A Transesophageal Echocardiogram (TEE) is a specialized diagnostic imaging test that provides detailed pictures of the heart. This procedure uses sound waves to create clear, moving images of the heart’s structures and major blood vessels. Unlike a standard echocardiogram, TEE captures images from inside the body, allowing for a more precise view of cardiac anatomy and helping healthcare providers assess the heart with greater clarity.
How a TEE Scan Works
A TEE scan operates on the principle of ultrasound imaging, but with a distinct approach to probe placement. During the procedure, a thin, flexible tube, known as an endoscope, is gently guided down the esophagus. At the tip of this tube is a small device called a transducer, which emits high-frequency sound waves. These sound waves travel a short distance to the heart, reflecting off its structures as echoes. The transducer then captures these returning echoes, sending the information to a computer that translates them into detailed, real-time images displayed on a monitor. The esophagus runs directly behind the heart, making it an optimal location for the transducer to obtain clear images without interference from skin, muscle, or bone, which can sometimes obscure views in traditional echocardiograms. This close proximity allows for superior visualization of heart chambers, valves, and surrounding vessels.
Reasons for a TEE Scan
Healthcare providers often recommend a TEE scan when a standard echocardiogram does not provide sufficient detail to diagnose a heart condition effectively. A common reason for a TEE is to evaluate heart valve function, specifically looking for issues like narrowing or leakage that affect blood flow. The scan can also detect blood clots within the heart chambers, particularly before procedures such as cardioversion for irregular heart rhythms, where clots could pose a risk if dislodged.
Another important application of TEE is in diagnosing endocarditis, an infection of the heart lining or valves, by identifying abnormal tissue around the valves. It is also used to assess congenital heart defects, which are heart issues present from birth, helping to locate abnormalities and understand their impact on blood flow. Furthermore, a TEE can help identify the source of a stroke when other tests are inconclusive, often by revealing small structures or clots not visible otherwise. The procedure can also monitor heart function during or after complex heart surgeries.
The TEE Procedure Explained
Before the Scan
Preparation for a TEE scan typically involves specific instructions to ensure safety and clear imaging. Patients are usually advised not to eat or drink anything for at least six to eight hours before the test to reduce the risk of complications from sedation. It is important to discuss all current medications with the healthcare provider, as some, like blood thinners, might need temporary adjustment. Patients will also sign a consent form after the procedure is explained.
During the Scan
Upon arrival, patients will have an intravenous (IV) line inserted, usually in the arm or hand, to administer fluids and sedatives. The sedation helps patients relax and often makes them drowsy during the procedure. The back of the throat is numbed with a spray to minimize discomfort and the gag reflex during probe insertion. Vital signs, including heart rate, blood pressure, and oxygen levels, are continuously monitored throughout the test.
A bite block is placed in the mouth to protect the teeth and the probe. The thin, flexible probe is then gently guided through the mouth and down the esophagus. Patients may be asked to swallow to assist with the probe’s passage. Once the probe is in position, images are captured, and the entire imaging process usually takes about 15 minutes, though the overall procedure time can be longer.
After the Scan
Following the TEE, patients are moved to a recovery area where vital signs continue to be monitored until they are stable and alert. The throat will likely remain numb for about an hour, and patients should not eat or drink until this sensation has completely worn off to prevent choking. A common temporary side effect is a sore throat, which may last for a few hours to a few days. Due to the sedation, patients cannot drive themselves home and must arrange for transportation.
Safety and What to Expect After a TEE Scan
A TEE is generally considered a safe diagnostic procedure, with serious complications being infrequent. The overall risk of complications in a non-operative setting is reported to be between 0.2% and 0.5%. Most patients experience only mild, temporary side effects, such as a sore throat, which is a very common occurrence due to the probe insertion. This throat soreness usually resolves within one to two days. Some individuals may also experience temporary hoarseness or feel groggy from the sedation.
While rare, more significant complications can include minor bleeding in the esophagus, or, in very few cases, a tear in the esophagus, with reported incidences ranging from 0.01% to 0.38%. Dental trauma is also a rare possibility, occurring in approximately 0.03% to 0.1% of cases. Following the procedure, it is important to adhere to all post-procedure instructions, including avoiding eating or drinking until the numbing sensation in the throat subsides. Patients should contact their healthcare provider if their sore throat worsens, persists beyond a few days, or if they experience other concerning symptoms like bleeding or chest pain.