Cardiac

Question 1

What are some contraindications to TEE?

Answer 1

1. Known esophageal strictures, perforation, lacerations or large diverticula
2. Cervical spine instability
3. Inability to protect the airway (if not intubated).
4. Loose teeth (need a dental exam and possible extraction before proceeding)

Relative

1. Dysphagia or odynophagia
2. Recent upper GI bleeding
3. Extensive radiation to the chest and mediastinum
4. Esophageal varices

Question 2

Complications of TEE

Answer 2

From medications:

1. Hypotension from sedating medications
2. Methemoglobinemia
3. Respiratory depression
4. Arrhythmia
5. Paradoxical reaction to sedating medications
6. Infection/Bleeding (from IV insertion site for IV medications)
7. Death (1/10,000)

From the probe:

1. Esophageal trauma, tear or perforation (1/1000 patients)
2. Aspiration
3. Upper GI bleeding
4. Dental injury, aspiration of a loose tooth
5. Displacement of endotracheal and nasogastric tubes