Transesophageal Echocardiography for Children

Echocardiography is an imaging test. It uses sound waves to make detailed moving pictures of the heart. It shows the size and shape of the heart, as well as the heart chambers and valves. Transesophageal echocardiography (TEE) uses a device that is placed in the esophagus. The esophagus is the tube leading from the throat to the stomach. It is located behind the heart in the chest. TEE may be used when certain pictures of the heart are needed.

The other type of echocardiography is called transthoracic echocardiography (TTE). This test uses a device that is moved across the outside of the chest. TEE can give better images than transthoracic echocardiography.

Most echocardiography is 2-D. Two views of the heart are used to create the images. Other types include:

• Doppler. This shows blood flow through the heart.
• Color Doppler. This shows color images to better see blood flow.
• 3-D. This gives 3 views of the heart.
• Stress echocardiography. This shows what the heart does under stress from medicine or exercise.

Echocardiography is one of the most important imaging tests for heart problems in infants and children. It may help diagnose problems your child was born with (congenital). It can also help diagnose problems that have developed (acquired). Below are reasons for having echocardiography.

Congenital

• Signs or symptoms that may mean a heart problem such as bluish color of the skin (cyanosis) or a heart murmur
• Checking the heart because of other congenital problems
• Family history of congenital heart disease
• Other abnormal test results

Acquired

• Infections or other conditions that may affect the heart
• High blood pressure
• Irregular heartbeats (arrhythmias)

TEE may also be used during procedures such as heart catheterization or heart surgery.

In general, echocardiography does not have any risks. There is a small risk for problems from the medicine used to help your child relax (sedative). There is also a small risk of damage to the mouth and throat. Talk with your child's cardiologist about this risk.Talk with the cardiologist or someone at the facility about how to get your child ready for the test. Your child may need to stop eating and drinking at a certain time before the procedure. He or she may also need to take or stop certain medicines. If your child is old enough, explain what will happen. You might ask the cardiologist or nurse to help explain the procedure.

TEE may be done at a hospital or at an imaging facility. It takes about an hour to do the test. The steps are as follows:

• Your child will be given sedative medicine through an intravenous (IV) line. Depend on your child's age, general anesthesia may be used. He or she will be asleep during TEE.
• Heart rate, rhythm, blood pressure, and oxygen levels will be monitored at all times.
• A mouth guard or bite protector will be placed in your child's mouth.
• The healthcare provider will put a device called a transducer in your child's mouth, down his or her throat, and into the esophagus.
• The transducer sends and receives sound waves. The sound waves create images that are displayed on a computer screen.

Your child will be watched after the TEE until the sedative wears off.  His or her blood pressure, heart rate, and oxygen will be checked. Since the probe is passed through the throat, your child might have a sore throat.

A pediatric cardiologist will look at the results of the TEE. Depending on the results, your child may need other tests or procedures.

 

Before you agree to the test or the procedure for your child make sure you know:

• The name of the test or procedure
• The reason your child is having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• When and where your child is to have the test or procedure
• Who will do the procedure and what that person’s qualifications are
• What would happen if your child did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how will you get the results
• Who to call after the test or procedure if you have questions or your child has problems
• How much will you have to pay for the test or procedure