Transoesophageal echocardiogram

The transoesophageal echocardiogram (TOE) test looks at the structure of the heart’s chambers and valves. It assesses the size of the chambers, the movement of the heart valves, and the action of the two lower chambers (called ventricles) when your heart muscle is contracting and resting. It involves you swallowing a ‘endoscopy echo probe’ to view the heart from the oesophagus (the tube that carries food to the stomach). This procedure is the most accurate way of assessing the heart's structure and function.

The endoscopy echo probe will go down to almost as far as your stomach. If you've had any problems with swallowing or narrowing in the oesophagus, this should be investigated before the procedure is carried out. There may be minor damage to, and bleeding from, the mouth and oesophagus during the procedure. This may cause pain when you swallow, but this should disappear within 24 hours.

Complications are not common, and serious complications are rare. A very rare but potentially serious complication is a tear of the oesophagus. Surgery would be needed to repair the tear.

The procedure can disturb your heart rhythm, but this usually lasts only a short time. Occasionally it is difficult to pass the probe down the oesophagus and the procedure cannot be performed.

If you are taking warfarin you do not need to stop taking this before the procedure. However, when you arrive on the ward, a blood test will be carried out to make sure that the level of warfarin in your blood is not too high. If it is, the procedure may have to be rearranged.

The doctor will see you on the ward and discuss the test with you. He or she will ask you to sign a consent form. This is to make sure you fully understand the procedure. A doctor or nurse will insert a small needle into the back of your hand to allow any necessary drugs to be given during your test. You should have nothing to eat or drink in the six hours before the procedure. Half an hour before your procedure the nurse will bring you a hospital gown. You will be asked to remove your shirt or blouse, but you can leave your underwear on.