The oesophagus is the food pipe connecting your throat to your stomach. Part of it lies just behind the heart. For a TOE, a doctor passes a flexible ultrasound probe through your mouth and into the oesophagus, not the windpipe. It stays outside the heart.
The probe sends sound waves through nearby tissue towards the heart and receives echoes as they bounce back. A computer turns those echoes into moving pictures of the heart's chambers and valves. The pictures come from ultrasound passing through the food pipe's wall, rather than a camera looking along it. The probe's closeness to the heart helps show details that can be difficult to see from the chest.
Call triple zero (000) for severe, worsening or persistent chest pain, or chest discomfort with breathlessness, sweating, nausea or pain spreading to your arm, jaw or back.
Do not wait for a routine appointment or drive yourself to hospital.
The hospital doctor explains the test and the planned sedation or anaesthetic before asking for your consent. Tell them if you're worried about gagging or having the probe in your throat.
In the procedure room, a small plastic tube called a cannula is placed in a vein for medicines. Staff monitor your heart rhythm, blood pressure and oxygen levels throughout the test and recovery.
Sedation is commonly given through the cannula to make you relaxed and drowsy. You may still be able to follow simple instructions, and may remember only parts of the test or very little of it. Some people have a general anaesthetic and are fully asleep instead. Local anaesthetic spray may also be used to numb the back of your throat and reduce gagging.
Staff help you lie on your left side or your back for the scan. Dentures may need to be removed, and a small mouthguard protects your teeth. The doctor guides the probe towards the back of your throat and may ask you to swallow to help it pass into the food pipe. You may gag briefly as it goes down; the throat spray and sedation help make this easier.
Once the probe is in place, the doctor adjusts it to obtain the required views and records the images. The probe is removed when the scan is finished. You then rest in a recovery area while staff check that you're recovering from the medicines. Preparation and recovery take additional time beyond the scan itself.
A TOE gives a detailed view of how a heart valve is formed and how it moves. That information can help the treating team decide whether a damaged valve could be repaired or whether replacement needs to be considered. It can also help doctors look for an infection affecting a valve.
Before some planned cardioversions, a TOE checks for a blood clot inside the heart. Electrical cardioversion uses a controlled electrical shock to restore a regular rhythm, but it could dislodge an existing clot. If a clot is found, the cardioversion is postponed so the clot can be treated first.
TOE can also show openings between heart chambers. During certain heart procedures, its moving pictures help the doctor guide treatment and check the result. A TOE itself doesn't repair a valve or remove a clot.
A standard echocardiogram, also called a transthoracic echo or TTE, takes ultrasound pictures with a probe on your chest. It answers many questions about the heart without an internal probe or sedation. A TOE may add information when those pictures aren't clear enough, or when a close view of a valve is needed to plan treatment.
Cardiac MRI or CT may be alternatives for some questions. Part of deciding whether a TOE is worthwhile is checking if another scan can provide the detail needed. Occasionally the probe can't be passed or the test can't be completed, and another scan may be used.
A sore throat is a common after-effect. Less common problems include damage to teeth or bleeding from an injury to the mouth, throat or oesophagus. A hole in the oesophagus is rare but serious and may need surgery.
Sedation can affect breathing or blood pressure, and medicines can cause an allergic reaction. Heart rhythm disturbances can also occur. Your swallowing history and any oesophageal disease matter because they can make passing the probe more difficult or increase the risk of injury.
Tell the hospital about difficulty swallowing, previous disease or surgery of the oesophagus or stomach, and loose teeth, dentures or bridgework. Mention allergies and previous problems with sedation or anaesthesia.
The hospital will tell you when to stop eating and drinking. An empty stomach reduces the risk of stomach contents entering your lungs during the test. Follow the hospital's instructions for your medicines, including blood thinners and diabetes medicines; don't change them yourself. Contact the hospital if the instructions aren't clear or you become unwell before the test.
Throat spray temporarily affects swallowing as well as numbing the throat. Wait until staff confirm it's safe before eating or drinking. They may first check how you manage small sips of water.
If you've had sedation, someone needs to take you home. Follow the hospital's advice about support at home, driving, alcohol and making important decisions. Feeling awake doesn't necessarily mean the medicine has worn off completely.
A mild sore throat can settle after the test. Contact the hospital promptly for swallowing problems that continue after the numbness has worn off, worsening pain or bleeding. Seek urgent medical care for chest pain or trouble breathing. Follow the hospital's discharge instructions.
A valid referral from your GP or specialist is needed for a Heartscope cardiologist appointment. The cardiologist can discuss whether a TOE would help and refer you to hospital if it's recommended. The clinic can answer questions about the consultation and which previous test results to bring.
Consultations are privately billed. If you're eligible, Medicare pays part of the consultation fee when you have a valid referral from your GP or specialist. The clinic will confirm the amount left to pay before the visit.
The TOE is performed in hospital, never at a Heartscope clinic. Hospital, test and anaesthetic fees are separate from the Heartscope consultation, and the hospital or provider confirms them.
Heartscope cardiologists see patients at clinics in Melbourne and Queensland. If you have a referral, our team can confirm the location and appointment details.
View clinic locationsNo. Heartscope cardiologists may be able to see patients with a valid referral from their GP or specialist, and refer them to hospital for a TOE when one is recommended.
No. It uses sound waves to form the pictures, like other ultrasound scans.
A cardiologist reviews the recorded images and sends a report to the doctor responsible for your care. Some findings may be discussed on the day, while the full result may be reviewed at a follow-up appointment. Before leaving hospital, confirm who will explain the report and any next treatment decision.
.png)
.png)
.svg)
