Transesophageal Echocardiography | What you need to know ?

Transesophageal Echocardiography (TEE) is a specialized diagnostic test used to assess the heart’s structure and function.

TEE is often used to diagnose and evaluate conditions such as heart valve disease, atrial fibrillation, and blood clots in the heart.

Whether you are a patient who may be undergoing TEE or someone who is simply interested in learning more about this advanced diagnostic tool, this article will provide a comprehensive guide to help you better understand Transesophageal Echocardiography and its role in assessing heart health.

What Is Transesophageal Echocardiography?

It is a diagnostic test that involves using a specialized ultrasound probe that is passed through the mouth and into the esophagus to obtain images of the heart.

The esophagus is located directly behind the heart and provides a closer and clearer view of the heart’s structures than a traditional echocardiogram, which is performed by placing the ultrasound probe on the chest.

During the TEE procedure, the ultrasound probe is attached to the end of a thin, flexible tube that is passed down the throat and into the esophagus, the probe emits high-frequency sound waves that bounce off the heart’s structures and create images that can be viewed on a monitor.

TEE is often used to diagnose and evaluate conditions such as heart valve disease, atrial fibrillation, and blood clots in the heart.

It is considered a safe and effective diagnostic test, although it may be associated with some risks and complications, such as throat discomfort, bleeding, or a reaction to the sedative medication used during the procedure.

What does a transesophageal echocardiogram show?

A transesophageal echocardiogram shows a detailed view of your heart’s structure and function. It can help diagnose and manage many different conditions, including:

Aortic aneurysm, which is a bulge in your largest blood vessel. 

Blood clots in your heart. People with atrial fibrillation face a higher risk of clots in their atria (upper heart chambers).

Cardiac tumors, which may be cancerous or noncancerous.

Congenital heart disease, which includes a range of heart problems that you’re born with.

Heart valve disease, including mitral valve disease. Your valves may be narrowed (stenosis) or leaky (regurgitation). TEE can also spot problems with prosthetic valves, such as growths or infections.

Infective endocarditis and other infections in your heart tissue or valves.

Pericardial disease, which affects the sac that covers your heart.

Why is a transesophageal echocardiogram performed?

A transesophageal echocardiogram may be performed for many reasons. These include:

You had a transthoracic echocardiogram (TTE), but your provider needs better or more detailed visualization of your heart. In this case, a TEE is a follow-up to the TTE that helps diagnose or manage a heart problem.

You have a life-threatening problem that your provider needs to see up- close, right away. TEE can be useful in emergency and critical care.

Your provider needs to check for blood clots before you have a medical procedure such as cardioversion.

You’re having a surgery or procedure. TEE helps providers confirm your surgery was successful. TEE also provides real-time imaging during some catheter-based procedures.

Comparing TEE to other diagnostic tests

Transesophageal Echocardiography (TEE) is a specialized diagnostic test that utilizes a specialized ultrasound probe that is passed through the mouth and into the esophagus to obtain images of the heart.

Standard Echocardiography

This is a non-invasive test that uses an ultrasound probe placed on the chest to obtain images of the heart.

While standard echocardiography is less invasive than TEE, it may not provide as clear and detailed images of the heart’s structures.

Electrocardiogram (ECG)

This is a non-invasive test that measures the electrical activity of the heart to assess heart function and detect abnormalities.

While ECG can provide valuable information about the heart’s electrical activity, it does not provide detailed images of the heart’s structures.

Cardiac Catheterization

This is an invasive procedure that involves inserting a thin tube (catheter) into a blood vessel in the arm, groin, or neck and guiding it to the heart to evaluate blood flow and pressure.

Cardiac catheterization can provide detailed information about the heart’s function, but it is more invasive than TEE and requires more recovery time.

Magnetic Resonance Imaging (MRI)

This is a non-invasive test that uses a powerful magnetic field and radio waves to produce detailed images of the heart and blood vessels.

MRI can provide detailed information about the heart’s structures and function, but it is more expensive and time-consuming than TEE.

Compared to these other diagnostic tests, TEE provides a closer and clearer view of the heart’s structures than standard echocardiography,  while being less invasive than cardiac catheterization, it is also more readily available and less expensive than MRI.

Who can benefit from TEE?

Transesophageal Echocardiography can benefit a variety of patients who require a more detailed evaluation of their heart’s structures and function. Here are some examples of patients who may benefit from TEE:

1.Patients with suspected heart valve disease:

TEE can provide detailed information about the heart’s valves, which can help diagnose and evaluate conditions such as valve stenosis (narrowing) or regurgitation (leakage).

2.Patients with atrial fibrillation:

TEE can assess the risk of stroke in patients with atrial fibrillation by evaluating the presence of blood clots in the heart.

3.Patients with suspected blood clots in the heart:

It can help diagnose and evaluate blood clots in the heart, which can be a serious condition that requires prompt treatment.

4.Patients undergoing heart surgery:

TEE can monitor heart function during and after heart surgery, and can help guide the surgical team in performing the procedure.

5.Patients with congenital heart defects:

It can detect structural abnormalities in the heart, such as congenital heart defects, which may be difficult to diagnose with other imaging tests.

6.Patients with suspected endocarditis:

Transesophageal Echocardiography can help diagnose and evaluate endocarditis, which is an infection of the heart’s inner lining.

7.Patients with suspected heart tumors:

TEE can help diagnose and evaluate tumors of the heart, which may require further treatment.

Overall, TEE is a valuable diagnostic tool that can provide detailed information about the heart’s structures and function, helping healthcare providers to diagnose and manage a variety of heart conditions.

The specific indications for TEE will depend on each individual case and the healthcare provider’s assessment of the patient’s needs.

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Fawaz Almutairi

Saudi Arabia

Fawaz Portrait GIS president


President, Gulf Intervention Society

Interventional Cardiologists

National Guard Hospital

Riyadh, Saudi Arabia

Abdullah Shehab

United Arab Emirates

shehab portrait vice president GIS


Vice President, Gulf Intervention Society

Professor of Cardiovascular Medicine

Chairman of Education, EMA 

Editor Chief New Emirates Medical Journal 

Alain, Abu Dhabi, UAE

Khalid Bin Thani



Treasurer, Gulf Intervention Society

Head of Scientific Committee, GIS Conference

Consultant Interventional Cardiologist

Bahrain Specialist Hospital Manama, Bahrain
Khalid Bin Thani GIS

Mousa Akbar



General Secretary, Gulf Intervention Society

Head of Cardiology Unit, Al Sabah Hospital

Kuwait City, Kuwait

mousa Akbar GIS