Transoesophageal echocardiogram

A transoesophageal echocardiogram (TOE) is a specialised procedure that uses echocardiography (ultrasound) to scan your heart and assess its function.

Find a Transoesophageal echocardiogram consultant

If you have symptoms or concerns about the health of your heart, we can offer you rapid access to a TOE procedure and other cardiac tests at one of our facilities in London and Birmingham.

TOE scan results sent within 48 hours
More than 20,000 echocardiograms performed per year
99% of cardiac patients would recommend us to their friends or family

Signs you might need a TOE scan

You might need a transoesophageal echocardiogram if you're experiencing any of the following symptoms and other tests have suggested a need for more detailed imaging of your heart:

Chest pain (angina)
Feeling extremely weak or tired
Headaches and migraines
Heart palpitations (fluttering or pounding feelings in your chest or neck)
Light-headedness and fainting
Nausea (feeling sick)
Rapid heartbeat (tachycardia)
Shortness of breath
Swelling in the feet, legs or belly

Don't hesitate to book an appointment with a cardiologist if you experience any of these symptoms, especially if they're persistent or gradually worsening. They could indicate a broad range of conditions, some of which could be life-threatening.

We can confirm your appointment within 24 hours. Your cardiac consultant will recommend a TOE scan and any other tests needed to give you a diagnosis. You can undergo the diagnostic procedures on the same day as your appointment, and your results will be available within two working days. After this, your consultant will explain your results to you and, if further action is necessary, recommend the most effective way to move forward – whether that's more advanced testing, physiotherapy or surgical treatment.

Find a cardiac care consultant

You’re in the best hands with HCA UK for a private TOE scan

#1 for private cardiac care: More than 26,000 cardiac patients per year receive our first-class care. We treat more people than any other private healthcare provider in the UK, and we can use this vast experience to provide you with outstanding care as well.
Leading specialists: A diverse team of clinical nurses, sonologists and other healthcare specialists support the 235 expert cardiologists in our network, working together to deliver seamless and superlative care.
Unparalleled facilities: Our outpatient centres and private hospitals are equipped with state-of-the-art equipment, so you can expect the highest levels of comfort and care.
Trusted by patients: 99% of patients would recommend us to their friends and family, making us the UK's most trusted private cardiac care provider.
Rapid access: We can confirm your cardiac consultant appointment within 24 hours, offer you your transoesophageal echocardiogram on the same day and send you the results within 48 hours.

What is a transoesophageal echocardiogram?

A transoesophageal echocardiogram (TOE) is a specialised ultrasound scan that produces detailed images of your heart that move in real-time. Unlike other types of echocardiograms, a TOE procedure takes images from your gullet (oesophagus) inside your body, instead of from outside, resulting in more detailed pictures. Our cardiovascular experts can use these images to provide a more detailed diagnosis and work out an effective course of treatment.

How does a TOE scan work?

During a transoesophageal echocardiogram, an ultrasound sensor is passed into your gullet (oesophagus) through your mouth and throat. The sensor emits ultrasonic waves that pass through soft tissues to reach your heart, where they echo or reflect off the heart's different structures.

The sensor picks up the reflected waves and sends them to a computer, which displays moving, real-time images of your heart. This helps diagnose any problems with your heart function, structure or valves.

How is a TOE procedure different to a standard echocardiogram?

The most common type of echocardiogram is called a transthoracic echocardiogram (TTE). This procedure involves placing an ultrasound sensor on the surface of your chest. The ultrasonic waves must travel through skin, muscle, bone and soft tissues before they reach your heart.

With a transoesophageal echocardiogram, the ultrasound probe is inserted into your gullet via your mouth and throat. The gullet is located directly behind the heart, so the ultrasound waves are closer to the heart and must only travel through soft tissues to reach it. As a result, TOE procedures produce clearer images of the heart compared to the TTE approach.

Why might my cardiologist recommend a transoesophageal echo?

There are several reasons why your consultant might recommend you have a TOE scan, including but not limited to:

To get more detailed imaging of your heart than a transthoracic echocardiogram could provide, or as a follow-up to a TTE.
To account for an unusual anatomy or lung conditions that would make a TTE difficult or less effective.
To quickly investigate life-threatening heart problems such as sudden low blood pressure (hypotension).
To check for clots before a procedure for heart rhythm problems (cardiac arrhythmias) like catheter ablation or cardioversion.
To evaluate the heart during cardiac surgery or to confirm the procedure's success.

Get rapid access to a private transoesophageal echocardiogram

Our cardiac diagnostic is the most comprehensive in the UK, delivering more than 20,000 echocardiograms each year across the country. Our specialists will ensure you get the most effective diagnostic procedure for you, whether that's a TOE scan or another type of heart test.

