Which finding is a contraindication to transesophageal echocardiography (TEE)?

• A. Esophageal strictures
• B. Hypertension
• C. Aortic stenosis
• D. Diabetes

Answer: (A)

Transesophageal echocardiography places a flexible probe into the esophagus to bring the heart into close view. Any condition that narrows or injures the esophagus increases the risk of complications when advancing or manipulating the probe. Esophageal strictures create a real risk of perforation or trauma and can impede or block passage, making this procedure unsafe. That’s why esophageal strictures are a contraindication. Other conditions listed—hypertension, aortic stenosis, and diabetes—do not inherently prevent placing the probe via the esophagus, though they may affect overall peri-procedural risk or the choice of imaging modality. If TEE isn’t suitable, alternative imaging like transthoracic echo can be considered.