What is a Transesophageal Echocardiography?

Transesophageal echocardiography is a diagnostic test using an ultrasound device that is passed into the esophagus of the patient to create a clear image of the heart muscle and other parts of the heart. A tube with a device called a transducer is passed down into the patient's throat and into the esophagus (the food tube that connects the mouth to the stomach). The transducer directs ultrasound waves into the heart, and the reflected sound waves picked up by the transducer are translated into an image of the heart.

Since the esophagus is right next to the heart, transesophageal echocardiography provides a very clear picture of the heart. It can provide information on the size of the heart, its pumping strength, and the location and extent of any damage to its tissues.  It can detect abnormal tissue growth around the heart valves. It is also good at detecting abnormalities in the pattern of blood flow,such as the backward flow of blood through partly closed heart valves, known as regurgitation or insufficiency. It is especially useful in cases in which conventional echocardiography (a test where the transducer is kept on the patient's chest) cannot offer a good image, such as when the patient is obese or has a thick chest wall. It is useful for monitoring heart function during cardiac surgery and detecting blood clots in the left atrium of the heart.

How the test is performed:
You will be asked to lie down on the examination table. A needle with a tube connected to it will be put in your arm. This is called an intravenous line or IV. The IV will give you a mild sedative to relax you throughout the test. Small metal disks called electrodes will be placed on your chest. These electrodes have wires called leads, which hook up to an electrocardiogram machine. This machine will monitor your heart rhythm during the test. The test will begin with the technician spraying your throat with an anesthetic, which will make it feel numb. 

Then, a small flexible tube called a probe will be put down your throat. The technician will ask you to swallow, and the probe will be gently moved down your throat. This is often the most uncomfortable part of the test. If you feel the need to gag, do not worry, this is quite common. Once the probe is in place, you should not feel any pain.

On the end of the probe is the transducer, which takes pictures of your heart. The technician can also move the probe to get pictures of your heart from different angles.

After the technician has enough pictures, the probe and IV line will be removed. You will also be disconnected from the electrocardiogram machine. You may feel a little sleepy until the sedative has worn off, and you will be watched to see that your heart rate and blood pressure are normal.

How to prepare for the test:
You will need to stop eating for at least 4 hours before the test. Your doctor will tell you exactly how long. Talk to your doctor about any medicines that you are taking because he or she may want you to stop taking them before the test.

How the test will feel:
After the test, it is important to refrain from eating or drinking until the gag reflex has returned--otherwise, the patient may accidentally inhale some of the food or beverage. If a sedative has been given, patients should not drive or operate heavy machinery for at least 10-12 hours. They should avoid consuming alcohol for a day or so, since alcohol may amplify the effect of the sedative.

You may find that you have a sore throat or trouble swallowing after the procedure. These side effects usually go away after a day or so.