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PATIENT GUIDE and PREPARATION Echo Transesophageal Echocardiogram (TEE) What is a Transesophageal Echocardiogram ? Transesophageal Echocardiography or TEE is a type of echocardiography (echo) that uses sound waves to create pictures of your heart and blood vessels. Echo provides information about the size and shape of the heart and how well the heart chambers and valves are working. Patient having a TEE would have already had a regular Echo (TTE - transthoracic echocardiography). Your doctor may recommend TEE if he or she needs more information than the regular echo can provide. While the regular echo (TTE) is done by placing a transducer on the chest. A echo (TEE) is done by placing a special scope down your throat in your esophagus (the passage leading from the mouth to the stomach). TEE creates pictures from inside the esophagus or, sometimes, from inside the stomach. Because the esophagus lies directly behind the heart, TEE provides closeup pictures of the heart and blood vessels. Transesophageal echo (TEE) pictures are of a higher quality as the lungs or ribs are not in the way to cause interference. How is the TEE test done? The TEE will be done by a team of a cardiologist, an echocardiographer ( echo technologist), and a nurse. Before the test, the cardiologist will explain the procedure in detail, including possible complications and side effects. 2 You will have the opportunity to ask questions and will be requested to sign a consent. Your test will take place in the operating room suite. You will need to put on a hospital gown The technologist will place three electrodes (small, flat, sticky patches) on your chest. The electrodes are attached to an electrocardiograph (EKG) monitor that charts your heart’s electrical activity. A blood pressure cuff will be placed on your arm to monitor your blood pressure. A small clip, attached to a pulse oximeter, will be placed on your finger to monitor the oxygen level of your blood. You will be given a solution to gargle that will numb your throat. A spray will be applied to the back of your throat to provide more freezing. None of this hurts but the freezing may not taste pleasant. You will have an IV in your arm. The doctor will put sedative medications into your IV to help you relax. You may feel drowsy. You will be asked to lie on your left side. A dental suction tip will be placed in your mouth to remove any secretions. 3 A small mouth piece will be placed between your teeth to protect the scope. The doctor will insert a thin, lubricated endoscope into your mouth, down your throat and into your esophagus. This part of the test lasts a few seconds and may be uncomfortable. The endoscope does not interfere with your breathing. You may be asked to swallow to help pass the endoscope into the esophagus. Once the probe is in position, pictures of the heart are obtained at various angles (you will not feel this part of the test). Your heart rate, blood pressure, and oxygen level of your blood will be closely monitored during and immediately after the exam. Because of the sedatives administered during the test, you may not be entirely awake for the test. We will keep you as comfortable as possible during the test. Tell the health care team if you feel uncomfortable at any time during the test. You may feel a temporary soreness or numbness in your throat after the test. How do I get ready for the test? Arrange for someone to be able to drive you to the hospital and drive you home after the test. 4 On the day before the test: Call the Day Surgery department at 902-749-0231 between 12:30 and 1:30 pm to find out what time to check in for your procedure. On the day of the test: Do not eat or drink anything for 6 hours before the test. If your test is in the morning and you are diabetic do not take your insulin or metformin before the procedure. If you are taking any other medication , please take them as you would normally, along with a little water. If you have any questions about your medication contact your family doctor or ordering doctor . If your test is booked in the afternoon, be sure to eat breakfast 6 hours before the procedure and take all your medications as you would normally . Check in at Day Surgery Dept. at the Yarmouth Hospital 75 minutes before your appointment time. (If this time is changed you will be told when you call Day Surgery on the day before.) 5 You will be requested to remove dentures before the test. You will be taken to a room in the Operating/Endoscopy Suite. Tell the doctor if you are on blood thinning medication, have any problems swallowing, have a hiatal hernia or heart valve disease, or allergies to medications; or any loose teeth. What happens after the test? You will be kept under observation for one hour in the Day Surgery observation area and then can be driven home by a responsible adult. You must be taken home. Going home alone by taxi or public transportation is not acceptable. You CANNOT drive your car or operate any dangerous equipment in the next 24 hours after the test. This is required because you are considered legally impaired due to the medication given during the test. It is recommended that someone stay with you for 24 hours after the procedure. Can I eat after the test? It is very important to wait at least two hours after the test (or until the numbness in your throat is gone) before eating or drinking. Start by drinking water. 6 If you don’t have any problems drinking water, you can eat and drink as you normally would. You may have a mild sore throat for about 24 hours . How do I get the results of my test? The cardiologist who did your test will report your test. A copy of your report will be sent to your doctor. How long does the test take? The test will take about 30 minutes. After you have recovered from the sedation given during the test (about one hour), you may go home. Remember, you CANNOT drive yourself home after the test. NOTES: ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ 7 The technologists are unable to give test results. Your doctor will receive a copy of the report within 1 - 2 weeks of the procedure. If you have any questions, concerns or if you are unable to keep your appointment, please do not hesitate to call the booking office at 742-2571 or toll free 1-877-742-2571. Diagnostic Imaging Department Yarmouth Regional Hospital 60 Vancouver Street Yarmouth, NS B5A 2P5 Patient Guides available on http://www.swndha.nshealth.ca/pages/guides.htm SWH promotes a smoke free and scent free environment. Prepared by – Diagnostic Imaging Department, SWH. Revised July 2014 8