Transoesophageal Echocardiogram (TOE)

What is it?

A transoesophageal echocardiogram (TOE) is a heart scan that uses ultrasound (sound waves) to produce images of the heart.  The test is painless and does not use radioactivity.

It involves swallowing a soft flexible tube as the pictures are taken via the gullet.

Below is a short video from the British Heart Foundation showing you what happens during the procedure.

You will have some local anaesthetic sprayed on the back of your throat and then asked to lay on your left hand side.  A drip will be placed in your arm.  If you have dentures, you will be asked to remove them before the test.  Often, you will then be given some sedation to relax you, although you will not be completely asleep.

You will then be asked to swallow the TOE probe.  This part may cause discomfort, but is not painful.  Recorded images of the heart will then be obtained.  The test will take about 20 minutes.

At the end of the procedure, the tube will be removed, your blood pressure will be checked again, and you will be kept for a short period of recovery.

Are there any special precautions that I need to take before the TOE?

You must NOT eat or drink anything for 6 hours before the test.

Normal medications should be taken on the morning of the TOE with a small sip of water.  Please bring a copy of your prescription with you.  If you are diabetic, please inform the nurses as soon as you arrive at the Day Care unit.  If you are on Warfarin, your INR should have been checked within the preceding 7 days.

Please inform your Doctor if you have any problems with swallowing, or if you have had any bleeding from your stomach.  This may prevent the TOE from being performed.

At the end of your TOE

After the TOE, you will be monitored for a short period of recovery.  When you are fully alert and the sensation has returned to your throat, you will be allowed a drink.

You will be allowed home when you are fully awake, usually 2-3 hours after the procedure.  Before you are discharged, the results of the scan will be explained to you.

If you have been given sedation, you should NOT drive or operate heavy machinery for the remainder of the day.  You should be accompanied home by a friend or relative.  You can go back to normal activities the following day.

Are there any risks in having the TOE?

The TOE scan is extremely safe, but there are some risks you need to be aware of.

It is not uncommon to have a sore throat after the procedure.  This may last for a day or two.

Occasionally the throat may bruise or bleed slightly.

There is a small chance of inhaling stomach contents during the procedure.  This is why it is important that you do NOT eat or drink anything for six hours before the procedure. 

There is an extremely small risk (less than 1 in 10,000) of damaging or tearing the gullet.  In extreme circumstances this may require an operation to repair the damage.

Your Doctor would not be requesting the TOE unless he or she felt it would help in deciding on the best treatment for your heart.  If you have any questions regarding the TOE please contact your Doctor’s secretary, or the Cardio Respiratory department.