Abstract
Agitated saline contrast echocardiogram (ASC) is a very useful technique to detect various intracardiac and extra cardiac shunts in daily cardiology practice . Conventional 2D and color echocardiogram may not be well effective in ruling out various intracardiac shunts especially with patients having poor echo window. The introduction of agitated saline with bubbles formed during the study can help delineate different right to left shunt physiology commonly like patent foramen ovale (PFO) which is often sought for in evaluation of cases with young stroke . Various other etiologies like atrial septal defects, atrial septal aneurysm, large right to left shunts with eisenmengerisation can also be evaluated with this simple bedside study.
Highlights
Agitated saline contrast echocardiogram (ASC) is an echocardiographic technique which uses agitated saline to primarily diagnose certain disorders like right to left shunt and even various extracardiac shunt physiology
The main disadvantage with color flow mapping can be with poor echogenicity as compared to bubble study
Are these ‘‘bubble studies’’ inexpensive and technically simple, but they can provide valuable information regarding the presence or absence of intracardiac or intrapulmonary shunts. This can help in diagnosing various clinical syndromes that have evasive etiology such as right ventricular dilatation or dysfunction, platypnea - orthodeoxia syndrome, refractory hypoxemia, and cryptogenic stroke
Summary
Agitated saline contrast echocardiogram (ASC) is an echocardiographic technique which uses agitated saline to primarily diagnose certain disorders like right to left shunt and even various extracardiac shunt physiology. The main disadvantage with color flow mapping can be with poor echogenicity as compared to bubble study Are these ‘‘bubble studies’’ inexpensive and technically simple, but they can provide valuable information regarding the presence or absence of intracardiac or intrapulmonary shunts. The ultrasound waves signals from the blood mixed with agitated microbubbles is much intense and echogenic to produce with increased contrast delineation. These microbubbles are too large to cross the micro capillaries of the pulmonary circulation and they do not appear in the left side of the heart unless there is right to left shunting present (negative contrast study).
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