into the back of your mouth. You will be asked to swallow the scope, and you may gag for a few moments. The doctor will advance the scope into your esophagus about 12 to 14 inches. The transducer will take a picture of the top right chamber of your heart. This is called the right atrium (AY-tree-um).
Next, the doctor will advance the scope 4 to 6 inches farther. The transducer will now get a picture of the lower left chamber, which is called the left ventricle (VEN-trih-col).
The scope will be in place at each site for 5 to 10 minutes. If saliva collects in your mouth, a small plastic suction tube will remove it.
What happens after the test?
You cannot eat or drink for at least 1 hour after the test. The numbing effect of the anesthetic takes this long to wear off. Your nurse will check your gag reflex often by touching the back of your mouth with a tongue depressor. You must be able to gag to keep from choking on food or fluid.
- You may have a mild sore throat for up to 24 hours after the test. This is normal.
- Your doctor may prescribe throat lozenges to relieve the mild soreness in your throat.
- You may have to stay in bed for 1 to 2 hours while the mild sedative wears off.
- You must have a responsible adult drive you home. You must arrange it in advance.
When to call the doctor
Tell your doctor or nurse if you have any of the following:
- Choking on foods, fluids, or saliva
- Severe pain or bleeding from your mouth or throat
How do I get my results?
Your doctor will discuss the results of the test with you. Check with your doctor or the testing center about how and when to get your test results.
Questions and concerns
It’s normal to have some anxiety before and during a test. But a diagnostic test should not be a frightening experience. Feel free to express concerns about your TEE test. Please ask the medical staff any questions you have.