Bubble contrast echocardiogram

A bubble contrast echocardiogram (bubble echo) is an ultrasound test used to detect the presence of holes in the heart.

What is a bubble contrast echocardiogram?

An echocardiogram (also known as a real time echo doppler) is a non-invasive test using sound waves via a small transducer to image and record the structure, function, size, and shape of the heart.

During a bubble echo, a very small amount of salt water bubbles (saline or gelofusine) are injected through a cannula (small tube) into your arm. This is usually performed to establish whether there is a small hole connecting the right and left side of your heart.

A bubble echo is carried out if a patient is suspected to have:

  • patent foramen ovale (a hole between the left and right upper chambers of the heart)
  • atrial septal defect

Having a bubble echo

You will be asked to remove all clothing from the waist up and to lie on your left side throughout the majority of the test. Stickers (electrodes) will be attached to your chest and connected to the echo machine to monitor your heart rate and rhythm (ECG).

A cannula will be placed through a vein into your arm. A number of images of your heart will then be taken whilst salt water bubbles are injected through the cannula. During the test, you may be asked to perform some breathing manoeuvres (valsalva manoeuvre). The test is quick and the bubbles are harmless.

The procedure takes approximately 45 minutes to complete.

No special preparation is required before a bubble echo.

The results of the test are sent to the referring doctor within 24-48 hours of completion. The doctor will discuss these results with you.

If the bubble moves from the right to the left, then it means there is the presence of a hole in the heart.

If not, then the bubble would be filtered by the lungs.

You may experience the following side effects from a bubble echo cardiogram:

  • pain from the insertion of the IV line
  • infection from the IV line
  • thrombus formation (rare)

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