ECHO Cardiogram

A transesophageal echo (TEE) test is a type of echo test in which the ultrasound transducer, positioned on an endoscope, is guided down the patient’s throat into the esophagus (the “food pipe” leading from the mouth into the stomach). An endoscope is a long, thin, flexible instrument that is about ½ inch in diameter.

The TEE test provides a close look at the heart’s valves and chambers, without interference from the ribs or lungs. TEE is often used when the results from standard echo tests are not sufficient, or when your doctor wants a closer look at your heart.

TEE may be combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart’s valves.

Why is this test performed?

The test is used to:

• Assess the overall function of your heart’s valves and chambers
• Determine the presence of many types of heart disease, such as valve disease, myocardial disease, pericardial disease, infective endocarditis, cardiac masses and congenital heart disease
• Evaluate the effectiveness of valve surgery
• Evaluate abnormalities of the left atrium

When this test is recommended, please tell your doctor if you have any problems with your esophagus, such as a hiatal hernia, problems swallowing, or cancer.

Please plan to bring someone with you on the day of the test so that you will have a ride home. You should not drive until the day after the test, as the sedation given during the test makes it unsafe for you to drive after the test.

Can I eat or drink on the day of the test?

DO NOT eat or drink anything for at least six hours before the test. Water is OK up to two hours before the test.
If you must take medication before the test, take it only with a small sip of water.

Should I take my medications the day of the test?

Take all of your medications at the usual times, as prescribed by your doctor. If it is four hours before the test, please take your medications with only a small sip of water.

If you have diabetes and take medications to manage your blood glucose, please contact your doctor for specific instructions about taking your medication before the test.

Plan for someone to drive you home

Someone should come with you the day of the test to drive you home. You should not drive until the day after the procedure. The sedation given during the test causes drowsiness, dizziness and impairs your judgment, making it unsafe for you to drive or operate machinery.

What should I wear on the day of the test?

You may wear anything you like. You will change into a hospital gown before the test. Please do not bring valuables. You will be given a locker to store your belongings during the test.

What happens during the test?

• Before the test, the healthcare provider will explain the procedure in detail, including possible complications and side effects. You will have the opportunity to ask questions.
• Your test will take place in the Echo Lab located at J1-5. The testing area is supervised by a physician.
• You will be given a hospital gown to wear.
• The sonographer will place three electrodes (small, flat, sticky patches) on your chest. The electrodes are attached to an electrocardiograph (EKG) monitor that charts your heart’s electrical activity.
• A blood pressure cuff will be placed on your arm to monitor your blood pressure.
• A small clip, attached to a pulse oximeter, will be placed on your finger to monitor the oxygen level of your blood.
• You will be given a solution to gargle that will numb your throat. The sonographer will spray an anesthetic (pain-relieving medication) at the back of your throat.
• The doctor will put medications into your IV to help you relax. You may feel drowsy.
• You will be asked to lie on your left side on an exam table.
• A dental suction tip will be placed in your mouth to remove any secretions.
• The doctor will insert a thin, lubricated endoscope into your mouth, down your throat and into your esophagus. This part of the test lasts a few seconds and may be uncomfortable. The endoscope does not interfere with your breathing. You may be asked to swallow at certain times to help pass the endoscope.
• Once the probe is in position, pictures of the heart are obtained at various angles (you will not feel this part of the test).
• Your heart rate, blood pressure and oxygen level of your blood will be closely monitored during and immediately after the exam.

How will I feel during the test?

Because of the sedative, you may not be entirely awake for the test. We will keep you as comfortable as possible during the test. Tell the healthcare team if you feel uncomfortable at any time during the test. You may feel a temporary soreness or numbness in your throat after the test.

How long does the test take?

The test will take about 90 minutes. After you have recovered from the sedation given during the test, you may go home or go to your other scheduled appointments. Remember, you CANNOT drive yourself home after the test.

Can I eat after the test?

Wait at least one hour after the test (or until the numbness in your throat is gone) before eating or drinking. Start by drinking a cool liquid. If you don’t have any problems drinking cool liquids, you can eat and drink as you normally would.

How do I get the results of my test?

After a cardiologist has reviewed your test, the results will be entered into your electronic medical record. Your physician will have access to the results and will discuss them with you.