Transesophageal echocardiogram (TEE)

TEE · transesophageal echo · heart ultrasound through the esophagus · TOE

The doctor looks at your heart with ultrasound from the inside, using a thin probe that you swallow into your food pipe. The heart is seen much better this way than through the chest.

To rule out clots in the heart before restoring a normal rhythm, to look at the valves in detail, or for a possible valve infection.

⏱ Duration: the procedure itself usually takes 15 to 30 minutes, plus prep and rest; the report is usually ready the same day

Be sure to tell your doctor

Blood thinners. Your doctor will tell you what to do with them
Problems with your food pipe or stomach, or trouble swallowing
Allergies, especially to numbing medicines
If you have removable dentures
If you want sedation. This is usually discussed in advance

How to prepare

Food. Usually no food for 6 hours and no drinks for 2 to 4 hours. Your clinic will give you the exact times.
Medicines. Do not stop them on your own. Ask your doctor which morning medicines to take and what to take them with.
Someone with you. If you will have sedation, come with someone. You cannot drive afterward.

What to bring

Your referral
Past echocardiograms and ECGs
A list of your medicines
Someone to take you home, if you have sedation

How it goes

Dentures are removed, and an IV line is put in a vein
Your throat is sprayed with a numbing spray
You lie on your left side with a plastic mouth guard
If you have sedation, medicine is given and you doze off
The doctor puts the probe in your mouth and asks you to swallow
The probe stays in the food pipe for a few minutes while the doctor checks the heart
The probe is removed

What you'll feel

Your throat goes numb from the spray, and swallowing feels strange
Swallowing the probe is unpleasant, and you may gag. Steady breathing helps
With sedation, you usually remember almost nothing

Afterwards

Do not eat or drink for 1 to 2 hours, until the numbness wears off
Your throat may feel a bit sore for a day or two
After sedation, do not drive for the rest of the day
The report is usually ready the same day

Contact a doctor straight away if

Severe pain in the throat or chest, or blood when coughing or vomiting: see a doctor right away or call emergency services
Trouble swallowing or a fever in the next few days

Common questions

Can I be asleep for a TEE?

Often yes, with light sedation. Ask the clinic in advance.

Is it like an upper endoscopy?

It is similar, since you also swallow a tube. But the probe is thinner and stays only in the food pipe.