Transesophageal echocardiography: what is it?

The pathology of the cardiovascular system are one of the most common causes of mortality. This group of diseases particularly prevalent among the elderly population. Diagnosis of cardiac pathologies on the early stages helps to reduce the risk of complications and mortality. One method of investigation is echocardiography. This diagnostic method is necessary to evaluate the activities of the heart. Often, echocardiography is carried out using the ultrasonic sensor, which is placed on the chest wall. In some cases, the study is performed during surgery. Then it is transesophageal echocardiography. This method allows to visualize the heart in more detail.

Transesophageal echocardiography – what is it?

Echo – is one of the main methods of diagnosis of diseases of the cardiovascular system. It can be carried out at any age, as it is not accompanied by radiation exposure on the body. Due to this instrumental study, you can visualize the size and thickness of heart chambers, assess the condition of the valves. Transesophageal echocardiography (Tee) is characterized in that it is carried out from the inside, not the outside (chest wall). Due to this, the quality of visualization increases. The survey is administered to all, but only for special indications. To perform echocardiography through the esophagus cavity, you should carry out her transthoracic. This diagnostic method is carried out by specially trained specialist in a hospital.

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Based On what method is transesophageal echocardiography?

Transesophageal echocardiography of the heart – this method of visualization, which is based on ultrasound examination. Ultrasound is applied using a special sensor and gel. The machine creates high frequency sound waves. Fabric “answer” on these signals according to the type of echolocation. Given the fact that each body has a certain density and structure, they have different displays on the monitor screen connected to the apparatus. The research is conducted in real-time. This means that the functional diagnostics doctor can assess the condition of the heart chamber, while the sensor slides over the surface of the body. In contrast to transthoracic echocardiography, transesophageal examination allows you to see even minimal disruption of the structure. The fact that when carrying out ultrasound for chest wall, it is not always possible to achieve sufficient visualization of the heart. This is due to the fact that the unit is “catch” echoes from other organs: ribs, adipose tissue, and muscle tissue. When performing Tee “ultrasonic window” is greatly reduced, making this method more informative.

Clinical research

The Main indication for the implementation research is the inability to make a diagnosis based on data from transthoracic echocardiography. Usually this diagnostic procedure is performed for patients who have suspected serious violations of cardiac activity. It is also necessary in the study of oral on. Given that ultrasound through the surface of the chest wall in these cases is uninformative, performed transesophageal echocardiography. Indications for study:

1. Complications after heart valve replacement. In some cases, the implant long-term survives, resulting in inflammation, abscesses.
2. The Dissection of an aneurysm of the heart or aorta.
3. Poorly functioning prosthetic valves.
4. Infection of the heart muscle – endo-, myo-, and pericarditis.
5. Abscess of the aorta.
6. Thrombosis ventricle of the heart.
7. The Need for research at the time of surgical intervention.

In Addition to these readings, transesophageal echocardiography is mandatory before valve replacement. A study performed at the increased airiness of the lungs (emphysema), obesity.

Contraindications for transesophageal echocardiography

Despite the advantages of Tee, this survey method has not received wide distribution. This is because it is invasive and not all patients agree to the procedure. In addition, there are a number of contraindications for transesophageal echocardiography. Among them:

1. Inflammatory diseases of the oral cavity and pharynx.
2. Developmental Abnormalities of organs (short esophagus, diverticulum).
3. Scarring, strictures. Often occur after poisoning with acids or alkalis.
4. Erosive esophagitis.
5. Bleeding from ulcers of the gastric cardia.
6. Varicose veins of the esophagus liver cirrhosis.
7. Cancer of the oral cavity and pharynx.
8. Cancer of the esophagus or cardia of the stomach.

In the absence of gastrointestinal disease Tee can be performed in patients of any age. The study also is not contraindicated for pregnant women andpeople suffering from somatic disorders. It is not accompanied by irradiation of the body.

Preparing for transesophageal echocardiography

Before you can assign transesophageal echocardiography, the patient should be sent to undergo a series of laboratory tests. Among them are: biochemical analysis of blood, and OAM KLA, coagulation. You experience changes such as increase in white blood cells, platelets, ESR acceleration. In addition, before conducting this test is often performed transthoracic ultrasound diagnosis. In addition, in cases of suspected pathology of the heart must ECG.

Transesophageal echocardiography is a safe procedure, therefore, does not require special training. If the patient takes some drugs, then cancel them before the study is not necessary. A prerequisite for the procedure is refraining from eating for 6 hours prior to Tee. If the patient has dentures, they should be removed. Sometimes, before the study was conducted premedication. To reduce salivation, intravenous drug “Atropine”. If the patient is in an excited state, prescribe tranquilizers (medication "Diazepam").

The Technique of transesophageal echocardiography

To avoid discomfort, mouth and throat numb. To this end, using the drug "Lidocaine” or “Tetracaine”. The patient is placed on left side. To avoid damage to the probe and to facilitate its introduction into the throat, using a special mouthpiece. The end device must be treated with special gel, used in ultrasound studies. After that, the probe endoscope is inserted into the cavity of the esophagus. To facilitate the process, the patient must run through the motions. Within 5-10 minutes the device is in the cavity of the esophagus. Lamp endoscope is directed toward the heart. Through the wall of the esophagus, the device detects echo signals. In real time they are displayed on the monitor and recorded on film.

What can be revealed during transesophageal echocardiography

Thanks to echocardiography, performed through the esophagus cavity, it is possible to assess the condition of the heart muscle, endocardium and valve apparatus. This study is crucial in the diagnosis. Given the high informativeness of the method, it is possible to detect even minor damage to the heart cavity. Tee allows to identify the presence of thrombus, inflammatory changes, aortic dissection. Very informative features three-dimensional study. Thanks to 3D ultrasound cardiography it is possible not only to assess the condition of the heart muscle, but also to prepare the patient for surgery for valve replacement. This method applies to high-tech research and is carried out in specialized clinics.

Possible complications of transesophageal echocardiography

One of the methods is considered diagnostic transesophageal echocardiography of the heart. Performing this procedure? This study is performed in a hospital having cardiology Department as well as in private clinics equipped with modern medical equipment. It is worth remembering that, despite the security, and in rare cases may develop complications. These include heart rhythm disorders, and allergic reactions to drugs (anesthetics, sedatives). To avoid severe consequences, it is necessary to have ready the crash cart.

Transesophageal echocardiography of the heart: patients and doctors

This study is safe and painless, so patients tolerate it well. For the diagnosis of serious pathologies is performed transesophageal echocardiography. Reviews of doctors about this method of examination is positive. The doctor noted its high informativeness and security.