Transoesophageal echocardiogram (oesophageal echo)

In a transoesophageal echocardiogram the cardiologist uses a probe which is placed behind your heart via your oesophagus. The advantage of an oesophageal echo is that your organs which are close to the oesophagus can be imaged much more clearly in comparison with a transthoracic echocardiogram. Your heart and aorta and also the smaller structures in the heart like the atria, major blood vessels and the mitral and tricuspid valves can then be studied.

Before the test

  • You must not eat or drink anything at all.
  • The risk associated with carrying out this test is extremely low. One extremely rare complication is oesophageal perforation. To keep this risk to a minimum, you are asked whether you have swallowing problems in everyday life. If this is the case, a gastroscopy will be carried out first. The test is contraindicated for patients who have a known Zenker’s diverticulum (pharyngeal pouch), a pouch formed from the oesophagus that often causes swallowing problems, and also for people with a tumour in the oesophagus.

The test

  1. A local anaesthetic spray is applied to your throat. Due to this anaesthetic the test is not painful. If you are allergic to local anaesthetics like Xylocaine, the doctor must be informed.
  2. If insertion of the probe is difficult, this can be made easier by administering a muscle relaxant (dormicum) which makes you feel sleepy and lowers the muscle tone.
  3. You will be lying on your left side on the examination table.
  4. The doctor will slowly insert the probe into your throat and will ask you to make a swallowing movement so that he can advance the probe into the oesophagus. This may feel unpleasant and sometimes it makes you feel as if you may vomit. Breathing through the nose and from the belly can prevent or suppress this feeling.
  5. Once the probe is in place the doctor will take the required images of your heart from various different angles.
  6. The time taken for this test varies from one patient to another, but it usually takes no more than 20 minutes.

After the test

  • If a muscle relaxant (dormicum) has been administered, you may feel dizzy and less alert after the test. It is therefore dangerous to drive a car, and it is best for someone to accompany you so that they can take you home afterwards.
  • Sometimes your throat may be sensitive for up to a few hours after the test. It is recommended to wait at least one hour before eating or drinking anything to prevent your food or drink going down the wrong way.

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