Transoesophageal Echocardiogram (TEE)

What is a transoesophageal echocardiogram (TEE)?

A transoesophageal echocardiogram (TEE) is an invasive but safe procedure that inserts a long, thin and flexible probe into the mouth and down the oesophagus (food tube).

TEE uses echocardiography, a technique that visualises the heart and its blood vessels using ultrasound waves. The resulting echocardiographic images allow your doctor to take a closer and clearer look at the valves of your heart and its chambers without interference from the chest wall.

Difference between transthoracic echocardiogram (TTE) and transoesophageal echocardiogram (TEE)

The difference between a TTE and TEE is explained below:

Your doctor will choose the type of echocardiogram you receive depending on the nature of your heart problem.

Why do you need a transoesophageal echocardiogram (TEE)?

Your doctor may request a TEE to:

• Assess heart conditions including congenital heart diseases
• Assess the success of previous heart procedures such as valve replacements and bypass surgeries
• Evaluate a stroke or transient ischaemic attacks (TIA or mini-strokes) due to blood clots
• Find valve problems such as infected heart valves (endocarditis)
• See if blood is leaking backward through your heart valves (regurgitation) or if your valves are narrowed or blocked (stenosis)

TEE can detect blood clots, tumours and abnormal masses within the heart, which may not be seen properly using standard echocardiographic (TTE) images.

What are the risks and complications of a transoesophageal echocardiogram (TEE)?

After a transesophageal echocardiogram, you may have a sore throat afterwards for a few hours.

In rare instances, the tube may scrape the inside of your throat.

Your oxygen level will be monitored during the procedure in case of any breathing problems caused by the sedation medication.

How do you prepare for a transoesophageal echocardiogram (TEE)?

Your doctor will ask you to avoid eating for several hours before a TEE. As you may not be able to drive home afterwords, do arrange for transport home.

What can you expect in a transoesophageal echocardiogram (TEE)?

A TEE may be done on an outpatient basis or as part of your hospital stay. You will be given a local anesthetic spray and a sedative before the procedure.

Estimated duration

Most echocardiograms take less than an hour.

Before the procedure

Your doctor will brief you about the procedure in detail, including its possible complications and side effects. You will be asked for your consent to proceed with the procedure and to show that you have understood the risks and benefits.

Once you are ready, the medical team will provide a hospital gown for you to change into.

During the procedure

The medical team will:

• Place electrodes on your chest to measure the electrical activity of your heart (electrocardiograph or ECG).
• Place a blood pressure cuff on your arm, and an oximeter clip on your finger.
• Numb your throat with a spray or gel to prevent a gag reflex during the procedure, and deliver a sedative through your IV to help you relax.
• Position you to lie on your left side on the exam table
• Use suction to remove excess moisture from your mouth.
• Guide a flexible tube containing the transducer down your oesophagus to obtain images of your heart.
• Monitor your heart rate, blood pressure, and oxygen level during and right after the procedure.

After the procedure

You may be kept under observation for a few hours. Once your observation period ends, you should be able to resume your normal daily activities.