The transesophageal echocardiogram (TEE) is used over the transthoracic echocardiogram (TTE) whenever better, more detailed images of the heart are needed by the cardiologist.

It is known as a TOE (transoesophageal echocardiogram) in the British system.

Method of transesophageal echocardiography

Unlike in TTE, the TEE's transducer is threaded through the mouth and esophagus. To do this, the back of the throat is sprayed with a topical anesthetic to soothe the nerves causing the gag reflex. In some centers, sedation is used to ease the discomfort to the individual. The use of local anaesthetic agents and sedation can decrease the gag reflex, making the ultrasound probe easier to pass into the esophagus.

The transducer and cable are then coated in a lubricant and placed in the patient's mouth and then passed down the patient's throat. The individual is instructed to swallow while the probe is being passed down, to prevent it from going into the trachea.

Although the placement of the thumb-wide transducer is uncomfortable, there are very few complaints of gagging from the patient once the transducer is in the correct location.

Complications

Known complications that are associated with transesophageal echocardiography include:

• Aspiration
• Rupture or perforation of the esophagus

Related topics

• Echocardiography
• Ultrasound