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A transesophageal echocardiogram (TEE) is an ultrasound test that uses sound waves to look at the heart. TEE is used instead of a standard echo test when we need clearer pictures of the heart.

How a TEE Works

We place a long, flexible tube (probe) into your mouth and down the esophagus (food tube). On the tip of the probe is a small device called a transducer. This tiny device sends ultrasound waves that bounce off parts of the heart. It then picks up the reflected waves and sends them to a computer. The computer turns the waves into moving pictures. The pictures show the size and motion of the parts of the heart and the flow of blood through the chambers and valves.

Getting Ready for a TEE

  • Do not eat or drink for 8 hours. Your stomach needs to be empty for this test. If you have diabetes, let your doctor know since you may need to adjust your medicine. 

  • Let your doctor know if you have any recent trouble with bleeding.

  • Arrange for someone to drive you home from the hospital. You may not drive yourself since you may be drowsy.

  • Tell your doctor if you have any problems swallowing or problems with your stomach or esophagus.

  • Tell your doctor if you are using a CPAP home device. 

  • Let your doctor know if you are allergic to any medicines.

  • Before a TEE, your doctor will tell you about the procedure and the risks and benefits. We will ask you to sign a consent form. If you have any questions, please ask.

Risks

Although the risk is small, these problems can occur:

  • Abnormal heart rhythms

  • Breathing problems

  • Reaction to medicines

  • Bleeding

  • Damage to the esophagus

Benefits

  • Clearer pictures than a standard echo test

  • May lead to a more accurate diagnosis and treatment plan

What to Expect During Your TEE

When you arrive, you will change into a hospital gown. We will place an IV into a vein in your arm. If you wear dentures, they will be removed before the TEE is started. 

We will ask you to lie down on your left side. We will spray your throat a numbing medicine. We will also give you medicine through your IV to help you relax. 

The doctor gently places the probe into your mouth. As you swallow, the probe is guided into your esophagus. Although you may gag as the probe is inserted, most people do not feel pain. Once the probe is positioned behind the heart, the doctor can move the probe up, down, and sideways to view the heart from many angles. 

Though the TEE exam takes 20-25 minutes, expect to be at the hospital for over 2 hours. 

After Your TEE

  • Do not drive for at least 12 hours.

  • Do not eat or drink until your throat is no longer numb (about 1 hour).

  • Your throat may be sore. After the first hour, soothe it with cold drinks and lozenges.

  • Due to a side effect of the medicine, you may not remember the procedure.

Results

The doctor doing the test should be able to give you initial results before you leave. Your doctor will receive a written report and talk with you about the final results.

When to Call 

  • Trouble swallowing

  • Shortness of breath

  • Chest pain

  • Bleeding

  • Fever

Who to Call

If you have any of the symptoms listed above, call your doctor or the UW Health Emergency Room at 608-262-2398.