What is a Transoesophageal echocardiogram?
An Echocardiogram or Cardiac Echo is an ultrasound of the heart evaluating the structure, size, function of the heart muscle and valves. A transoesophageal echocardiogram (TOE) is performed by inserting a flexible endoscope that has a camera or ultrasound probe attached to its tip. The endoscope is about the width of your finger through the mouth and into the oesophagus (swallowing tube). A TOE gets a clearer picture than a regular echocardiogram as the heart and oesophagus are close together, without any bony structures between them. The TOE probe has a transducer, which sends out sound waves that move through the heart tissues, where the signal is transformed into moving pictures of the heart muscle, valves and the flow of blood through the heart.
What can you expect?
A cardiologist, a cardiac sonographer and registered nurse or anaesthetist will be present during the test. You will be monitored closely throughout the test.
You will be asked to sign a form to give permission to do the test.
ECG leads will be connected to your chest so the doctor can see your heart rhythm.
During the exam, you will be placed on nasal oxygen. A finger clip will be placed on one of your fingers to monitor your oxygen levels at all times.
A small cannula will be placed in a vein in your hand or arm and connected to an intravenous line (IV) line to allow sedation to be given to you.
Your throat will be sprayed with a local anaesthetic to numb your throat and allow you to swallow the TOE probe.
You will be rolled on your left side. The doctor will place the probe in your mouth and ask you to swallow; they will gently pass the probe into your oesophagus. A mouth guard will be provided for you to rest your teeth on and to protect the probe.
After the exam the probe is removed along with the mouth guard. A nurse will continue to monitor your heart, blood pressure and oxygen until the effects of the sedatives have worn off.
Are there any risks to this procedure?
The probe does not interfere with breathing. There is no risk of heart damage from the exam. On the day of the exam, you might experience slightly blurred vision and slower reaction times as a result of the sedative medications. For a day or two after the exam, you may feel some slight throat discomfort. You may also have slight irritation of the vein at the IV site. Please notify staff if you have any allergies.
Are there any limitations to a TOE?
A TOE is contraindicated in patients with oesophageal pathology and a history of gastrointestinal surgery or bleeding. It is also problematic if you have significant trouble with swallowing.
Why do you need a TOE?
It is needed prior to cardioversion or pulmonary vein isolation and in patients with stroke /or mini-stroke to see if there may be a source for the stroke in the heart. A TOE can detect structural heart problems such as
Spetal defects (holes in the heart walls)
Endocarditis (infection of heart valve)
How to prepare?
You cannot eat or drink anything for at least six (6) hours before the test.
Bring a responsible person with you to drive you home.
How long is the test?
The TOE procedure takes approximately 15-30 minutes, however, expect the entire time you spend to be 2 hours. You will stay in the hospital until the effects of the medication wear off enough to allow you to go home. This may take 30-60 minutes or longer. The medication will make you drowsy, so you will not be allowed to drive for 24 hours after the exam.
When will you get your result?
Your doctor will discuss your results with you after your test is complete.
If you have any questions about your test or instructions, please call us on 8837 9141 (or extension 141 from within Westmead Private Hospital).