Transesophageal echocardiography improves image quality in many ways over transthoracic echo but at the expense of being an invasive procedure. The echo probe is placed within the esophagus and ultrasound is projected at the neighboring structures, such as the heart and aorta, which are in close proximity. Because of imaging at shallower depths, TEE can use higher frequency transducers (up to 7MHz).

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Becoming familiar with obtaining standard tomographic views takes some time and practice working along side an experienced echocardiographer. The standard views can be divided by how far in the TEE probe is into the esophagus or stomach. Most of the information usually is obtained in the mid-esophageal view. The transgastric views show the LV in short and long axis and helps one obtain aortic valve gradients. It is one of the best views to evaluate left ventricular function and pericardial effusions. The high esophageal view allows visualization of the great vessels. These are discussed on separate pages.