Transesophageal Echocardiogram

Purpose

This test provides valuable information regarding the size of the heart, how well it is contracting, the structure of the heart valves, and the amount of blood flow that may not have been available with a standard echocardiogram. A standard echo Doppler study is usually done before a transesophageal echocardiogram unless the patient has undergone an echo Doppler in the prior six months.

Description

1. The procedure is explained by a registered sonographer who assists the doctor with the study.
2. The patient is asked to sign a consent form. This form is required before the test can proceed.
3. The patient is asked to remove any dentures or dental appliances.
4. Blood pressure, heart rate, and respiration rate are monitored before, during, and after the test.
5. The sonographer or physician places an intravenous line in the patient’s arm. This is for the administration of a mild sedative and for an injection of dye during the study.
6. The patient is asked to turn onto his or her side and a towel is placed under the mouth.
7. The doctor sprays the back of the patient’s throat with a painkiller. The anesthetic has an unpleasant taste, but is not harmful when swallowed.
8. The doctor inserts an ultrasound probe through the back of the throat and into the esophagus (food passage). The doctor asks the patient to swallow several times to enable the probe to get past the gag reflex. A bite guard is placed in the patient’s mouth to make sure the patient does not bite the probe or the doctor's fingers.
9. Once the probe is positioned behind the heart, the patient will feel more comfortable.
10. The doctor manipulates the probe and the sonographer takes recordings and measurements.
11. After approximately 20 minutes, the probe is withdrawn and the test is over.
12. The patient is kept nearby until the sonographer and the physician feel that it is safe for him or her to leave with an accompanying adult.
13. The cardiologist reviews the information obtained and sends a report to the patient’s doctor.

Patient Instructions

The patient must not eat or drink for at least six hours before or for one hour after the test.

The patient must be accompanied by another person, and this accompanying individual must remain on site for the duration of the test.

The patient should not drive or operate heavy equipment for six to 12 hours after the test because of the medications administered.