Like standard echocardiography, transesophageal echocardiography (TEE) uses sound waves to produce images of the heart and heart function. Doctors use TEE when they cannot get clear information via standard echocardiography. TEE provides more detailed information on the size, shape, and movement of heart muscle, the condition of the aorta, how the heart valves are working, and the quality of blood flow through the heart and arteries.

With standard echo, the transducer is placed on the outside of the chest over the heart. With TEE, the transducer is placed internally. It is passed down the throat into the esophagus. (The esophagus connects the mouth to the stomach.)

How It Works

TEE uses high-frequency sound waves (also called ultrasound) to produce moving pictures of the heart. The test is like standard echocardiography except that the pictures of the heart come from inside the esophagus rather than through the chest wall. The sound waves are sent to the heart with a transducer that is attached to a tube and placed in the esophagus. The sound waves bounce off of the heart and return to the transducer as echoes. The echoes are converted into images on a television monitor to produce pictures of the heart and aorta.

What To Expect

Patients should follow their doctor’s instructions regarding eating and drinking prior to the test and discuss their test-day medication schedule.

To begin the test, the technician sprays the patient’s throat with an anesthetic. The patient lies down on the examination table. An intravenous line (or IV) is inserted into the patient’s arm so that a sedative can be administered throughout the test. EKG electrodes are placed on the patient’s chest so that the electrocardiogram machine can continually monitor the patient’s heart rhythm.

The technician inserts a small, flexible tube or “probe” into the patient’s throat. The patient is asked to swallow as the probe is gently moved down the throat. This is often the most uncomfortable part of the test. Some patients feel the need to gag, which is quite common. After the probe is in place, the patient should not feel any pain.

The transducer on the end of the probe takes the pictures of the heart. The technician moves the probe to get pictures from different angles. After the technician has captured all the pictures, the probe and IV line are removed. The EKG recording is stopped. The patient may feel sleepy until the sedative has worn off; he or she is monitored until heart rate and blood pressure are normal. Some patients may have a sore throat or trouble swallowing after the procedure. These side effects resolve within a day or two.


Texas Heart Institute