Transesophageal Echocardiography

Transesophageal Echocardiography (TEE)

A transesophageal echocardiogram is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient’s esophagus. This allows image and Doppler evaluation which can be recorded.

The advantage of TEE over TTE is usually clearer images, especially of structures that are difficult to view through the chest wall. The explanation for this is that the heart rests directly upon the esophagus leaving only millimeters that the ultrasound beam has to travel. This reduces the weakening of the ultrasound signal, generating a stronger return signal, ultimately enhancing image and Doppler quality. Comparatively, transthoracic ultrasound must first traverse skin, fat, ribs and lungs before reflecting off the heart and back to the probe before an image can be created. All these structures, along with the increased distance the beam must travel, weaken the ultrasound signal thus degrading the image and Doppler quality.

In adults, several structures can be evaluated and imaged better with the TEE, including the aorta, pulmonary artery, valves of the heart, both atria, atrial septum, left atrial appendage, and coronary arteries. TEE has a very high sensitivity for locating a blood clot inside the left atrium.

A local anesthetic spray is used for the back of the throat, such a xylocaine and/or a jelly/lubricant anesthetic for the esophagus.