A TEE - Trans Esophageal Echocardiogram is a special ultrasound test for examining the heart in greater detail.
An echocardiogram is an ultrasound of the heart. Most people are familiar with ultrasound. Women who are pregnant generally get an ultrasound to look at the fetus. We know that high quality pictures of the baby, pictures that can astound us, can be obtained during pregnancy utilizing ultrasound.
Ultrasound can also be used to examine the heart.
Ultrasounds of the heart come in 2 varieties. A Trans-thoracic echocardiogram is done across (trans) the chest wall from the outside. An ultrasound technologist will first apply a thick ultrasound imaging jelly, and then place an ultrasound probe on various places of the chest to obtain different views of the heart from outside the body. Although the test is not considered to be painful, sometimes the technologist will have to press quite hard to obtain adequate images.
The examination usually lasts 30 minutes to an hour.
An ultrasound is very accurate for seeing if the heart function is strong. A very strong prognostic indicator for heart disease is whether the heart has been damaged. Cardiologist’s guide therapy, and determine whether testing is needed based on the results of the heart ultrasound. The heart valves can be examined as well as portions of the aorta and atrium.
Although very helpful, sometimes adequate pictures of the heart cannot be obtained from outside the body. A person might be too heavy, have a rotated heart, or just doesn’t give good pictures.
A TEE (Trans-Esophageal Echocardiogram) is an ultrasound that is performed from inside the esophagus. Because the heart lies nearly on top of the esophagus inside the chest, if an ultrasound probe is placed in the esophagus, very accurate pictures of the heart can be obtained.
TEE’s are a 2-4 hour test that is most often performed in an outpatient setting. They are very similar to a gastric endoscopy where a gastroenterologist places a scope in the esophagus and stomach to look at these organs.
The patient first has their throat and mouth made numb with the use of gargling or spraying an anesthetic. Next, IV medication is given to sedate the patient. The cardiologist will then place the ultrasound probe in the mouth and pass it down into the stomach. The actual time that pictures are taken is generally 30 minutes to an hour.
Why is a TEE utilized?
• In Atrial Fibrillation a TEE is often done to visualize a structure called the Left Atrial Appendage. This structure often hides blood clots in people with atrial fibrillation.
• TEE is useful for determining the cause of leakage of the Mitral Valve and to help determine the severity of the valve leakage. It is also useful for determining if surgical repair of the valve is possible.
• TEE is helpful for determining if a hole is present in the divider between the upper chambers called the Atria. An ASD or PFO is a whole that if present can cause enlargement, strokes, or heart rhythms problems.
• TEE can also look more closely at the Aorta to determine if it is enlarged, has buildup of calcium, or torn.
• TEE’s are often utilized to determine the cause of a Stroke or TIA.
• TEE’s are useful for finding and examining tumors inside the heart.
• TEE’s are helpful for determining if the valves have an infection.
By and large a TEE is a complimentary test to a traditional Trans-Thoracic Echocardiogram.
Any Risks to Having a TEE?
TEE’s are considered minor procedures but there are some risks.
• Any person receiving an anesthetic has some risk. Depending on whether the person receives mildly sedating medications or is completely unconscious can alter the risk.
• Mouth, tooth, and throat irritation is possible. Rarely more severe injury of the esophagus, vocal chords, stomach, or teeth is possible.
TEE’s are a very useful test that is utilized under certain conditions.
Most people find that the test isn’t uncomfortable and rarely experience symptoms following the procedure.
You shouldn’t be worried if your doctor tells you that a TEE is needed.
Dr. Kirk Laman