A transesophageal echocardiogram (TEE) is a type of echo test that uses sound waves to create pictures of your heart. Unlike other types of echo tests, a TEE creates pictures from inside your body. Your provider guides a thin, flexible tube down your esophagus. A TEE can diagnose many problems including blood clots and infections in your heart.
A transesophageal echocardiogram (TEE) is a test that uses sound waves to create pictures of your heart. A TEE is different than other forms of echocardiogram or ultrasounds because it takes pictures from within your body, rather than outside of it.
Your provider uses a long, thin tube called an endoscope to carefully guide a small transducer down your throat and esophagus (food tube). The transducer is a device that makes sound waves. These sound waves bounce off the different areas of your heart, making echoes. The transducer then sends these echoes to a computer that makes them into pictures. These pictures show the structure and function of your heart in great detail.
Your provider may combine TEE with Doppler ultrasound and color Doppler methods. These specialized techniques show the speed and direction of blood flow through your heart.
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A transesophageal echocardiogram shows a detailed view of your heart’s structure and function. It can help diagnose and manage many different conditions, including:
A transesophageal echocardiogram may be performed for many reasons. These include:
Your provider may need more information than what a TTE, performed outside your body, can provide. So, they may run a TEE to examine your heart without your ribs or lungs getting in the way.
Imagine standing on a sidewalk, looking through a storefront window. Inside the store, near the back, you see a glass display case. You can tell the display case contains plates with flower patterns. But you can’t make out the details since people are standing around the case. So, you go inside and walk to the back of the store to get a better look.
A transthoracic echo gives your provider a storefront window view, which is still very helpful. But a transesophageal echo lets your provider see directly inside the display case. It’s the difference between seeing the plate has flowers and learning the flowers are roses.
Since your esophagus runs behind your heart, it’s the perfect spot for the transducer to send and receive sound waves. A TEE is especially valuable for examining structures in the back of your heart. These include your:
Sometimes, providers skip the TTE and use TEE first. This may be the case if you have:
TEE can help investigate life-threatening medical conditions. In some critical situations, providers use TEE without using TTE first. This may happen if you have one of the following conditions without a clear cause:
TEE may also be used initially, without a prior TTE, to investigate:
Providers use TEE to check for blood clots before certain procedures that treat arrhythmias. These include:
These procedures may cause a blood clot to break free and travel through your bloodstream (thromboembolism). Your provider will let you know if you need TEE to check for clots before your procedure.
TEE is a valuable tool during certain surgeries and procedures. Your provider may use TEE before your surgery to check your anatomy. They may also use TEE afterward to confirm the surgery’s success. TEE may be used for:
Providers also use TEE to see inside your body and guide procedures in real time. TEE may be used during percutaneous procedures including:
A TEE is an invasive procedure because your provider needs to put a device inside your body. You may experience mild discomfort. But the risk of serious problems is low.
Usually, a TEE requires only local anesthesia and moderate sedation. That means your provider will spray the back of your throat with pain-relieving medication. They’ll also give you medicine through an IV to help you relax.
Most people don’t need general anesthesia (deep sleep). Talk with your provider about what’s best for you during your TEE.
Moderate sedation should make you drowsy and allow you to tolerate the procedure without significant discomfort. The staff will be constantly monitoring for signs of discomfort and can decide if you need more sedation. . If you need general anesthesia, you’ll be fully asleep and you won’t remember the procedure. With general anesthesia, you will need to be placed on a breathing machine. Because you are deeply sedated, the recovery will be longer compared to moderate sedation.
A TEE examination may take up to 90 minutes. The picture-taking part usually only takes 15 minutes.
Talk with your provider about your medical history. Some medical conditions make a TEE too risky to perform. Tell your provider if you have:
Also tell your provider if you take medication for:
Your provider will give you detailed instructions on how to prepare for your TEE. Be sure to follow them closely and ask questions if anything is unclear. These instructions will tell you:
A transesophageal echo includes the following steps:
Someone will need to drive you home from your TEE. You won’t be able to drive for 24 hours after your TEE due to the sedation. You can expect to:
Some people have a sore throat after a TEE. It may last a few hours or up to three to five days.
Other complications are less common but may include:
Talk with your provider about the risks of a TEE before your procedure.
Your provider will discuss your test results with you. They may also be available as part of your electronic medical record (an online resource that lets you see your medical information). Talk with your provider about when your results will be available and how you can view them.
A note from Cleveland Clinic
Medical tests make some people feel nervous or uneasy. It’s normal to feel that way. But tests like a transesophageal echocardiogram play a huge role in helping you stay healthy or treating problems that come up. A TEE is a common procedure that has a low risk of complications. If you need a TEE, talk with your provider about how to prepare and what to expect.
Last reviewed by a Cleveland Clinic medical professional on 05/06/2022.
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