What is a TRANSESOPHAGEAL ECHOCARDIOGRAM?

The patient swallows a special pipe that is connected to a cardiac ultrasound (sonar) machine. With the pipe halfway down the food-pipe (oesophagus), an excellent view of the heart chambers (ventricles and atria) and valves (these open and close to let blood into and out of the heart) is obtained. The main arteries arising from the heart are also seen.

How is this done?

After fasting overnight, the patients throat is numbed by spraying it with a local anaesthetic agent. A mouth-guard is placed between the teeth to prevent the patient biting the pipe and to prevent the pipe from moving. Sometimes a mild sedative is given into a drip to relax the patient.

Lying on the left side, the patient swallows the lubricated pipe. Once it is behind the heart, usually about halfway down the oesophagus, a clear picture of the heart is obtained. About 10 minutes later the pipe is removed.

Eating and drinking can recommence about an hour or two later, once the throat is no longer numb. Mild discomfort may be felt in the throat for a few hours after the test, but most patients have no symptoms at all.

When is a Transesophageal echocardiogram indicated?

There are several indications; more common indications include:

• When it is not possible to get a good image of the heart from the front of the patients chest wall due to obesity, ribs that are spaced closely together, or over-inflated lungs (emphysema)
• Bandages over the chest following trauma or heart surgery
• Excluding infection on the valves of the heart
• Determining the cause of a stroke, especially in a young patient
• Assessing the function of an artificial heart valve
• Assessing heart abnormalities a patient acquired at birth (congenital heart disease)
• Assessing whether the main artery (aorta) arising from the heart is diseased (e.g. enlarged, torn, filled with clot)
• Assessing whether there is a hole in the heart (atrial/ventricular septal defect)
• Monitoring the contractility (strength) of the heartbeat during a heart operation
• Assessing the success of valve surgery or corrective surgery performed for congenital heart disease

© 2003 Prometheus™ Healthcare (Pty) Ltd