Transesophageal Echocardiography is used when transthoracic imaging is suboptimal. The ultrasonic transducer is placed as close to the heart as possible. The result is a more accurate picture. To place the transducer next to the heart, the transducer is introduced into the esophagus and "snaked" down until it lies adjacent to the cardiac muscle. Due to the discomfort of the test, sedation is usually required.