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Trans Oesophageal Echo Cardiogram Information

Trans Oesophageal Echo Cardiogram Information

A Trans Oesophageal Echo Cardiogram is an investigative procedure involving an ultrasound test that provides pictures of your heart which is carried out under sedation. 

This involves a probe which is introduced via the oesophagus.  As the oesophagus is beside the heart, clear pictures are seen on the screen and can be stored.  It is an excellent way of looking at the valves and chambers of the heart and can give vital information to determine further treatment.  

You are asked to find your own transport to bring you to the hospital for your procedure and take you home again. If you are unable to make your own way there please advise the nurse.  We respectfully request that hospital transport is only requested where absolutely necessary.

Please note it is not possible for friends/relatives to enter the Unit on your arrival. For infection prevention reasons entry into the unit is limited to strictly a `need only’ basis.

Make-up should not be worn and nail polish should be removed.

Mobile phones do not work in the department due to lead lining in our walls etc.  If a mobile phone is brought into the unit, it must be on silent at all times.

Please leave all jewellery at home (except wedding rings which can be taped) and do not bring any valuables into hospital with you.  It is Mid-Essex Hospitals Trust Policy that we cannot accept responsibility for valuable items.  Every effort is taken to ensure the safety of personal items.  However, once again, we cannot be responsible for the loss or damage to ANY belongings.

You will be admitted to the Angiography Suite as a day case.  You will need to bring your medication/list of medication with you and an overnight bag.

It is essential you remain nil-by-mouth (avoiding diet and fluids) from mid-night prior to your procedure.
You will need to undress and wear a gown (under pants/pyjamas may be left on).  Please bring slippers and dressing gown with you for mobilising around the unit and leave all valuables at home. You will be provided with a basket to place your belongings in.

Allergies

You will be asked if you have any allergies or sensitivities.

Once comfortable on the bed you will be asked various simple questions to give vital information to ascertain your previous medical history and current medical condition.  Your observations (i.e. blood pressure, pulse, temperature and oxygen saturations) will be recorded and a cannula (a small plastic tube) will be inserted into your hand/arm.

It is a legal requirement to obtain written consent prior to carrying out a TOE.  The nurse will fully explain the procedure, the benefits and possible complications prior to obtaining your signature on the consent form.

Consent

The Procedure: Trans Oesophageal Echo Cardiogram

The intended benefits: To examine the heart to determine further treatment
Complications which may consist of:-

• Sore Throat
• Oesophageal Trauma
• Laryngeal Trauma
• Pharyngeal Trauma
• Perforation 

You will need to sign the consent form for the procedure to go ahead.

(Reference: British Heart Foundation 18/08/11 bhf.org.uk)

You will be seen by the doctor prior to the procedure.

A nurse, doctor and cardiac physiologist will be present for the procedure.

The lights will be dimmed.

We will assist you in turning onto your left side and when comfortable you will be attached to a monitor to record your observations throughout the procedure.  The back of your throat will be sprayed with an anaesthetic solution to numb the area (this may cause a nasty taste in your mouth) and you will be given sedation.  A nurse will be sitting right beside you throughout and will explain everything to you.  Once you are adequately sedated a small tube will be passed down your throat/oesophagus  and you will be asked to swallow (you will be able to understand instructions but will not remember following the procedure, due to the anaesthetic effect of sedation).  Once the tube has been passed we will then be able to take the pictures.

The procedure should take no longer than 10-15 minutes.

Reference: http://en.wikipedia.org/wiki/Atrial fibrillation - cite note Wyndham 2000-0 

When you awake you will not remember the procedure and we will have obtained the necessary pictures to make an accurate diagnosis.

Following several observation recordings and once you are fully awake (approximately 45-60 minutes), you will be offered sips of water and when fully alert, tea, coffee, toast etc.

Your Consultant will discuss the results with you and following 2-3 hours recovery you will be able to make arrangements to go home. It is essential you have an adult with you for 24 hours after discharge.

Post care following a T.O.E.
During the following 24 hours YOU MUST NOT.....
• Drink alcohol for at least 24 hours.
• Drive for 24 hours.
• Operate heavy machinery or sign any legal documents

You must rest for 24 hours and have someone with you at all times. We advise you have assistance with cooking etc. for this time to avoid injury.

You may take normal pain relief for any discomfort you may have as a result of your procedure.

Your throat may feel sore and you are able to gargle with salty water and take sips of water to relieve this.

It is possible that you will feel tired and lethargic for the first 24 hours following your procedure.  This is normal.  Please allow yourself the time needed to fully recover.

The medication given for this procedure does have an amnesic effect and therefore you may not remember your procedure and time with us.

You may resume your normal drug regime (unless advised otherwise) following discharge.

The nursing staff will contact your relative/friend an hour before you are ready for discharge.

They are advised to turn left on the roundabout, (first exit) and continue passed the main hospital entrance.  After the multi storey car park there is a right turn.  Take this turning and park close to the Chemotherapy Day Unit and Assessment Unit.  LEAVE YOUR HAZARD LIGHTS ON.  Enter through this outer doorway, follow the corridor and turn left.  Follow the walk way until you reach 210 ‘The Cardiac Dept’.  Report to reception and a nurse will escort your relative out to you.

We hope this information has given you sufficient insight into the procedure you/your relative will be undertaking in the near future.  (This electronic information is in addition to the written and verbal instructions/information our patients are given).  However if you have ANY queries regarding the procedure, please do not hesitate to contact us on 01245 514418  

References

British Heart Foundation. A registered Charity No 225971. Registered as a Company limited by guarantee in England and Wales. Registered office at Greater London House, 180 Road, London NW1 7AW. Registered as a Charity in Scotland.
Eido Healthcare 
National Institute for Health and Clinical  Excellence. Mid City Place, 71 High Holborn, London, WC1V 6NA: www.nice.org.uk. 2011.
Mayo Foundation for Medical Education and Research

We look forward to welcoming you/your relative to the Angio Suite and hope this information has given you sufficient insight into the procedure you/your relative will be undertaking in the near future.  (This electronic information is in addition to the written and verbal instructions/information our patients are given).  However if you have ANY queries regarding the procedure, please do not hesitate to contact us on 01245 514418