Find a cardiac care consultant

What conditions can a TOE test help diagnose?

A transoesophageal echocardiogram can help diagnose signs and symptoms of many different conditions including:

Aortic aneurysm, which is a bulge in an artery or vein
Atherosclerosis, the clogging of the arteries by fatty materials in the bloodstream
Blood clots, commonly resulting from atrial fibrillation
Cardiac tumours, which are potentially cancerous growths in the heart structures
Cardiomyopathy, which is a thickening of the heart walls
Congenital heart disease, a wide range of heart problems you're born with
Endocarditis, a rare bacterial infection of your heart's inner lining
Heart failure, when the heart can no longer pump blood efficiently around the body
Heart valve disease, which covers conditions that prevent the doors to your heart chambers from working correctly such as aortic regurgitation
Pericarditis, which affects the fluid-filled sac covering the outside of the heart

Transoesophageal echocardiogram FAQs

How to prepare for your TOE scan?

Your consultant will explain the procedure to you, answer any questions you have and tell you how to prepare. You'll need to stop eating and drinking for a few hours beforehand.

It's also important you let your consultant know if you're taking any medication, as you may need to stop taking it before your scan. Depending on your medical history, they may have other specific recommendations for how you should prepare.

What happens during a transoesophageal echocardiogram procedure?

A TOE scan usually takes about 20 minutes in the catheter lab.

First, your medical team will ask you to remove any dentures, jewellery or other objects that might interfere with the procedure. They may also ask you to empty your bladder and change into a hospital gown.

Next, the medical team will offer you general anaesthetic or a sedative to help you feel as comfortable as possible during the procedure. They'll also spray the back of your throat with anaesthetic to numb the area.

When you're ready, you'll be asked to lie on your side and wear a bite protector. You'll be connected to an electrocardiogram (ECG), which will monitor your vital signs such as heart rate, blood pressure, breathing rate and oxygen level during the TOE procedure. The lights may be dimmed to help the team see the images better.

Your consultant will then pass a flexible tube (the ultrasound sensor) through your mouth and into position. The sensor takes real-time images of your heart valves and chambers, which show up on a screen for your consultant to analyse. The team will carefully remove the sensor after they've taken all the images they need.

What are the risks of a TOE scan?

Ultrasound waves are harmless and carry no exposure risks, unlike X-rays. The main risks of a transoesophageal echocardiogram come from the insertion of the probe into the gullet.
Some people have a sore throat after the procedure, lasting from a few hours to as much as a few days. Other risks are rare but could include:

Voice weakness
Difficulty swallowing
Breathing problems
Injury to the teeth, mouth, throat or oesophagus
Heart rhythm problems

There may be other risks depending on your personal medical history. Your consultant will evaluate you carefully before recommending a TOE scan or any other medical procedure. They'll also explain all the risks involved and answer any questions you have.

What happens after your transoesophageal echocardiogram?

When the TOE procedure is over, the medical team will move you to a recovery area where nurses will continue to monitor your vitals. You'll be able to get dressed when they're satisfied that you're stable. Your consultant will then discuss your results with you and let you know if you need further testing or treatment.

You should be able to go home on the same day as your scan. Please arrange for someone to travel home with you, as you won't be able to drive for the first 24 hours due to the sedatives or anaesthetic. Make sure you get plenty of rest during this time.

Your consultant will let you know when you can get back to your usual routine and activities. They'll also give you advice on when you can resume your usual medication, exercise, travel, diet and alcohol consumption.

What other types of echocardiograms are there?

As well as transoesophageal echocardiograms, there are other types of echocardiographic procedures that help your consultant better understand your heart in different ways. These include:

Transthoracic echocardiogram (TTE): An ultrasound probe is placed on the surface of your chest to scan your heart from the outside of your body. A small amount of dye or 'contrast' might be injected into your bloodstream to help produce clearer images of your heart's structures – sometimes referred to as a contrast echocardiogram.
Bubble echocardiogram: This type of echocardiogram is performed in the same way as a TTE, except that a small amount of salt water (saline) containing micro-bubbles is first injected into your bloodstream. The bubbles show up on the imaging and make it easier to identify any holes in your heart.
Stress echocardiogram: While monitoring your vitals closely, your cardiac team will either give you an injection of dobutamine or ask you to perform some exercise to get your heart working harder than usual. This helps to show any arteries that aren't getting enough blood, indicating coronary artery disease.

Your consultant will recommend the most suitable diagnostic tests given your symptoms and medical history.

Our experts in TOE scans and other heart tests

Our cardiac departments are aided by nurses and sonologists, who will support you while you receive your transoesophageal echocardiogram. Your consultant cardiologist will talk you through the results, answer your questions and explain what's next.

Find a cardiac care consultant