About Your Transesophageal Echocardiogram (TEE)

Figure 1. A transesophageal echocardiogram (TEE)

This information will help you prepare for your transesophageal echocardiogram (TEE) at Memorial Sloan Kettering (MSK).

A TEE is a procedure that uses ultrasound (sound waves) to create moving pictures of your heart. It lets your doctor see how your:

  • Heart valves are working
  • Heart muscle is moving
  • Blood is flowing

A TEE is a diagnostic exam. This means that it’s done only to help your doctor find a diagnosis (the cause of your illness) and decide on the best treatment plan.

During your TEE, your doctor will insert a probe (flexible tube) into your esophagus (food pipe). This will allow your doctor to get detailed pictures of your heart because your esophagus is directly behind your heart (see Figure 1).

7 Days Before Your Procedure

Ask about your medications

Talk with your doctor about the medications you’re taking. If you take insulin or other medications for diabetes, you may need to change the dose before your procedure. This is because you cannot eat after midnight on the evening before your procedure.

  • If you take metformin (for example, Glumetza® or Glucophage®), stop taking it 24 hours before your procedure.
  • If you take insulin, ask the doctor who prescribes it what dose you should take on the evening before and the morning of your procedure.
  • If you take another medication for diabetes, ask the doctor who prescribes it what you should do on the day before and the morning of your procedure.

Get a letter from your doctor, if necessary

If you have an automatic implantable cardioverter-defibrillator (AICD) and are not currently followed by a cardiologist at MSK, you will need to get a clearance letter from your cardiologist before your procedure.

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. If you don’t have anyone, call one of the agencies below. They will provide someone to accompany you home. However, there is usually a charge for this service, and you will need to provide transportation.

In New York:
Partners in Care 888-735-8913
Prime Care 212-944-0244

In New Jersey:
Caring People 877-227-4649

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3 Days Before Your Procedure

A few days before your procedure, you will receive a telephone call from an endoscopy nurse. The nurse will review the instructions in this resource with you and ask you questions about your medical history. They will also review your medications and tell you which to take the morning of your procedure.

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The Day Before Your Procedure

Time of your procedure

A clerk from the Admitting Office will call you after 11:00 am the day before your procedure. They will tell you what time you should arrive at the hospital for your procedure. If you’re scheduled for your procedure on a Monday, you’ll be called on the Friday before. If you don’t receive a call by 5:00 pm, call 212-639-7882.

If you need to cancel your procedure for any reason, please call the doctor who scheduled it for you.

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The Day of Your Procedure

Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of clear liquids (see Figure 2). This includes the liquids you will need to swallow any medications you were instructed to take the morning of your procedure.

Figure 1. 12 ounces of clear liquid

Examples of clear liquids include:

  • Clear broth, bouillon, or consommé (no particles of dried food or seasonings)
  • Gelatin, such as Jell-O®
  • Clear fruit juices (no pulp), such as white cranberry, white grape, or apple
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, or Gatorade®
  • Coffee or tea, without milk or cream
  • Water

Things to remember

  • Take only the medications your nurse told you to take the morning of your procedure. Take them with a few sips of water.
  • Don’t smoke the day of your procedure.
  • Don’t put on any lotion, cream, powder, deodorant, make-up, or perfume.
  • Don’t wear any metal objects. Remove all jewelry, including any body piercings.
  • Leave all valuables, such as credit cards and jewelry, at home.
  • If you wear contact lenses, wear your glasses instead.

What to bring

  • A list of the medications you take at home.
  • Your rescue inhaler (such as albuterol for asthma), if you have one.
  • Only the money you may need for the day.
  • A case for your personal items, such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, or religious articles.
  • Your Health Care Proxy form, if you have completed one.

Where to park

Parking at MSK
Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital. If you have questions about prices, call 212-639-2338.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Where to go

The Endoscopy Suite is located on the 2nd floor at 1275 York Avenue, between East 67th and East 68th streets. This is the main building of MSK. Once you’re in the building, take the M elevator to the 2nd floor. Once you are there, you will see two glass doors that say “Surgical Day Hospital.” Go through these doors and check in at the reception desk directly in front of you.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.

After changing into a hospital gown, you will meet your nurse. Your nurse will place an intravenous (IV) catheter into a vein, usually in your hand or arm. You will receive fluids through the IV, and it will be used later to give you anesthesia (medication to make you sleepy).

Your doctor will explain the procedure and answer any questions you have. Tell your doctor if you:

  • Are not able to swallow liquids or food
  • Have had surgery to your esophagus
  • Have had radiation to your chest, spine, or upper back
  • Are allergic to any medications

When it’s time for your procedure, you will be asked to remove your dentures or false teeth, if you have them. You will be brought into the procedure room and helped onto an exam table. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose, and a mouth guard will be placed over your teeth to protect them. Your doctor may numb your throat with a spray. You will receive anesthesia through your IV, which will make you fall asleep.

Once you’re asleep, your doctor will insert the probe into your mouth and pass it slowly down your esophagus. Your doctor will move it around slightly to take pictures of your heart and blood flow. This takes about 15 minutes.

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After Your Procedure

In the recovery room

When you wake up after your procedure, you will be in the recovery room. Your nurse will continue to monitor your heart, breathing, and blood pressure. Once you’re fully awake, your nurse will remove your IV. If you have someone waiting with you, your nurse will explain your discharge instructions to both of you before you go home.

At home

  • You may feel soreness in your throat. This will go away in 1 to 2 days. In the meantime, drink plenty of water and use cough drops to soothe your throat.
  • Your doctor may give you a prescription for antibiotics. Be sure to take all of them as directed.
  • You may resume your normal activities 24 hours after your procedure.
  • Don’t drink alcoholic beverages for 24 hours after your procedure.
  • Don’t smoke for 24 hours after your procedure.
  • You may have a little blood in the phlegm (mucus) or saliva that you cough up. If this occurs for more than 24 hours or if there is a lot of blood, call your doctor.
  • Your results will be available in 2 to 3 business days. Your results will be given to the doctor who sent you for your TEE.
Call your doctor or nurse if you have:
  • A temperature of 101° F (38.3° C) or higher
  • Blood in your phlegm or saliva for more than 24 hours after your procedure
  • A lot of blood in your phlegm or saliva, such as when you cough
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