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About Transoesophageal Echocardiography

Transoesophageal echocardiography or echocardiogram is the term given to an ultrasound examination of your heart via an endoscope (a long, thin, flexible instrument) placed inside your oesophagous or food pipe. The technique is the same as the transthoracic echocardiograph, in which high frequency sound waves are used to create a moving picture of your heart.

Why am I having a Transoesophageal Echocardiography?

As the oesophagous runs right beside the back of the heart, very clear images of the inside of the heart can be obtained. Doctors often us this technique for cardiac valve assessment, but it can be used in any condition where the standard echocardiogram does not provide enough information. Transoesophageal echo is sometimes used to monitor heart function during heart surgery and also used to guide some procedures done during cardiac catheterization.

Preparation

The test will be performed as an inpatient and therefore will require admission into hospital. You will be required to fast for at least 6 hours prior to the procedure, that means nothing to eat or drink, including water. Check with your doctor before taking your usual medications, as some may be withheld until after your procedure. If you are on Warfarin you may be required to check your INR level before the procedure to ensure that it is not too high.

How is the test performed?

A cardiologist will be performing the transoesophageal echo along with an anaesthetist and nursing staff. An IV line will be placed in your arm and medications given to put you into a light sleep. Your electrocardiogram (ECG), oxygen levels and other vital signs will be monitored during and after the procedure. You will be lying down during the test, a mouth guard may be inserted to protect your teeth.

The probe will then be guided into your mouth while the cardiologist gently presses your tongue out of the way. You may be asked to swallow to help move the probe down your oesophagus. The actually procedure usually takes between 10 and 20 minutes.

What happens after the test is completed?

For several hours after the test you may feel sleepy and may have a dry or mild sore throat. Also due to the nature of some of the medications you will not be able to remember much of the test.

You will remain in hospital until you are fully alert and have had something to eat and drink.

You are not permitted to drive for 24-hours after the procedure, so you will need someone to take you home from hospital.

Results

A report will be sent electronically to your referring Doctor, usually within 24-hours. You will need to contact them to get your results and find out if you require any follow up tests or treatment.

Risks

Transoesophageal echo is an invasive procedure with some risk. Some of these risks are breathing problems, abnormal or slow heart rhythm, drug reactions and minor bleeding. In extremely rare cases, perforation or tearing of the oesophagus could occur.

  • 5 in 1000 people can have abnormal heart rate.
  • 7 in 1000 people can have an abnormally high or low blood pressure.
  • 7 in 1000 people can have temporary breathing problems.
  • 3 in 10 000 people can have a tear in the oesophagus.
  • 3 in 10 000 people can develop pneumonia due to breathing in stomach secretions or saliva.
  • 2 in 10 000 can result in death.

Most people will have a sore throat for 1-2 days post procedure.