What is Transoesophageal Echocardiogram (TOE)  & why do I need one?

A TOE is an ultrasound scan of the heart performed by passing a probe on the end of a flexible scope into your oesophagus (the `food pipe'). The oesophagus lies directly behind the heart, with no intervening structures, so the images are much clearer than those from the front of the chest (transthoracic echocardiography), where the chest wall, ribs and lungs get in the way.

What should I should I do before the test 
  • Do not eat or drink for up to 6 hours before your test. This includes water except for taking tablets. If your appointment is early morning we ask you to fast from midnight.
  • Unless instructed otherwise by your doctor, you should continue to take normal medications (including warfarin). Have them with just a sip of water.
  • Many patients prefer to have a sedative for the test, and so you should arrange for a responsible adult to accompany you to your appointment and escort you home as you may feel sleepy following your sedation. If you live alone, we ask that you have someone to stay with you overnight.
  • If you have difficulty in swallowing or have ever had surgery on your throat or gullet, you should inform the department as soon as you receive your appointment. It may be necessary to have further investigations prior to the test.
  • Please bring slippers and a dressing gown with you.
What will happen when I arrive? 

On arrival you will usually be met by a sonographer or nurse who will explain the test, ask questions according to a routine checklist and ask you to countersign a consent form.

What does the test involve? 

The test is performed on a couch or bed. A small cannula will be inserted into an arm vein (like a blood test) to administer sedation. An ECG and a blood oxygen monitor will be attached and you may be given oxygen through your nose. You will be asked to remove any dentures and your throat will be sprayed with a local anaesthetic to make it numb. A bite guard will be placed between your front teeth. The tube is lubricated then placed at the back of your mouth. You will be asked to swallow a small number of times to help it pass into the `food pipe'. This may be uncomfortable, but will not be painful. Once the probe is in place, it is only mildly uncomfortable. You can breath through your mouth or nose.

How long will it take? 

The procedure, including preparation, may take up to 1 hour and you should usually allow up to 2 hours to include waking up afterwards if sedation is used. The probe is usually in the `food pipe' for a much shorter time, typically 10 minutes.

What happens after the procedure?

You will be asked to sit or lie in a recovery area until you feel awake enough to travel home. The sedative can have a `hangover' effect. Although you may feel fine, your reasoning, reflexes, judgement, co-ordination and skill can be affected by having sedation. The nurse will check that the local anaesthetic throat spray has worn off by using sips of cold water.

Until the day after your test, please do not:
  • Drive any vehicle, including riding a bicycle
  • Operate any machinery
  • Attempt to cook, use sharp utensils or pour boiling fluids
  • Drink alcohol
  • Take sleeping tablets
  • Make any important decisions or sign any contracts

A written report of your test results will be sent to your referring doctor. You may experience some soreness in the throat afterwards. This should resolve in a day or two.

Are there any risks? 

The procedure is very safe and complications are rare. Occasionally bruising of the back of the throat can occur.

Who should I contact if I cannot keep my appointment or have any questions? 

Cardiology Department - 01228 814112

Cardiac Nurse 01228 814112

Cardiology Secretary - 01228 616848

 

Confidentiality

‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.

For further information on confidentiality contact the Information Governance Team:

Information.Governance@ncic.nhs.uk | 01228 603961

Feedback

We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:

pals@ncic.nhs.uk | 01228 814008 or 01946 523818

If you would like to raise a complaint regarding your care, please contact the Complaints Department:

complaints@ncic.nhs.uk | 01228 936302