Basic overview

• This test involves the use of a specialised ultrasound probe that images the heart through the oesophagus. Because the probe is anatomically closer to the heart than probes that image through the chest wall it is able to take higher resolution images. This test often allows us to see some structures of the heart that we are unable to visualise with a standard transthoracic echocardiogram.

• In experienced hands the operator is able to construct 3D images of your heart to help in better identifying the nature of the heart problem.

Indications for the test

• Detailed assessment of the severity and mechanism of heart valve problems, often performed to assist in surgical planning
• Assessment for a stroke when a heart cause is suspected i.e. blood clot or ‘hole in the heart’
• Assessment for infection of the heart valves, usually in patients with bacterial infections in the bloodstream
• Assessment of heart structure and function if adequate images are not able to be obtained using standard transthoracic (‘over the chest’) ultrasound

What to expect

• You will be attached to a monitoring system (heart rate, blood pressure and oxygen levels).
• A local anaesthetic spray is often used to ‘numb’ the throat and suppress the ‘gag-reflex’.
• A cannula will be inserted, and you will be given either sedation (‘drowsy’) or in most cases anaesthesia (‘put to sleep’).
• A small lubricated ultrasound ‘camera’ is gently inserted into your oesophagus (food pipe) to take detailed pictures of your heart.
• The procedure is painless, but some people may be aware of the sensation of something in their mouth or throat if done with light sedation (medications will keep you comfortable). The procedure will take about 20-30 minutes depending on the complexity of your issue.
• Patients are instructed not to drive for the remainder of the day (following light sedation) or for at least 24 hrs following an anaesthetic (i.e. propofol). You will need to ensure that you have organised transportation arrangements prior to your test.

Resources