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Transoesophageal Echocardiogram (TOE)

Transoesophageal Echocardiogram (TOE) at London Heart Centre

This test is carried out by our Consultants at one of local private hospitals.

What is a transoesophageal echocardiogram?

Transoesophageal echocardiogram is a diagnostic test that uses sound waves to help your doctor look at the inside of your heart. During this test, a doctor will help you swallow a flexible tube. This tube will pass through your throat and into your oesophagus (gullet), where it will be used to take pictures of the heart.  

How do I prepare for the test?

Please do not eat or drink for 6 hours before the test.

If you are diabetic, do not take medications for diabetes on the morning of test.

Please arrange for a responsible adult to accompany you to the examination as you may need assistance to go home after having a sedative. 

How much time the test will take?

The test will last 45 minutes but expect to be with us for one and half hour.

What happens during the test?

You will be escorted into an Ultrasound room by our doctor.

The doctor will ask you to sign a consent form to confirm that you understand the procedure and agree to go ahead with it. Please do not hesitate to ask any questions you may have about the test. Please inform the doctor if you have any allergies, difficulty in swallowing, had surgery to throat/neck, or are pregnant.

You will be given a gown to wear and asked to lie on a bed. You will need to remove any dentures or glasses. An IV (intravenous line) will be placed in your arm. You will get fluid and medications through this line. Your heart rhythm, blood pressure, breathing and oxygen level will be checked throughout the test.

First, the doctor will numb your throat with an anaesthetic spray. This will lessen your need to gag and help you swallow the tube. You may be given some sedation through your IV line to help you relax.  A “bite block” (a small piece of plastic with a hole in the middle) will be placed between your teeth. This will allow your mouth to stay open during the test. You will be asked to lie on your left side and rest your chin on your chest. When you are in this position, the doctor will pass a tube through the hole in the bite block. You will be asked to swallow the tube. You may feel an urge to gag, but this will go away once the tube is in place. Your saliva will also be suctioned out during the procedure. Once the doctor has acquired the necessary information, the tube and IV line will be removed.

What are the risks from the test?

Risks from transoesophageal echocardiography are tiny. Usually the investigation is tolerated well; some patients may have mild symptoms during the test (mostly coughing). Serious risks are very rare and include bronchospasm/hypoxia (8 patients in every 1000), palpitations (7 patients in every 1000), bleeding (2 patients in every 1000) and oesophageal perforation (1 patient in every 10,000). Your doctor would not recommend that you have transoesophageal echocardiogram unless he/she felt that the benefits of the procedure out-weighed these small risks.

What happens after the test?

You will need to stay for 30 minutes to recover.
 
Your throat may be slightly sore for a few hours. You should not eat or drink for about 30 minutes, or until your swallowing reflex comes back to normal. When all feeling in your throat has returned, start taking small sips of water. If you can swallow these easily, you may eat or drink. You must not sign legally binding agreements, drive or operate machinery for 24 hours if you have been given sedation.    

The results of your test will be sent to the doctor who requested it.

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London Heart Centre