A transoesophageal echocardiogram (TOE) is an ultrasound scan which looks at the structure and function of your heart.
A regular echocardiogram (also known as a transthoracic echocardiogram) uses a probe on the outside of the chest to take ultrasound pictures of your heart. For a TOE the probe taking pictures of the heart is on the end of a small exible tube called a scope, which is inserted through the mouth and into your food pipe (oesophagus). The pictures taken using TOE can be much more detailed than regular echo pictures as the probe is much closer to your heart.
Preparing for your test
You should not have anything to eat or drink (including water) for four hours prior to your admission.
During this test you will be given sedation so it’s important that you arrange for a friend or relative to collect you from hospital and stay with you overnight following the procedure. You should continue to take all of your normal medications, but you must only take them with a very small amount of water.
If you take warfarin, you must have your INR level checked within seven days prior to your admission. You’ll need to call us with your INR results 24-72 hours prior to your admission.
At the appointment
On arrival a nurse will admit you to the cardiac short stay unit and ask you questions from a routine checklist. You’ll need to change into a hospital gown for the procedure. A doctor or sonographer (qualified specialist who operates ultrasound equipment) will then explain the procedure to you, including any specific risks that might relate to you and you’ll have a chance to ask questions. We’ll ask you to sign a consent form before we start the procedure. A small tube called a cannula will be inserted into one of the veins in your arm so that we can give you sedation to help relax you.
The procedure is performed in a treatment room and monitoring equipment will be attached to you to measure your heart rate and oxygen levels (we’ll give you oxygen through your nose).
The doctor will spray your throat with a local anaesthetic to make it numb and a mouth guard will be placed between your teeth to protect them while we use the scope. Once you’re sedated and are comfortable and sleepy, the procedure will begin. The lights will be dimmed to help the doctor see the images on the monitor more clearly.
Your cardiologist will perform this procedure with the assistance of a nurse and anaesthetist. The procedure, including preparation time, may take up to one hour. The procedure can feel unpleasant but should not be painful. When the test is complete the probe is gently removed. After the procedure you will return to the recovery room, where you will be monitored for around two hours until the sedation has fully worn off.
Risks of procedure:-
Common risks and complications (more than 5%)
- Sore throat for a day or two afterwards.
Uncommon risks and complications (1 – 5%)
- Damage to your teeth or jaw due to the presence of instruments in your mouth.
- Tear in the oesophagus, which usually settles without treatment.
Rare risks and complications (less than 1%)
- Abnormal heartbeat that usually settles without treatment.
- Breathing problems. You may need medication to treat this.
- Oesophageal perforation. This may need surgery to repair.
- Death as a result of this procedure is extremely rare.
This procedure is currently done in hospital setting and can be organised after assessment by our Cardiologist.