Bubble study: Difference between revisions
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==Background== | ==Background== | ||
A patent foramen ovale (PFO) is a flaplike opening between the atrial septa primum and secundum at the location of the fossa ovalis that persists after 1 year of age. With increasing evidence being found that PFO is the culprit in paradoxical embolic events, the relative importance of the anomaly is being reevaluated. | A [[patent foramen ovale]] (PFO) is a flaplike opening between the atrial septa primum and secundum at the location of the fossa ovalis that persists after 1 year of age. With increasing evidence being found that PFO is the culprit in paradoxical embolic events, the relative importance of the anomaly is being reevaluated. | ||
==Diagnostics== | ==Diagnostics== | ||
*Contrast echocardiography (Bubble Study): After obtaining optimal visualization of atrial septum on TTE or TEE, a bolus of agitated saline is injected to an antecubital vein. Subsequently, microbubbles appear in the right atrium. The study is positive for PFO if microbubbles appear in left atrium within 3 cardiac cycles of their appearance in the right atrium. Valsalva increases right atrial pressure and facilitates | *Contrast echocardiography (Bubble Study): After obtaining optimal visualization of atrial septum on TTE or TEE, a bolus of agitated saline is injected to an antecubital vein. Subsequently, microbubbles appear in the right atrium. The study is positive for PFO if microbubbles appear in left atrium within 3 cardiac cycles of their appearance in the right atrium. Valsalva increases right atrial pressure and facilitates<ref>Bernard S, et al. Agitated Saline Contrast Echocardiography in the Identification of Intra- and Extracardiac Shunts: Connecting the Dots. J Am Soc Echocardiogr. 2020 Oct 23. PMID 34756394</ref> | ||
*2D TEE with contrast provides superior visualization and is therefore preferred for detecting PFO. When clinically indicated, 2D TEE with contrast is strongly recommended if transthoracic echo is negative. | *2D TEE with contrast provides superior visualization and is therefore preferred for detecting PFO. When clinically indicated, 2D TEE with contrast is strongly recommended if transthoracic echo is negative. | ||
==References== | ==References== | ||
emedicine.Medscape.com | emedicine.Medscape.com | ||
[[Category:Cardiology]] | |||
Latest revision as of 11:00, 22 March 2026
Background
A patent foramen ovale (PFO) is a flaplike opening between the atrial septa primum and secundum at the location of the fossa ovalis that persists after 1 year of age. With increasing evidence being found that PFO is the culprit in paradoxical embolic events, the relative importance of the anomaly is being reevaluated.
Diagnostics
- Contrast echocardiography (Bubble Study): After obtaining optimal visualization of atrial septum on TTE or TEE, a bolus of agitated saline is injected to an antecubital vein. Subsequently, microbubbles appear in the right atrium. The study is positive for PFO if microbubbles appear in left atrium within 3 cardiac cycles of their appearance in the right atrium. Valsalva increases right atrial pressure and facilitates[1]
- 2D TEE with contrast provides superior visualization and is therefore preferred for detecting PFO. When clinically indicated, 2D TEE with contrast is strongly recommended if transthoracic echo is negative.
References
emedicine.Medscape.com
- ↑ Bernard S, et al. Agitated Saline Contrast Echocardiography in the Identification of Intra- and Extracardiac Shunts: Connecting the Dots. J Am Soc Echocardiogr. 2020 Oct 23. PMID 34756394