Transesophageal echocardiography: what is it?

Pathologies of the cardiovascular system are one of the most common causes of mortality. This group of diseases is especially common among the elderly population. Diagnosis of cardiac pathologies in the early stages helps to reduce the risk of complications and mortality. One of the methods of research is echocardiography. This diagnostic method is necessary for assessing the activity of the heart. Often, echocardiography is performed using an ultrasound transducer, which is placed on the chest wall. In some cases, this research is performed during surgery. Then transesophageal echocardiography is performed. This method allows you to visualize the heart in more detail.

Transesophageal echocardiography - what is it?

Echocardiography is one of the main ways to diagnose diseases of the cardiovascular system. It can be performed at any age, since it is not accompanied by radiation exposure to the body. Due to this instrumental research, it is possible to visualize the size and thickness of the heart chambers, to assess the condition of the valves. Transesophageal echocardiography (CTEHCG) is distinguished by the fact that it is carried out as if from the inside, and not from the outside (chest wall). This improves the quality of visualization. This examination is not intended for everyone, but only for special indications. What to perform echocardiography through the cavity of the esophagus, you must first hold it transthoracally. This method of diagnosis is carried out by a specially trained specialist in a hospital.

What is the method of transesophageal echocardiography based on?

Transesophageal echocardiography of the heart is a method of visualization based on ultrasound. Ultrasound is performed with a special sensor and gel. The device creates high-frequency sound waves. The tissues "respond" to these signals by the type of echolocation. Considering that each organ has a certain density and structure, they are displayed differently on the screen of the monitor connected to the device. The study is conducted in real time. This means that the physician of functional diagnostics can assess the state of the heart chambers, while the sensor slides over the surface of the organ. In contrast to transthoracic echocardiography, transesophageal examination allows one to see even minimal structural disturbances. The fact is that when performing ultrasound on the chest wall, it is not always possible to achieve sufficient visualization of the heart. This is due to the fact that the device "catches" echoes from other organs: ribs, fatty tissue, muscle tissue. When the TEEE is executed, the "ultrasonic window" is significantly reduced, so this method is more informative.

Indication for the study

The main indication for the study is the impossibility to make a diagnosis based on the data of transthoracic echocardiography. Usually this diagnostic procedure is carried out in patients who are suspected of serious violations of cardiac activity. It is also necessary in the study of the cavity of the organ. Given that ultrasound through the surface of the chest wall in these cases is not informative, transesophageal echocardiography is performed. Indications for the study:

1. Complications after prosthetic heart valves. In some cases, the implant persists for a long time, resulting in inflammation, abscesses.
2. Stratification of an aneurysm of the heart or aorta.
3. Unsatisfactory functioning of the prosthetic valves.
4. Infectious lesions of the cardiac muscle - endo-, myo-, pericarditis.
5. Abscess of the aorta.
6. Thrombosis of the ventricle of the heart.
7. The need for research at the time of surgery.

In addition to these indications, transesophageal echocardiography is an obligatory procedure before valve replacement. Also, the study is performed with increased lightness of the lungs (emphysema), obesity.

Contraindications for transesophageal echocardiography

Despite the advantages of TSEHCG, this survey method has not been widely used. This is because it is invasive, and not all patients agree to the procedure. In addition, there are a number of contraindications for conducting transesophageal echocardiography. Among them:

1. Inflammatory diseases of the oral cavity and pharynx.
2. Anomalies in the development of organs (short esophagus, diverticulum).
3. Cicatricial changes, stricture. Often occur after poisoning with acids or alkalis.
4. Erosive esophagitis.
5. Bleeding from the ulcer of the cardiac department of the stomach.
6. Expansion of the esophagus in cirrhosis of the liver.
7. Oncological diseases of the mouth and pharynx.
8. Cancer of the esophagus or cardiac part of the stomach.

In the absence of diseases of the gastrointestinal tract, PEEP can be administered to patients of any age. Also, the study is not contraindicated to pregnant women and people suffering from somatic pathologies. It is not accompanied by irradiation of the body.

Preparation for transoesophageal echocardiography

Before assigning transesophageal echocardiography, the patient should be sent to undergo a series of laboratory tests. Among them: biochemical blood test, UAC and OAM, coagulogram. At the same time, such changes as increase of leukocytes, platelets, acceleration of ESR can be observed. In addition, transthoracic ultrasound diagnosis is often performed before this test. In addition, if the heart is suspected of a pathology, it is necessary to remove the ECG.

Transesophageal echocardiography is a safe procedure, so it does not require special preparation. If the patient takes any medications, then you do not need to cancel them before the test. A prerequisite for the procedure is the refusal to take food for 6 hours preceding the TSEHCG. If the patient has dentures, they must be removed. Sometimes, pre-study is conducted before the test. To reduce salivation, intravenously injected drug "Atropine". If the patient is in an excited state, prescribe tranquilizers (Diazepam medicine).

Technique for performing transesophageal echocardiography

To avoid unpleasant sensations, the oral cavity and pharynx anesthetize. For this purpose, the drug "Lidocaine" or "Dicaine" is used. The patient is placed on the left side. In order not to damage the probe and facilitate its introduction into the pharynx, use a special mouthpiece. The end of the device must be treated with a special gel, which is used for ultrasound. After this, a probe with an endoscope is inserted into the cavity of the esophagus. To facilitate the process, the patient must perform swallowing movements. Within 5-10 minutes the device is located in the cavity of the esophagus. The endoscope lamp points toward the heart. Through the wall of the esophagus, the device catches echoes. In real time, they are displayed on the monitor and recorded on a film.

What can be detected with transoesophageal echocardiography

Due to echocardiography performed through the cavity of the esophagus, it is possible to assess the condition of the heart muscle, endocardium and valvular apparatus. This study is decisive in the diagnosis. Given the high information value of the method, even minor damage to the heart cavity can be detected. CPEHCG can detect the presence of thrombi, inflammatory changes, aortic dissection. Three-dimensional research is especially informative. Thanks to ultrasound 3D-cardiography, you can not only assess the condition of the heart muscle, but also prepare the patient for the operation of prosthetic valve. This method refers to high-tech research and is conducted in specialized clinics.

Possible complications of transoesophageal echocardiography

One of the methods of diagnosis is transesophageal echocardiography of the heart. Where do this procedure? This study is performed in dispensaries with a cardiology department, as well as in private clinics equipped with modern medical equipment. It is worth remembering that, in spite of safety, in rare cases, the development of complications is possible. These include heart rhythm disturbances, as well as allergic reactions to drugs (anesthetics, tranquilizers). To avoid severe consequences, you need to have a resuscitation kit ready.

Transesophageal echocardiography of the heart: reviews of patients and doctors

This study is safe and painless, so patients tolerate it well. For diagnosis of serious pathologies, transesophageal echocardiography is performed. The doctors' comments on this method of examination are positive. Doctors say its high information and safety.