Trans-oesophageal Echocardiogram (TOE)

A Trans-oesophageal Echocardiogram (TOE) is a medical imaging test that uses high-frequency sound waves to produce images of the heart and its blood vessels. The test involves inserting a flexible tube with an ultrasound probe on the end through the mouth and into the oesophagus, which lies behind the heart.

Why is TOE performed?

TOE is performed for several reasons, including:

• To evaluate the structure and function of the heart valves
• To diagnose and monitor conditions such as endocarditis, cardiac tumors, and aortic dissection
• To assess the heart's blood flow and pressure
• To guide certain medical procedures, such as catheter ablation or percutaneous valve repair
• To evaluate the effectiveness of surgical repairs or other treatments

How is TOE performed?

The TOE procedure typically involves the following steps:

1. The patient is given a local anaesthetic to numb the throat and a sedative to help them relax.
2. A flexible tube with an ultrasound probe on the end (called a transducer) is inserted through the mouth and into the oesophagus.
3. The transducer emits high-frequency sound waves that bounce off the heart and its blood vessels, producing images on a monitor.
4. The doctor or technician performing the test will move the transducer to different positions in the oesophagus to obtain images of the heart from various angles.
5. The procedure typically takes 30-60 minutes to complete.

Risks and complications of TOE

While TOE is generally a safe procedure, there are some potential risks and complications, including:

• Bleeding or perforation of the oesophagus
• Infection
• Allergic reaction to the anaesthetic or sedative
• Dental damage or tooth loss
• Temporary sore throat or hoarseness

Preparation for TOE

To prepare for a TOE, patients should:

• Fast for at least 4-6 hours before the procedure
• Avoid eating or drinking anything that can irritate the throat, such as spicy or acidic foods
• Tell their doctor about any medications they are taking, especially blood thinners or diabetes medications
• Remove any dentures or dental work before the procedure

What to expect after TOE

After the TOE procedure, patients can expect:

• A sore throat or hoarseness that should resolve on its own within a few hours
• A numb feeling in the throat that should wear off within a few hours
• To be monitored for any signs of complications, such as bleeding or infection
• To receive instructions on how to care for themselves after the procedure, including what to eat and drink