What is a Transoesophageal Echocardiogram?

If your have had, or are currently suffering from, any type of heart trouble your doctor will probably send you for a series of tests. One such test may be a transoesophageal echocardiogram, or TOE. This is a diagnostic test that uses ultra sounding equipment to monitor and visualise the functions of the heart.

The overall working mechanism of the heart can be monitored, as can the flow of blood, blood volume and functions of the valves. Often, a TOE is offered after a normal echocardiogram has been performed and has produced unsatisfactory results, possibly due to the access to the rear or because the problem needs to be seen from a different angle.

What Is Involved In The Procedure?

Initially, your doctor will spray some local anaesthetic into the back of your throat to numb the area. This will take effect almost immediately. If needed or specifically requested, a small amount of sedation may be given to help you to relax.

Using specialist equipment, the physician will then introduce a small flexible probe into the oesophagus via the mouth and pass it down to the chest. This method obtains clearer images of the heart and lungs due to its close proximity.

Using controls that allow the probe to be twisted and rotated to view different areas of the heart, the doctor can make a full assessment of its overall function. The images can be transmitted via the probe and projected onto a screen where the pictures can be examined and a diagnosis made.

How to Prepare for the Procedure

First of all it is important to relax. With the right amount of local anaesthetic and sedation the whole process should not be too distressing. You will probably be asked to refrain from eating and drinking for up to six to eight hours prior to the procedure to prevent any vomiting, which can be dangerous.

The whole procedure should take no longer than half and hour, with the average time being around ten minutes. It can often take longer to administer the anaesthetic and sedation than it takes to perform the TOE.

Following the process, you will not be permitted to drive or operate machinery for up to two hours, as the sedation can remain in the system for this length of time and can alter judgement and reaction times.

Sips of water may be tolerated, but hot drinks and food should also be avoided during this period.

You may be asked to attend a special clinic, the hospital or indeed just your normal GP surgery for the procedure, depending on where you live and the services offered by your local health authority.

What About the Results?

The treating physician will normally be able to make a definite diagnosis immediately after the procedure. Occasionally, if the problem is quite rare, a recording may be taken of the TOE and a second opinion sought before an accurate diagnosis is made. These results will be documented, but often not discussed until a later time due to the effects of the sedation, meaning the patient will be unable to clearly retain any information given.

Transoesophageal Echocardiogram is a very useful and accurate diagnostic test that is performed regularly on a large number of people. It should not be too uncomfortable and is more easily achieved if the patient remains relaxed throughout the procedure.