This leaflet answers common questions about having a transoesophageal echocardiogram (TOE). If you would like further information, or have any worries, please do not hesitate to ask your nurse or doctor.

In all cases, a doctor will explain the procedure to you and answer any questions you may have. In most cases it will be possible for a friend or relative to accompany you for all or part of the procedure. Please ask your nurse or doctor.

What is a TOE?

A TOE is a test that involves inserting a flexible untrasound probe into the gullet under sedation to acquire images of your heart. Your consultant may request this test to get a more detailed view of the heart than is possible with some other techniques. You must be accompanied home from your procedure by a friend or relative, as a TOE involves sedation. If you are unaccompanied, you will not be able to have sedation.

How is a TOE performed?

You will be invited into a private treatment room. Several staff will be present including a consultant cardiologist who will perform the procedure, along with a cardiac physiologist and nurse to help. You will be asked to undress to the waist and put on a gown that should be left open to the front.

You will then lie on a couch while we connect you to heart monitoring stickers attached to the echocardiography machine. Local anaesthetic will be sprayed at the back of your throat, and you will then be asked to lie on your left side. You will receive sedation through a small needle placed in your arm.

Once you are more relaxed, the consultant will ask you to swallow the camera/probe as it passes down your throat towards the stomach. The camera may be in place for around 10 minutes, after which it is withdrawn, and you will be able to recover in a monitored area.

Before your TOE

  • Do not eat or drink anything for six hours before the test.
  • Normal medication can be taken on the morning of the procedure with a small sip of water. Please bring a copy of your prescription with you.
  • If you are diabetic, please inform the nurses as soon as you arrive for your appointment.
  • If you are on warfarin, please have your INR checked within seven days prior to the test and bring the result of the INR with you. We will also need to check your INR on the day.
  • Please inform the department if you have any problems with swallowing, or if you have had any bleeding from your stomach.
  • If you have dentures, you will be asked to remove them before the test.

After your TOE

There will be a short time after the procedure before you are allowed to eat and drink again (usually 1.5 hours). You will be allowed home when you are fully alert (around two hours after the procedure). If you have been given sedation, you should not drive or operate heavy machinery for the remainder of the day.

Risks and side-effects

The stickers used can cause a skin reaction. If you have an allergy to skin adhesive or plasters, please let us know. You may have a sore throat after the procedure lasting for one to two days. Occasionally the throat may bruise or bleed slightly.

There is an extremely small risk (around 1 in 10,000) of damaging the oesophagus (gullet). In extreme circumstances this may require an operation to repair the damage.