An advanced echocardiography technique in which a thin probe advanced through the esophagus provides close-range evaluation of structural problems such as heart valves, atrial thrombus, and endocarditis.
Indication
- Investigation of left atrial / left atrial appendage thrombus in atrial fibrillation
- Suspected infective endocarditis and assessment of vegetations
- Detailed evaluation of mitral, aortic, and prosthetic valve disease
- Suspected shunt such as atrial septal defect (ASD) or patent foramen ovale (PFO)
- Pre-diagnosis of aortic dissection and assessment of the aortic root
- Investigation of cardiac sources of embolism (stroke)
- Cases in which standard (transthoracic) echocardiography is inadequate
Preparation
- Stop solid and liquid food intake at least 6 hours before the procedure
- Remove dentures, eyeglasses, and accessories around the throat
- Inform your physician about anticoagulants, antiplatelet agents, and diabetes medications
- Arrange a companion since you should not drive after the procedure
- Disclose any history of swallowing difficulty, esophageal disease, or allergies
How it's performed
- An intravenous line is placed; blood pressure, oxygen, and ECG are continuously monitored
- The throat is numbed with a local anesthetic spray, then sedation is given
- A soft, thin TEE probe is advanced through the esophagus to behind the heart
- Heart valves, chambers, and great vessels are imaged from multiple angles
- If needed, color Doppler and contrast (bubble study) are used to evaluate shunts
- At the end of the study the probe is gently removed and the patient is observed in the recovery area
Post-procedure
- Observation under monitoring until the effect of sedation wears off (usually 1-2 hours)
- No food or drink until throat numbness resolves (about 1 hour)
- Do not drive or perform heavy work on the day of the procedure
- Sore throat, mild hoarseness, and difficulty swallowing typically resolve within 24-48 hours
- Seek emergency care for high fever, bloody vomiting, or severe chest pain
Risks
- Temporary sore throat, hoarseness, and difficulty swallowing
- Sedation-related respiratory depression and nausea
- Esophageal injury or bleeding (rare, less than 0.1%)
- Arrhythmia or drop in blood pressure
- Tooth or palate injury (very rare)
FAQ
Is the TEE procedure painful?
Because of throat numbing and sedation, most patients do not remember the procedure; you may feel mild pressure during swallowing of the probe.
Why must I fast for 6 hours before the procedure?
Fasting is required to prevent stomach contents from entering the lungs (aspiration) under sedation.
Why is TEE needed when standard echocardiography is available?
Areas such as the left atrium, heart valves, and aortic root are seen far more clearly from the esophagus; some diagnoses can only be made with TEE.
When can I eat after the procedure?
It is generally safe to start with liquids about one hour after the swallowing reflex has fully returned, then progress to soft foods.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Echocardiography
Cardiology
Echocardiography (cardiac ultrasound) — sound-wave imaging of the heart chambers, valves, and pumping function.
Arrhythmia Evaluation and Treatment
Cardiology
Arrhythmia evaluation and treatment — diagnosis of cardiac rhythm disorders and a personalized treatment plan.
Electrocardiography
Cardiology
Electrocardiography (ECG) — a painless and rapid recording of the heart's electrical activity.
Holter monitoring
Cardiology
Holter monitoring (24-hour ECG) — long-term recording of the heart rhythm during daily life.
Heart Failure Follow-Up
Cardiology
Heart failure follow-up — long-term monitoring with guideline-directed medical therapy and lifestyle measures.
Pacemaker Implantation and Follow-up
Cardiology
Permanent cardiac pacemaker implantation and regular pacemaker check-ups — treatment for bradyarrhythmias.
Exercise Stress Test
Cardiology
Exercise stress test — evaluation of electrocardiographic changes under increased cardiac workload during exertion.
Coronary Angiography
Cardiology
Coronary angiography — imaging and evaluation of the heart vessels using a catheter.