What will happen during a transesosphageal echocardiogram (TEE)?

Once you have been escorted into the exam room, you will remove your clothing from the waist up (women will be given a gown to wear for privacy) and lie down on a padded table. Sticky electrode patches will be applied to your chest with wires that connect to an electrocardiogram (ECG) machine that monitors and records your heart rate and rhythm. You will also have a blood pressure cuff wrapped around your arm and an oxygen sensor clipped to your finger. You may be given oxygen through a soft tubing that fits in your nose. A nurse will start an intravenous (IV) line in a vein in your arm. If you have dentures or other removable dental work, you will be asked to remove them.

Next, your throat will be numbed with an anesthetic spray, gel or gargling solution. You may be given a sedative through the IV line, to help you relax during the procedure and lessen the likelihood that you will gag.

When it is time to begin the echocardiogram, the room lights will be dimmed, to make it easier to see the images of your heart on the echo monitor. The echocardiographer (a cardiologist specializing in echocardiography) will place a thin flexible tube in your mouth with a small probe, or transducer, on the tip. You will be asked to swallow the tube as it is passed into your esophagus, the food pipe that connects your mouth to your stomach. During the procedure, the echocardiographer will move the transducer in your esophagus and stomach in order to take pictures of your heart from various angles, or views. This movement should not be uncomfortable.

Just as with standard echocardiography, the transducer sends harmless sound waves into the heart and receives the “echo” waves that bounce back off of the heart. These echoes are translated by a computer into images of your heart. Because the transducer is so close to the heart during TEE, it can capture small details of the heart’s structure, and the images will be very high quality.

Throughout the test, the echocardiographer will save specific images for later review. Once the echocardiographer has obtained all the detailed information about your heart, he or she will gently remove the transducer probe from your esophagus. This should not be too uncomfortable for you. As the transducer comes out, the echocardiographer will also be able to obtain detailed images of your aorta to look for any evidence of any fatty deposits in the wall of the aorta. 
A transesophageal echocardiogram (TEE) is a diagnostic procedure that uses echocardiography to assess the heart's function. Echocardiography is a procedure used to assess the heart's function and structures. During the procedure, a transducer (like a microphone) sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves echo off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer interprets the echoes into an image of the heart walls and valves.

A transesophageal echocardiogram is performed by inserting a probe with a transducer down the esophagus rather than placing the transducer on the chest. The TEE transducer works in the same manner as the one described above.

By inserting the transducer in the esophagus, TEE provides a clearer image of the heart because the sound waves do not have to pass through skin, muscle, or bone tissue. For example, obesity or pulmonary disease (emphysema or chronic obstructive pulmonary disease, also known as COPD), may interfere with the ability to obtain adequate images of the heart when the transducer is placed on the chest wall.

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