Royal Sussex County Hospital. Princes Royal Hospital. Hove Polyclinic. Sussex Universities

Trans-oesophageal Echocardiogram (TOE)

The information on this page is for patients who are having a trans-oesophageal echocardiogram of the heart known as a TOE. It explains what the examination is for, what is involved and any significant risks there may be.

What is a TOE for?
A TOE takes ultrasound images of the heart, similar to an ordinary echocardiogram, except the probe is passed into the oesophagus (gullet).  This gives clearer and more detailed pictures, as the ultrasound waves do not have to travel through the chest wall.  Also, smaller areas of the heart that are not seen with an ordinary echocardiogram can be imaged by TOE.


What preparation do I need?
You will be admitted as a day case to one of the cardiac wards.  This means that you go home on the same day you come in for the test and will not need an overnight stay. You will need to be nil by mouth (not eat or drink anything) on the day of the test. Continue taking all medication as normal (including Warfarin).

Please make sure that you tell the doctor if you have had surgery to the throat or neck; if you have difficulty swallowing food or if you have ever vomited a large amount of blood

You will need to arrange for a responsible adult to accompany you to home.  You will not be able to drive home or take public transport on your own.

What does the procedure involve?
You will be admitted to the day case unit, where a doctor will fully discuss the procedure with you.  You will be asked to sign a consent form to confirm you understand and wish to proceed with the procedure.  The test is performed by a senior cardiac doctor with the assistance of a cardiac physiologist and a cardiac nurse.  Leads to monitor your heart rate, blood pressure and oxygen levels will be applied.

The back of your throat will be numbed with a local anaesthetic spray, and you will be given sedative medication.  You will be asked to lie on your left hand side and the doctor will ask you to swallow the probe (similar to an endoscopy probe).  Once the probe has been passed into the oesophagus (gullet) the doctor and cardiac physiologist will record the images.  This takes approximately ten minutes. Once the probe has been removed you will return to the day case unit until fully recovered from the sedative.

After the procedure
You will remain in the day case unit for a short time, usually 1-2 hours, until fully recovered from the sedation. Once all TOE procedures have been completed a doctor will come to the ward to discuss the results with you.  If you have received sedative medication you will not be able to drive home or take public transport on your own.  You should bring a responsible adult with you to accompany you home.

You must not operate any machinery or electrical appliances (including cooker/kettle etc) for the rest of the day.

Sedation for a TOE is given as standard.  If for any reason you were not given sedative medication, you will be able to get dressed and go home immediately after speaking to the doctor.  You should not have anything to eat or drink for thirty minutes and nothing hot for an hour and a half, until the spray to numb your throat has worn off.