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Heart Valve Surgery
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Hybrid Ablation
Implantable Cardioverter Defibrillator (ICD) Insertion
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Left Atrial Appendage Ligation (LAL)
Pacemaker and Defibrillator Lead Extraction
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Open Thoracoabdominal Aortic Aneurysm Repair
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Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram (TEE) is a diagnostic procedure that uses sound waves to produce pictures of your heart, and the arteries around your heart.

A TEE is often used to diagnose heart disease, detect blood clots, or evaluate heart valves. It may also be used to monitor your heart during a non-cardiac or heart surgery.

UPMC doctors are experts at using TEE technology to evaluate the function of your heart and develop a treatment plan for your condition.



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What Is Transesophageal Echocardiogram?

A transesophageal echocardiogram (TEE) is performed by inserting a probe with a transducer down the esophagus to take pictures of your heart. This is instead of placing the transducer on your chest.

By going through the esophagus, TEE provides a clearer image of the heart because the sound waves do not have to pass through skin, muscle, or bone tissue.

TEE is used to diagnose heart conditions, including different types of heart disease. It may also be used during surgery to assess your cardiac status if you are having a non-cardiac procedure or to evaluate the result of a surgical procedure on your heart.

What conditions does a TEE diagnose?

Transesophageal echocardiography can evaluate the signs and symptoms of several conditions, including:

  • Atherosclerosis.
  • Cardiomyopathy.
  • Congenital heart disease.
  • Congestive heart failure.
  • Aneurysm.
  • Valvular heart disease.
  • Cardiac tumor.
  • Pericarditis.
  • Infective endocarditis.

Why Would I Need a TEE?

You may need a TEE if your doctor suspects you may have a heart condition. You may also need a TEE if you have a heart condition and are undergoing surgery.

Is a TEE right for me?

  • You would be a good candidate for a TEE if you have a heart condition or your doctor suspects you have one. A TEE may be the best way to get a detailed view of your heart.
  • If you have a bleeding condition or problems with your esophagus, you may not be a good candidate for a TEE.

Possible alternatives to a TEE test

Alternatives to a TEE test include:

  • Exercise stress test — A stress echocardiogram is a widely used test that creates moving images of your heart while you are increasing your heart rate with exercise or by taking medication that increases your heart rate.
  • Electrocardiogram (ECG or EKG) — This test records the electrical activity of your heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage.
  • Computed tomography (CT) scan — This imaging test uses cross-sectional x-rays and a computer to create detailed 3D images.
  • Magnetic resonance imaging (MRI) —MRI uses a large magnetic field, radio waves, and computers to create detailed images of your veins.
  • Nuclear stress test — A nuclear stress test, also known as nuclear cardiac imaging, measures blood flow to the heart at rest and after activity.

What Are the Risks and Complications of a TEE?

TEEs are generally considered safe. However, there are some possible risks and complications, including:

  • Injury to the mouth, throat, esophagus, or teeth.
  • Reaction to medication.
  • Sore throat.
  • Feeling weak, tired, or groggy.
  • Esophageal bruising or bleeding.

What Should I Expect From a TEE?

Before: How to prepare for a TEE

  • Your cardiologist will explain the procedure to you and answer any questions.
  • You will need to fast for a certain time prior to the procedure. Your doctor will notify you how long to fast, usually overnight.
  • Notify your doctor of all medications (prescription, over-the-counter or herbal supplements) you are taking, if you are pregnant or suspect that you may be pregnant, if you are allergic to or sensitive to medications, local anesthesia, or latex.
  • Your doctor may request a blood test to determine how long it takes your blood to clot.
  • If you are given a sedative before the procedure, you will need someone to drive you home afterward.

How long does a TEE take?

A TEE usually takes between 30–90 minutes (about an hour and a half).

During your TEE

  • A TEE may be performed on an outpatient basis or as part of your stay in a hospital.
  • An intravenous (IV) line will be started in your hand or arm to inject medication and administer IV fluids if needed.
  • Lying on your left side, you will be connected to an ECG monitor that records the electrical activity of your heart and monitors your heart during the procedure. Your heart rate, blood pressure, and other vitals will also be monitored.
  • A local anesthetic spray will be applied to the back of your throat, and sedative medication will be injected into your vein. You will be drowsy and relaxed.
  • The TEE probe will be passed through your mouth and down your throat and the necessary images will be taken.

Recovery after a TEE

  • During recovery, nurses will monitor your heart rate, ECG, and other vitals.
  • You may feel weak, tired, or groggy for the remainder of the procedure day. You should feel normal by the following day.
  • Your throat may be sore for a few days.

If the procedure was performed on an outpatient basis, you may be discharged home, unless your doctor determines that your condition requires further observation or hospital admission.

When to call your doctor about TEE complications

Call your doctor if you experience:

  • Bleeding from your esophagus.
  • Injury to your teeth or mouth.
  • Difficulty breathing.

Why Choose UPMC for TEE?

UPMC cardiovascular doctors are experts in treating all types of heart disease. Depending upon the results of your TEE, your doctor will develop the appropriate treatment plan for your condition.


By UPMC Editorial Staff. Last reviewed on 2024-10-01.

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