should i get a transesophageal echo? pros/cons?

[YZ1911]

i have an update of my dental/heart problems but i am looking for advice from one of the doctors who posts here or from the premium members who know heart conditions.

well,i went to my GP and got some antibiotics for my dental abscesses,i still get horrible pain but i hope it goes away. now,my GP is also a cardiologist and he decided to do another EKG on me and this one really concerned him. it showed sinus tachycardia at 127 and a right bundle branch block and left posterior fascicular block. he said that it was a bifascicular block. he is very concerned that i am having these conduction delays with my heart.

like i said before,i have had about 6 or 7 previous ekgs during a 6 month span and each and every one showed a different conduction delay. one time it was a RBBB,another time a LBBB and another time first degree AV block. this recent one concerned him the most and he wants me to go to a large hospital and get a TEE done. now,i am afraid of this invasive procedure,but he told me that it would clear alot of things up.

can anyone here tell me the pros/cons of this test and can anyone tell me why am i getting all these conduction delays at my young age? i am 28 and besides my teeth,i am healthy,though my resting hr is high. i am confused.

[is_something_wrong]

I'm sorry - the doctors on this forum just answer an occational post now and then. An alternative is posting in the Heart Disease Expert forum (free, but limited to 2 questions/day) or the Heart Rhythm Expert forum ($20 fee, answered within few days).

I'm not sure if you consider me a "premium member" (I'm a community leader, not sure if that's what you meant), but I will try to give you an answer.

You are lucky to have a GP that is also a cardiologist. If a cardiologist is "really concerned" about your EKG, and wants you to take an echo, I would follow his advice. You ask about the cons with a TEE, as far as I know it's not that many, but did you get a TTE (normal echo) done first? TEE is most commonly used to investigate the atria, just like an esophagal EKG is used to investigate atrial electrical activity.

The procedure is usually done with mild sedation, and the risk of complications is low. The upside is that your upper heart is very clearly visible for the doctor, but as far as I know it's usually combined with a normal (standard) echo or done after a normal echo

It sounds like you have a lot of temporary blocks (you can't have RBBB and LBBB at the same time, this is dangerous and would have caused fainting, it's the same as a complete heart block). Maybe your blocks are heart rate dependent? I'm also afraid that your EKG findings and tachycardia are caused by your infections that are left untreated. Dental infections are known to possibly affect the heart (valves and other structures).

If your resting heart rate is in the 120-130s, (given that you are not extremely anxious every time you measure it) there is something going on that needs attention and treatment.

I can't do anything else than to recommend that you follow the advice from your GP/cardiologist..

[DeltaDawn23]

This is a standard test they do before electrocardioversion, to rule out clots.  It just gives them a better picture from the inside.  I have had it, and wouldn't hesitate to have it again if indicated.  Sounds like your doctor is trying to gather all the information he can to decide how best to treat you. Good luck.