EVALUATION METHODS
ADDITIONAL EXAMINATIONS
TRANSOESOPHAGEAL ECHOCARDIOGRAPHY
Why are you offered a transoesophageal echocardiography?
This test explores the heart, its valves and chambers, using the same principles as a transthoracic ultrasound, using a very small ultrasound sensor placed on an endoscope (usually used to visualize your esophagus or stomach). This is in fact a preferred way to obtain images of the heart since the esophagus (into which the probe is inserted) is attached to the heart: the images are of very good quality, which is not always the case in transthoracic ultrasound. ETO allows the study of the heart and aorta, and especially small cardiac structures that are sometimes inaccessible not only to transthoracic ultrasound but also to other radiological imaging methods (CT scan, for example).
Transthoracic echocardiography (ETT) always precedes the performance of a transesophageal ultrasound: the two examinations provide additional information.
Frequent indications for transesophageal ultrasound:
Testing for an intracardiac clot is an important indication, especially when the heart is irregular (in fibrillation or arrhythmia). The search for an abnormality of the heart valves or an abnormality in the functioning of a cardiac prosthesis is a frequent indication. The thoracic aorta, a large vessel starting from the heart and bringing blood to all the organs, is also explored in its different segments, looking for an abnormality in the wall (clot, tear, etc.). Other indications of the examination may also justify the performance of a transesophageal echocardiography. All you have to do is ask the doctor who ordered the examination for this information.
Performing the transesophageal echocardiography:
Preparation: On an empty stomach (food, drink, cigarette, candy) within 6 hours before the examination. Medication should normally be taken with a small amount of water, if possible, at a distance from the examination. An infusion may be placed in a vein in the arm to inject medication to relax you, in case you are hospitalized, or to inject saline to look for an unusual path of blood inside the heart. Under these conditions, the doctor will explain to you very precisely when the injection will be performed, so that it can be carried out in good conditions of tolerance and interpretation.
The location of the exam
In an ultrasound room in a hospital or clinic, equipped with all the essential medicines and equipment in case of emergency.
The duration of the exam
The examination lasts 10 to 15 minutes, except in special cases. However, the prior performance of a transthoracic ultrasound and the possible implementation of an infusion lengthen the duration of the examination. But in the majority of cases, the tube is not left in the digestive tract for more than 10 minutes.
The modalities of the examination
Upon arrival, you will be asked questions to check that there are no contraindications to this examination.
An anesthetic spray is sprayed into your back throat to numb this area, and to make the passage of the catheter painless. You will be asked to remove your removable dentures and glasses to avoid damage. Your usual position when inserting the catheter is lying on your left side; A plastic piece of mouth called a toothlock is put in place before the catheter is inserted.
If the anesthesia is local: It is normal that during the examination, nausea occurs; You have to let the saliva flow without trying to hold it, try not to speak because the probe prevents you, and breathe regularly. At the end of the examination, the catheter is gradually removed. It is important to remain calm for the duration of the examination in order to avoid trauma.
In the case of general anesthesia: the examination is completely painless.
After the exam
Pain in the back of the throat, resembling strep throat, may occur for a few hours (especially if you haven't let the saliva flow). You must fast for an hour after the examination is carried out, because the local anesthetic that has been sprayed has put your back throat to sleep and you risk, in the case of food or fluid intake, going down the wrong path, i.e. swallowing not in your esophagus but in the trachea. Do not hesitate to ask questions as soon as you arrive to the team present during this exam.
Are there any risks associated with transesophageal ultrasound?
Minor incidents are possible such as digestive disorders, palpitations, etc. Serious complications are extremely rare (digestive perforation 0.02 to 0.03%, usually in patients with oesophageal diseases; death in less than 0.01% of cases).
What benefits can be expected from transesophageal ultrasound?
The information obtained will make it possible to confirm or rule out a diagnosis that was suspected (valve infection, clot, aortic problem, etc.), to assess the severity of valve damage (original valve or prosthesis), and to guide certain intervention decisions.
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