Transesophageal Echocardiography


Echocardiography is a diagnostic technique that uses ultrasounds to visualize the structure and function of the heart and also, the great vessels emerging from the heart. During the procedure a transducer (like a small microphone) emits ultrasounds (with a very high frequency, so they can not be heard by the human ear) that penetrate the chest wall to the heart. The heart will reflect the ultrasound to be captured by the transducer and will be transmitted to a computer that displays on a screen the image of the walls and valves of the heart and also the blood flow through its compartments. Transthoracic echocardiography uses a transducer that is applied to the chest offering an image of the heart anterior to posterior.Trans3

 

Unlike the usual transthoracic echocardiography, transesophageal ultrasound uses a thin flexible tube which is attached to the tip of the transducer that emits the ultrasounds, this tube being inserted into the esophagus to visualize the cardiac structures. The esophagus is a tubular structure that connects the mouth and stomach, being located immediately behind the heart, without the interposition of other organs.

 

Why is transesophageal echocardiography required?

 

Transthoracic ecography views the heart from the chest (anterior)to  posterior, so that structures behind the heart can not be seen;

If the chest wall is thicker (obesity, lung diseases,  viewing the  structures in front of the heart is difficult;

In case of metallic prosthetic valves, the part of the heart behind these can’t be seen (metallic prostheses creats obscurity).

 

What are the indications for performing transesophageal ultrasound?

 

Detection of cardiac sources of embolism (clots, tumors, atherosclerotic plaques that can cause stroke or embolism in lower/upper limbs, kidneys etc);

Full evaluation of prosthetic valve operation (especially prostheses in mitral position);

Full assessment of heart valvular damage in infectious endocarditis;

Diseases of the thoracic aorta (aortic anevrysm, aortic dissection);

Complete diagnosis and preoperative evaluation of certain congenital heart diseases (atrial septal defect).

 

Before the procedure

 

Fasting 6 hours before performing ultrasound is needed;Trans1

The drugs are taken as normal with a small amount of water;

Tell your doctor if you are allergic to certain drugs, local anesthetics or latex;

Tell your doctor about the medicines you are taking;

Tell your doctor about other illness you suffer, especially diseases of the esophagus, liver, stomach or lung diseases;

If you wear dental prosthetics, they will be removed during the procedure;

If you suffer from diabetes and need insulin you have to ask your doctor about the dosage of insulin that you should administrate, sinceyou are fasting on that day;

It’s good to come accompanied – if a sedative is administrated, you can not drive after completing the exam, someone else must take you home.

 

How is the procedure?

 

Several small electrodes will be applied on your chest to monitor cardiac activity during the procedure;

The examining doctor will apply a local anesthetic spray to reduce neck discomfort linked to the introduction of the probe, then, a plastic mouthpiece will be fixed between the dental arches through which the examination probe will be introduced later;

The exam takes about 10 minutes, it is not painful, the only uncomfortable moments is during the insertion of the probe, when you cand feel like vomiting or coughing;

The examination is performed either seated or lying in bed in lateral position.

 

Post examination

 

Fasting is necessary for another 2 hours after investigation;

If a sedative was administere, after ultrasound you are not allowed to drive for 4 hours.Trans2

 


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