Transesophageal echocardiography (TEE) is an advanced imaging test that uses ultrasound to create highly detailed pictures of the heart. Unlike a standard echocardiogram performed on the chest, TEE involves placing a small ultrasound probe into the esophagus (the tube that connects your mouth to your stomach). Because the esophagus sits directly behind the heart, this approach provides clearer, more precise images of cardiac structures.
When performed as an outpatient procedure (TEE OP), patients are able to go home the same day after a short recovery period. TEE is commonly used when more detailed information is needed to diagnose or guide treatment for heart conditions.
What Is a Transesophageal Echocardiogram?
A transesophageal echocardiogram is a type of ultrasound test that allows your cardiologist to examine the heart from inside the body. By positioning the probe in the esophagus, TEE avoids interference from the chest wall, lungs, or ribs—resulting in high-resolution images of the heart.
TEE is particularly useful for evaluating structures that may be difficult to see with a traditional (transthoracic) echocardiogram.
Why Is TEE Performed?
Your physician may recommend TEE to:
- Detect blood clots inside the heart (especially in the left atrial appendage)
- Evaluate heart valve function and abnormalities
- Assess infection of the heart valves (endocarditis)
- Identify structural issues such as septal defects
- Evaluate the source of a stroke or transient ischemic attack (TIA)
- Guide certain procedures, such as cardioversion or device placement
- Provide additional detail when standard echocardiography results are unclear
TEE is often used when precise imaging is critical for diagnosis or treatment planning.
How the Procedure Works
TEE is typically performed in an outpatient setting and usually takes about 30 to 60 minutes.
During the Procedure:
- You will receive a sedative to help you relax
- Your throat will be numbed to reduce discomfort
- A thin, flexible probe is gently guided through your mouth into the esophagus
- The probe uses ultrasound to create detailed images of the heart
- Your cardiologist views and records these images in real time
Because of sedation, most patients are comfortable and may not remember the procedure.
What to Expect Before and After
Before the Procedure:
- You will be asked to fast (no food or drink) for several hours
- Medications may be reviewed or adjusted
- You should arrange for someone to drive you home afterward
- Your provider will review your medical history and explain the procedure
After the Procedure:
- You will be monitored until the sedation wears off
- Your throat may feel slightly sore or scratchy for a short time
- You should avoid eating or drinking until your swallowing reflex returns
- Most patients go home the same day
- Normal activities can usually be resumed within 24 hours
Your care team will provide specific instructions for recovery.
Benefits of TEE
Transesophageal echocardiography offers several important advantages:
- Superior image quality compared to standard echocardiograms
- More accurate detection of clots, valve problems, and structural abnormalities
- Helps guide medical and interventional treatment decisions
- Minimally invasive with no surgical incisions
- Performed as an outpatient procedure with quick recovery
Risks and Considerations
TEE is generally safe, but potential risks include:
- Mild throat discomfort or irritation
- Reaction to sedation
- Difficulty swallowing (temporary)
- Rare risk of injury to the esophagus
- Breathing or heart rhythm changes (rare)
Your physician will review your medical history and ensure the procedure is appropriate for you.
Frequently Asked Questions
Is TEE painful?
Most patients experience little to no pain. Sedation and throat numbing help keep you comfortable during the procedure.
Will I be awake?
You will be sedated and relaxed, and many patients do not remember the procedure.
How long does the test take?
The procedure typically takes 30 to 60 minutes, with additional time for preparation and recovery.
Why not use a standard echocardiogram?
TEE provides clearer, more detailed images, especially for certain parts of the heart that are harder to see from outside the chest.
When can I eat again?
You can usually eat once your swallowing reflex has returned, typically a few hours after the procedure.
Can I drive myself home?
No. Because sedation is used, you will need someone to drive you home.
When to Consider TEE
Your doctor may recommend a transesophageal echocardiogram if you have:
- Suspected heart valve disease
- A history of stroke or unexplained embolic events
- Possible blood clots in the heart
- Inconclusive results from a standard echocardiogram
- A need for detailed imaging before or during a cardiac procedure
TEE plays an important role in providing accurate diagnosis and guiding effective treatment.
Schedule a Consultation
If you need detailed imaging of your heart or have been advised to undergo further evaluation, a transesophageal echocardiogram may be the next step in your care.
The team at Cedars Heart Clinic offers advanced diagnostic testing in a comfortable outpatient setting, with a focus on accuracy, safety, and patient-centered care. Contact our office to schedule a consultation and learn more about whether TEE is right for you.
