Transesophageal Echocardiography (TEE) – A Detailed Overview

Introduction

Transesophageal echocardiography (TEE) is a specialized ultrasound imaging technique that provides high-resolution images of the heart and surrounding structures. Unlike transthoracic echocardiography (TTE), where the probe is placed on the chest wall, TEE involves inserting a probe down the esophagus to get a closer and clearer view of the heart.

Why is TEE Performed?

TEE is especially useful for diagnosing and monitoring various heart conditions, such as: - Endocarditis: Detecting infection in the heart valves. - Atrial Thrombi: Identifying blood clots in the atria, especially in patients with atrial fibrillation. - Valvular Disease: Assessing valve function in cases of stenosis or regurgitation. - Aortic Aneurysm and Dissection: Evaluating abnormalities in the aorta. - Congenital Heart Defects: Providing detailed images of structural abnormalities, particularly in children and adults with complex congenital heart disease. - Post-Surgical and Post-Interventional Monitoring: Evaluating the results of cardiac surgery or interventional procedures such as valve replacements.

How is TEE Performed?

1. Preparation: The patient is asked to refrain from eating or drinking for several hours before the test.
2. Sedation: Mild sedation is usually given to make the procedure more comfortable.
3. Probe Insertion: A flexible probe with an ultrasound transducer at its tip is passed into the esophagus.
4. Imaging: The doctor moves the probe to acquire detailed images of the heart.
5. Recovery: After the test, the patient is monitored for a short period until sedation wears off.

Risks and Considerations

While TEE is generally safe, it may have some risks, including: - Throat discomfort or minor irritation - Risk of aspiration (rare) - Esophageal injury (very rare but possible) - Reactions to sedation

It is important to inform your doctor about any swallowing difficulties, gastrointestinal issues, or allergies to medications before undergoing a TEE.

Conclusion

TEE is a highly valuable cardiac imaging tool that provides exceptional details of heart structures, especially when standard transthoracic echocardiography is insufficient. Discuss with your cardiologist if TEE is necessary for your specific condition.

Source recommendations

1. American Society of Echocardiography Guidelines

1. https://www.asecho.org/guidelines-search/
2. https://pubmed.ncbi.nlm.nih.gov/30282592/
3. https://www.asecho.org/wp-content/uploads/2018/10/Guidelines-for-Performing-a-Comprehensive-Transthoracic-Echocardiographic-Examination-in-Adults.pdf
4. https://www.onlinejase.com/content/aseguidelines
5. https://www.asecho.org/guideline/

2. European Association of Cardiovascular Imaging Guidelines

1. https://www.escardio.org/Guidelines/Scientific-Documents/Recommendations-and-position-papers
2. https://academic.oup.com/ehjcimaging/article/16/1/12/2403250
3. https://www.escardio.org/Sub-specialty-communities/European-Association-of-Cardiovascular-Imaging-(EACVI)
4. https://academic.oup.com/ehjcimaging/article/20/12/1321/5572609
5. https://pubmed.ncbi.nlm.nih.gov/29045589/