Heart test
Transoesophageal Echocardiogram
A transoesophageal echocardiogram uses an ultrasound probe passed down the gullet to get detailed pictures of the heart from close behind it.
Quick answer
Transoesophageal Echocardiogram: what it is and what the results mean
A transoesophageal echocardiogram (TOE) is a type of heart ultrasound where the probe is passed down the oesophagus (gullet), which lies just behind the heart. This gives clearer, more detailed images than a standard chest (transthoracic) echo.
- Why it is done: It is used when a standard echo does not give enough detail — for example to look closely at the heart valves, check for blood clots or infection (endocarditis), examine the heart before certain procedures, or investigate the source of a stroke.
- Understanding results: A cardiologist reviews the detailed images and reports on the valves, chambers, any clots, infection or structural problems, guiding treatment or procedures.
What it is
A transoesophageal echocardiogram (TOE) is a type of heart ultrasound where the probe is passed down the oesophagus (gullet), which lies just behind the heart. This gives clearer, more detailed images than a standard chest (transthoracic) echo.
Why it is done
It is used when a standard echo does not give enough detail — for example to look closely at the heart valves, check for blood clots or infection (endocarditis), examine the heart before certain procedures, or investigate the source of a stroke.
What to expect
You fast beforehand and usually have throat-numbing spray and sedation. A thin, flexible ultrasound probe is passed down the gullet while you lie on your side; it takes about 20–40 minutes, and you rest until the sedation wears off.
Understanding the results
A cardiologist reviews the detailed images and reports on the valves, chambers, any clots, infection or structural problems, guiding treatment or procedures.
Good to know
Risks and limitations
It is more involved than a standard echo. Risks are small but include a sore throat, and rarely damage to the gullet or reactions to sedation. You should not drive for the rest of the day after sedation.
Education and reference only. This explains the test in general terms and is not medical advice. Always follow the specific instructions from the team arranging your test, and discuss your results with your clinician.
Answers
Transoesophageal Echocardiogram: frequently asked questions
Why can’t a normal echo give the same pictures?
A standard echo images the heart through the chest wall, which can limit the view. Because the gullet sits directly behind the heart, a TOE gives much clearer pictures of structures such as the valves and the back chambers.
Will I be asleep for the test?
You are usually given sedation to keep you relaxed and comfortable rather than a full general anaesthetic, along with numbing throat spray. You will need someone to take you home afterwards.
Related tests
Other heart test investigations
Sources
Where this is drawn from
- NHS — Tests and treatments
- NICE — diagnostic guidance
- British Cardiovascular Society / relevant professional body
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