Transesophageal Echocardiography

Overview

What is Transesophageal Echocardiography?

Echocardiography is a noninvasive procedure (the skin is not pierced) used to assess the heart's function and structures. A transducer (like a microphone) sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves echo off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer interprets the echoes into an image of the heart walls and valves.

Transesophageal echocardiography (TEE) is performed by inserting a probe with a transducer on the end down the throat. The TEE transducer works the same as the one described above. However, a clearer image can be obtained, because the sound waves do not have to pass through skin, muscle, or bone tissue.

A TEE can utilize one or more of four special types of echocardiography, as listed below:

1. M-Mode echocardiography
   This, the simplest type of echocardiography, produces an image that is similar to a tracing rather than an actual picture of heart structures. M-mode echo is useful for measuring heart structures, such as the heart's pumping chambers, the size of the heart itself, and the thickness of the heart walls.
   
   
2. Doppler echocardiography
   This Doppler technique is used to measure and assess the flow of blood through the heart's chambers and valves. The amount of blood pumped out with each beat is an indication of the heart's functioning. Also, Doppler can detect abnormal blood flow within the heart, which can indicate a problem with one or more of the heart's four valves, or with the heart's walls.
   
   
3. Color Doppler
   Color Doppler is an enhanced form of Doppler echocardiography. With color Doppler, different colors are used to designate the direction of blood flow. This simplifies the interpretation of the Doppler technique.
   
   
4. 2-D (2-dimensional) echocardiography
   This technique is used to "see" the actual structures and motion of the heart structures. A 2-D echo view appears cone-shaped on the monitor, and the real-time motion of the heart's structures can be observed. This enables the physician to see the various heart structures at work and evaluate them.
   

Reasons for the Procedure

Transesophageal echocardiography may be scheduled to further evaluate signs and symptoms that may suggest atherosclerosis, heart disease, cardiomyopathy, congenital heart disease, congestive heart failure, aneurysm, valvular heart disease, a cardiac tumor, or other conditions.

Risks of the Procedure

There is a small risk for complications such as breathing problems, heart rhythm problems, infection of the heart valves, bleeding of the esophagus, or a reaction to the sedative medication

Patients with known problems with the esophagus, such as esophageal varices, esophageal obstruction, or radiation therapy to the area of the esophagus should be evaluated carefully by the physician before having the procedure.

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