The patient's perspective on transesophageal echocardiography - a prospective observational study.

Transesophageal echocardiography (TEE) is a common methodology regularly performed in every echocardiography laboratory. Naturally, the procedure requires inserting the probe into the patient’s esophagus, which can cause worries about the examination. We sought to prospectively investigate how patients feel who are referred for TEE.

From January until Juli 2024, consecutive patients with indication for TEE were included at our tertiary center for this prospective observational study. Critically ill patients were not included. A questionnaire investigating anxiety and previous TEE experiences was performed before the examination.

A total of 101 patients (54% male) with a mean age of 66 years (range 26-86) were included in this preliminary analysis. Most common indication for TEE was to exclude intracardiac thrombi before ablation therapy (32%) or cardioversion (18%), evaluation of valvular heart disease (32%), search for source of embolism (9%), and suspicion for endocarditis (6%).

Sixty-three patients (62%) had had previous TEE examinations, 83% under sedation. Good past experiences were reported by 71% of those who had been sedated, compared to 64% who had received TEE without sedation. Forty-two patients expressed worries before the procedure, mainly about gagging (n=12), sore throat (n=6), sedation effects (n=7), and death or respiratory arrest (n=5).

In echocardiography, TEE is a common, quick, and low-risk procedure which adds incremental information in numerous diseases. With our data we discovered that patients who are referred for TEE express a diverse range of worries before the examination. Satisfaction with previous examinations was moderate, both in those who had and who had not received sedation. This needs to be addressed by thorough consultation before the procedure, and a calm and professional atmosphere in the examination room.