What is a Transoesophageal Echocardiogram (TOE)?

An echocardiogram is a test that uses sound waves to create high quality pictures of the heart and its blood vessels.

A TOE is a special echocardiogram your Cardiologist uses to get a better look at your heart from inside your body. This is done by placing a tube with an ultrasound probe into your oesophagus (the passage leading from your mouth to your stomach).

From this position, the sound waves have a more direct path to your heart. This allows your doctor to get a more detailed view of your heart and its blood vessels.

Why do I need a TOE?

The test is used to detect and assess blood clots, disease of the aorta, infection in the heart and heart valve malfunctions. Your doctor may recommend a TOE to help diagnose such a disease or condition.

What to expect before the procedure

  • Do not eat or drink anything 6 hours prior to your procedure.
  • Tell your doctor if you have any difficulties swallowing.
  • Inform the nurse or doctor if you have dentures, as they will need to be removed.
  • Your doctor will visit you to explain the procedure and answer any questions you may have. You will be asked to sign a form consenting to the procedure.
  • An IV cannula will be placed in your arm, so that you can be given medications to help you relax/sleep during the procedure.

What to bring to hospital on the day of the procedure

  • A book or magazine to keep you occupied.
  • Wear anything you like as you will change into a hospital gown prior to your procedure.
  • Do not bring any valuables, jewellery or excess money.
  • Mobile phones must be switched off inside the hospital as they interfere with sensitive electronic equipment.

During the Procedure

  • You will be connected to our monitor so that we can monitor your heart rhythm, blood pressure, breathing and oxygen levels throughout the procedure.
  • The doctor will numb your throat with an anaesthetic spray. This will lessen your need to gag and help you swallow the tube. You will also be given some sedation through your IV to help you relax.
  • A “bite block” (a small piece of plastic with a hole in the middle) will be placed between your teeth. This will allow your mouth to stay open during the test.
  • You will be asked to lie on your left side and rest your chin on your chest. The Anaesthetist will administer a light anaesthetic, so you will be unaware of the tube passing down your oesophagus.
  • The test will last 15-20 minutes.

What are the potential complications?

The most common problem during a TOE is minor throat discomfort while the probe is passing through your oesophagus.
Your throat might be sore for a few days after the test, which is normal. In rare cases, the probe used during a TOE can cause minor throat injuries such as perforation or bleeding.

Your doctor will discuss the risks with you.

Recovery and Discharge

You may have a sore throat following the TOE. You shouldn’t eat or drink for 30 to 60 minutes afterward. Once all feeling and your gag reflex have returned you may have sips of water. Most people can resume their normal activities within 24 hours of the test.

Your Cardiologist will visit you when you are fully awake to discuss the results of the procedure. In most circumstances, you will be discharged after a few hours.

You will need someone to take you home after the procedure. Due to the medication given during the procedure you will not be allowed to drive or use heavy machinery for 24 hours following your TOE.

If you have further questions regarding this procedure, please ask your nurse or doctor for clarification.


In some cases patients may require contrast to enhance the quality and clarity of their echo pictures.  The charge for contrast is not rebateable by Medicare or healthfunds.  The price for contrast is at cost.  Should you require contrast or would like to know what the charge would be, please contact our reception staff.