A transesophageal echocardiogram is a procedure that uses sound waves to produce images of heart structures and function. A TEE is performed by inserting a long flexible tube with an ultrasound (sound wave) transducer at its tip, through the mouth and into the esophagus. The transducer sends sound waves into the heart, which are returned as echoes. These echoes are converted into live pictures of the heart and blood flow through the chambers and valves. The images are displayed on a monitor and recorded on videotape or disk.


Pre-Registration and Testing Location

Please call 2 days before the date your test is scheduled to confirm your appointment. At this time we can also answer questions you may have. Please have your referring physician complete the echo order form. Plan to arrive 20 minutes before the scheduled time of your test. Bring your hospital and insurance cards with you. Go directly to the test location. Echocardiograms are performed at:

NewYork-Presbyterian Hospital/Weill Cornell Medical Center
Echocardiography Laboratory
Starr Pavilion
520 East 70th Street, off York Avenue
New York, NY 10021
Take the Starr elevators to the 4th floor, make a right and follow the signs to room K-425


Before the TEE

You will be asked to sign a consent form before the procedure is started. Your doctor will explain the purpose of the test, how it is done and any possible side effects before you sign the consent. Read the form carefully and be sure to ask any questions you may have. Do not eat or drink anything for at least 6 to 8 hours before the test. If you are taking medicines, ask the doctor if you should take them before the test. Remove your dentures or other dental prostheses.

Tell the doctor at the TEE laboratory about all medications, allergies to medications and your medical history (including peptic ulcer, difficulty swallowing, esophageal disease, prior heart surgery, or problem with bleeding) before the test.


During the TEE

In the procedure room an IV (intravenous) line will be started in your vein and an EKG monitor will monitor your heart. A pulse oximeter will be clipped on your finger. This monitors the oxygen level in your blood and counts your heart rate. You may be given a small amount of oxygen during the procedure. Your blood pressure will be checked throughout the procedure.

You will be asked to gargle with a liquid that will numb the back of your throat. You will then swallow the solution and gargle again with two or three different solutions. These solutions are bitter tasting and may give you a gagging sensation. It is important to numb your throat so that you can swallow the tube. This part of the procedure may take up to 30 minutes.

As you lie on your left side a sedative is given through your IV (usually Versed or Demerol). Please tell the doctor if you have any allergies to these medicines. A bite block will be placed in your mouth to protect your teeth. The doctor will than slowly begin to insert the scope through your mouth and esophagus. You will assist by swallowing the tube. More anesthetic will be sprayed on the back of your throat if you need it. The scope will be in you esophagus for about 20 minutes. During this time images are recorded on tape and can be reviewed later.


After the TEE

After the scope is removed your throat will still be numb. After the test, nurses will monitor you until you are awake and able to swallow. Do not eat or drink anything for at least one and one half-hours after the test. Test for the return of feeling to your throat by swallowing a little cold water. If you can feel the cold water and you have no difficulty swallowing, you can eat and drink again. Most patients have a mild sore throat after the anesthetic has worn off. This should go away after about 24 hours. Throat lozenges and cool foods will help soothe the irritation. It is normal to have a small amount of blood tinged mucous secretions.

If you notice any of the following symptoms, notify your nurse or call your doctor:

• Chest pain or comfort
• Signs of infection (for example, temperature greater than 100° F, redness or warmth at the site where the IV was inserted)
• Difficulty in swallowing

What else do I need to know?
TEE is a very safe procedure with few complications. Very rarely there may be trauma to the throat or esophagus. This is most often seen in patients who have had past medical problems with the esophagus. Before the test is started, it is very important to tell the doctor if you have ever had esophageal disease. The findings of the test are usually available right away; if you are still drowsy, the results of the test will be discussed with you at a later time.

Do not drive and avoid heavy lifting, strenuous exercise and alcohol consumption for 24 hours.


Contact


Cardiac Echocardiography Laboratory
Starr 4, Cardiovascular Center
520 East 70th Street
New York, NY 10021

Phone: (212) 746-2158, (212) 746-2655, (212) 746-2169
Fax: (212) 746-6951