Trans-Oesophageal Echocardiogram

Trans-Oesophageal Echocardiogram

Patient Information

Cardiology Department

• Author ID: KJ
• Leaflet ref: Card 013
• Version: 9
• Leaflet title: Trans-Oesophageal Echocardiogram
• Last review: August 2025
• Expiry date: August 2027

What is it?

A Trans-Oesophageal Echocardiogram (TOE) is a heart scan that uses ultrasound (sound waves) to produce images of the heart.  The scan is painless and does not use radioactivity.

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

Benefits

• A TOE allows your doctor to take extremely detailed images of your heart.
• A TOE is often used to look carefully at the valves and the structure of the heart.
• The TOE will help the doctor decide on the best treatment for your heart.

What does the procedure involve?

This procedure is performed as a day case in the cardiology department at RAEI.

Three members of staff will usually be present to perform the scan: a doctor, cardiac clinical physiologist, and an assistant. 

You will be offered a gown, but loose clothing would also suffice. You will have 3 stickers attached to your upper body so that your heart rate can be monitored throughout the scan.  You will also have your blood pressure checked and be given oxygen through your nose. You will be able to breathe normally throughout the test, but you will have a mouthpiece given for you to bite on. 

You will have some local anaesthetic spray applied to the back of your throat and then you will be asked to lie on your left side.  A drip may be placed in your arm.  If you have dentures, you will be asked to remove them before the scan.  You will then be offered some sedation to relax you, although you will not be completely asleep.  We do not always give sedation, but the advantages and disadvantages of sedation will be discussed with you during your consultation. The decision to be sedated will be between you and the doctor.

You will then be asked to swallow the TOE probe.  This part may cause some discomfort but is not painful. Recorded images of the heart will then be obtained.  The scan 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 allowed 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 six hours before the scan.
• 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 staff when you arrive.  If you are on Warfarin, your INR should have been checked within the last seven days and this will be on your appointment letter.
• Please inform the doctor if you have any problems with swallowing, or if you have had any bleeding from the stomach.  Either of these may prevent the TOE from being performed.
• Please inform the doctor if you have any problems with swallowing, or if you have had any bleeding from the stomach. Either of these may prevent the TOE from being performed.

At the end of the echocardiogram

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 to drink.

You will be allowed home when you are fully awake, usually one to two hours after the procedure.  Before you are discharged, the results of the scan may be explained to you. However, in most cases the results will go to the referring consultant.

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?

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.  Therefore it is important that you do not eat or drink anything for six hours before the procedure.
• There is an extremely small risk (1 in 4 ,000) of damaging or tearing the gullet.  In extreme circumstances this may require an operation to repair the damage.

Contact information

If you have any questions that is not covered in this leaflet, please contact 01942 822445, Monday to Friday, 8am to 4:30 pm.