transesophageal echocardiography (TEE)

Indications

• visualization of heart valves*
  • rule out endocarditis
    • 1st line test in patient with high likelihood of endocarditis
  • prosthetic valve dysfunction
• aortic disease
• left atrial thrombus

* sensitivity of TEE is far greater than transthoracic echocardiography (TTE) for visualizing heart valves

• TEE can detect vegetations as small as 1.0-1.5 mm
• TTE can detect vegetations as small as 2-3 mm

Advantages

• high-quality images, especially of posterior cardiac structures
• most accurate test for evaluation of:
  • endocarditis
  • prosthetic heart valves
  • left atrial thrombus
• excellent imaging of aorta from aortic root to descending thoracic aorta

Disadvantages

• requires esophageal intubation, typically with conscious sedation

More general terms

• echocardiography
• endoscopic ultrasound; endosonography (EUS)