Transesophageal Echocardiography
Transesophageal Echo is a scan advanced imaging extremely important in some clinical situations. It is necessary when the echo – (standard) fails to visualize the structures of the heart in an appropriate manner in order to establish a diagnosis.
Echo transesofagiana is an examination that uses a small probe system at the end of a flexible tube, probe that is inserted into the esophagus to view the cardiac structures from the rear. Thus, the heart is regarded transesofagian much more closely. In addition to visual horizon structures inaccessible to standard ecocardiografiei,transesophageal ultrasonography using the son of issuing ultasunete with a higher frequency allows for high quality images.
Indications
Doctor uses the echo transesofagiana for:
- assessment of dimensions and the aorta morphology;
- assessment the presence trombilor in the left atrium in the event of a disturbance of the heart rhythm (for example in the event of atrial fibrillation);
- assessment the presence, of unendurable severity and mechanism of diseases of the valves of the heart;
- evaluation of prostheses valvulare;
- assessment of congenital cardiopatii with a view to the therapeutic decision (ex: perimembranous atrially for interventional closing with the tool;
- clarification of certain problems diagnostics why they could be resolved using the transthorasic ultrasonography.
Procedure Overview
The esophagus is a tubular organ connecting the oral cavity to the stomach, passing immediately behind the heart, without intervening structures such as lungs or other organs. Consequently, during Transesophageal echocardiography (TEE), the heart is visualized much closer and in an opposite zone compared to standard echocardiography (transthoracic).
A probe is inserted into the esophagus through the patient's oral cavity by a physician, who easily advances it during swallowing.
The examination may cause mild discomfort (a feeling of nausea), which lasts only a few seconds, occurring when the probe touches the back wall of the throat and disappears after the probe is swallowed and positioned in the esophagus. Discomfort induced by esophageal echocardiography is similar to that experienced during gastroscopy.
Risks
Complications during the examination are extremely rare. Nevertheless, promptly inform the attending physician if any of the following symptoms occur after the examination:
- unexplained pain or difficulty swallowing;
- abdominal or chest pain;
- vomiting with black or coffee ground-like contents;
- vomiting blood.
Preparation
Thorough preparation is necessary for esophageal echocardiography. You may dress as you wish; however, for effective examination, it is necessary to expose the chest completely (in the case of women, dresses should be avoided). A fasting period (no food or drinks) of at least 6 hours before the examination is required to prevent vomiting during probe insertion. If continued treatment is necessary, you may take all medications according to the usual schedule, using a reduced amount of water. Bring all previous medical documents. The examining physician should be informed in advance of:
- esophageal conditions (diverticula, tumors, prior surgical interventions, dysphagia, hiatal hernias, etc.);
- chronic liver conditions (cirrhosis, etc.);
- previous chronic hepatitis;
- medication allergies;
- glaucoma;
- lung conditions;
- stomach conditions.
If you wear glasses or dentures, they should be removed during the examination. If you have diabetes, consult your physician regarding the insulin dosage for the day, considering the required fasting period.
If anti-anxiety medication is necessary, do not drive after the examination. It is recommended to come for the examination accompanied by someone capable of driving you home.
Results
You have the option to receive the examination results on-site. Esophageal echocardiography always precedes full standard transthoracic echocardiography. This procedure confirms the indication for the examination and provides a comprehensive and additional assessment of various heart structures, reducing the duration of esophageal examination and, consequently, discomfort.
In general, there should be no discomfort a few minutes after the examination. If sedatives were prescribed, wait at least 30 minutes before leaving the clinic and refrain from driving for at least 4 hours. It is advisable to have someone accompany you for this examination.
In the case of local anesthesia use, the throat may be slightly inflamed or numb. To prevent inhalation of food masses, continue fasting for an additional 1 or 2 hours after the procedure. You can start drinking cold water afterward. If you do not perceive the water as cold, wait another 30 minutes before trying again. Once you feel the water is cold, you can resume eating and drinking normally.