Transoesophageal Echocardiogram (TOE)

Transoesophageal Echocardiogram

A TOE is a specialised heart scan that uses ultrasound to take detailed images of your heart from inside your body. Unlike a standard echocardiogram—which is performed by a sonographer using a probe on the outside of your chest—a TOE is carried out by a cardiologist using a small probe inserted into your oesophagus. This position allows the cardiologist to view the back of the heart with much greater clarity.

TOE is often recommended when high-resolution images are needed to assess heart valves, detect blood clots, or investigate unexplained symptoms.

How to prepare

  • Avoid eating, drinking, smoking, or alcohol for at least six hours before your appointment.
  • Take your usual medications with a small sip of water, unless your cardiologist advises otherwise.
  • Bring a list of your medications in their packets with you to the hospital.
  • Arrange for a family member or friend to take you home, as you will not be able to drive after the procedure.
  • You will also need someone to stay with you overnight.

 

TOE is safe and well tolerated. However, like any medical procedure, it carries some risks. Your cardiologist has considered the benefits of this test against the risks of not performing it.

What Happens During the Procedure?

  • A small canula or drip will be placed in your arm so the medical team can give you medications.
  • You will receive a local anaesthetic spray to numb your throat.
  • A sedative will be given to help you relax and become sleepy.

The ultrasound probe, which is attached to a flexible tube, will be gently guided through your mouth and down into your oesophagus. Once in place, the probe will capture images of your heart from behind. The scan usually takes about 15 to 30 minutes.

After the test, the probe is removed, and you will be monitored in recovery.

Common risks

  • Sore throat for a day or two after the procedure

Uncommon risks

  • Minor injury to teeth or jaw from the probe
  • Small tear in the oesophagus, which usually heals without treatment.

Rare risks

  • Irregular heartbeat (arrhythmia), usually temporary
  • Breathing difficulties requiring medication
  • Serious tear in the oesophagus (perforation), which may need surgery.
  • Death is extremely rare.

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