Transoesophageal echocardiogram: Keeping your heart on its TOE(s)

Written in association with: Dr Francesco Lo Monaco
Published:
Edited by: Karolyn Judge

A test called a transoesophageal echocardiogram (TOE) uses a probe that’s inserted into your oesophagus in order to take images of the heart’s valves and chambers using ultrasonography. It detects diseases of the heart muscle and valves.

 

Well-known and highly-regarded London cardiologist Dr Francesco Lo Monoco speaks to Top Doctors about the TOE procedure in expert detail. He discusses how effective this safe procedure is, what’s involved and what the result of a diagnosis can lead to, in this informative article.   

Cardiology ultrasound used in TOE testing

How is TOE defined?

A transoesophageal echocardiogram (TOE) is similar to a regular echocardiogram test, and is a safe and effective procedure. It’s used by doctors to take a look at the heart’s chambers and valves, and is performed using an ultrasound transducer, or probe.

 

The transducer is placed into the back of the throat, and onto the oesophagus directly beside your heart. The ultrasound aspect of this probe refers to an imaging technique which produces images of interior body structures by using high-frequency sound waves.

 

After the probe is in the oesophagus, it’s carefully lowered down to the level of your upper right heart chamber (atrium). This is the position that it will be in when the ultrasound images are obtained. You won’t be able to feel or hear the sound waves during the test, and to help your doctor assess your heart function you may be given a saline or contrast dye via IV injection.

 

While the TOE procedure lasts around 10 to 15 minutes, patients spend around an hour in the clinic. This is because of intake, preparation and monitoring after the test. The TOE test is very safe, but can be somewhat invasive; it will often include a sedative, and/or a numbing solution for your throat and mouth. Furthermore, your doctor may ask you to fast, avoiding food and water for as long as up to several hours before the procedure.

 

A transoesophageal echocardiogram test is generally painless and has very few side effects. These may include:

  • Nausea;
  • Minor discomfort;
  • Dry throat;
  • Bleeding directly after the procedure.

 

 

What does a TOE test show?

A TOE test is done by inserting a probe into the oesophagus against the chest wall. It’s considered a more specialised procedure than a normal echocardiogram, due to the probe being placed much closer to the heart than a standard probe. This provides a crisper and more thorough picture of the heart’s anatomy. This means that the ultrasound waves can pass through the surrounding skin, fat and muscle tissue without touching the ribs or lungs. It’s a better location for taking realistic photographs of the heart’s chambers and valves as the blood flows in and out, as a result.

 

 

When and why is a TOE test conducted?

Your doctor might book you a TOE test for many reasons. Typically, they are used to diagnose a problem or malformation within one of your heart valves, cardiomyopathy, congenital heart disease, or aortic dissection. Plus, they determine whether valves can be repaired or replaced.

 

Various medically-safe locations can be used for administration of a TOE test. These include:

 

  • An operating room;
  • An intensive care unit;
  • A hospital bed, if it’s a private transoesophageal echocardiogram test. Doctors can obtain critical diagnostic information without having to move patients due to the relative mobility of the testing equipment.  

 

 

If you require a transoesophageal echocardiogram test, or are looking for expert treatment and diagnosis for other cardiology conditions, arrange a consultation with Dr Lo Monoco via his Top Doctors profile.

By Dr Francesco Lo Monaco
Cardiology

Dr Francesco Lo Monaco is an award-winning and highly rated cardiologist in London, who has just been recognised for his expertise in clinical cardiology in the European Awards in Medicine/Cardiology category 2022* He is expert in clinical cardiology and cardiac imaging, particularly in echocardiograms, electrocardiograms (ECG), stress tests, palpitations and heart check-ups. Dr Lo Monaco also sees private patients at a range of locations in central and west London including Chelsea and Westminister Hospital, 104 Harley Street, One Welbeck Heart Health as well as at the BMI Syon Clinic in Brentford.

*Dr Lo Monaco is a winner in the European Awards in Medicine 2022. Held every year at the Ritz Hotel in Paris, this prestigious award ceremony celebrates the professional achievements of specialists that have excelled in every field of medicine. Dr Lo Monaco has distinguished himself for his exceptional achievements in clinical cardiology. Read more about his achievement on the European Awards in Medicine website

Dr Lo Monaco qualified in medicine with honours from the University of Pavia, Italy in 1997. He then completed specialist training in cardiology in Milan and worked in the city as a consultant cardiologist for several years. In 2006 he relocated to New York to undergo a postdoctoral fellowship in cardiology at the New York Medical College. During this period, Dr Lo Monaco qualified in medicine in the USA and published ground-breaking research related to cardiac stem cells. He went on to present his findings at 2008’s American Heart Association meeting, held in New Orleans. In 2009, he was appointed as a specialist cardiologist within Chelsea and Westminster NHS Trust. Since then, Dr Lo Monaco has worked at several locations in central London as an associate specialist in cardiology, providing general cardiology care and cardiac imaging services for his patients.

Additional to his clinical work, Dr Lo Monaco is also actively involved in education and has been an honorary senior clinical lecturer and undergraduate tutor at Imperial College London since 2013. He is also an affiliate member of the Royal College of Physicians. In 2022, Dr Lo Monaco's significant contributions to his field were recognised when he won the Cardiology Award at the European Awards in Medicine.

Dr Lo Monaco appreciates that concerns about heart health can be worrying and offers same-day appointments at multiple locations as well as onsite exercise tolerance testing and twenty-four hour ECG Holter Monitor testing for the convenience of his patients. He additionally offers a free initial online consultation to discuss any problems you may experiencing and accepts all types of private health insurance.

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