What is Transoesophageal Echocardiogram?

In order for the test to be as comfortable as possible, a mild sedative is injected into the patient’s vein, so a cannula must be inserted into the arm. First, a topical, bitter-tasting anaesthetic is sprayed into the throat. Then, two drugs are administered through a vein (usually midazolam and fentanyl), to lightly sedate the patient.

The exploration is carried out with the person lying on their side on a bed. To prevent the probe damaging their teeth, these are protected with a mouth guard. During the study, the blood pressure, heart rate, and oxygen saturation in the blood are all monitored. The test takes approximately 15-20 minutes.

When the exploration has finished, the patient must wait until they have recovered from the effects of the sedative. Once they have recovered, the cannula is removed and they may leave.

Complications are extremely rare. During the procedure the patient may require oxygen to be administered. It is usual that they feel nauseous, although vomiting is not normal. The most common complication is mild discomfort in the throat due to the administration of the spray. Exceptionally, in 1 out of every 10,000 studies, there may be oesophageal perforation that requires, in most cases, surgical intervention. In isolated cases, despite the sedative given by the cardiologist, the test cannot be performed safely due to lack of sufficient sedation with the medication administered, and the test must be reprogrammed and monitored by the anaesthesiologist.

You have to fast for 6 hours, including drinking no water, and must continue fasting for two hours after the test, until the effect of the topical anaesthetic has worn off. It is recommended that someone comes with you, and that you avoid driving until the next day because the drugs you are given cause drowsiness and reduce your reflexes. You should also tell your healthcare team about any drug allergies, if you wear removable dentures, are having anticoagulant treatment, have had previous oesophageal or stomach surgery, oesophageal problems, or you are pregnant.