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==Contrast echocardiography==
==Contrast echocardiography==
* Used to determine the presence of intercardiac shunting often seen in the apical four chamber view
* Used to determine the presence of intercardiac shunting often seen in the apical four chamber view
* Commonly referred to as a '''Bubble study'''
* Agitated saline is commonly used as the contrast material.
* Agitated saline is commonly used as the contrast material.
:* Saline contrast can visualize heart function, problems in the left ventricle, and problems in the surrounding valves.
:* Injected into a peripheral [[vein]] during [[echocardiography]], small air bubbles can be seen on the imaging.
:* Injected into a peripheral [[vein]] during [[echocardiography]], small air bubbles can be seen on the imaging.
:* It may be possible to see bubbles travel across an atrial septal defect either at rest or during a cough.
:* It may be possible to see bubbles travel across an atrial septal defect either at rest or during a cough.

Revision as of 13:31, 23 August 2011

Atrial Septal Defect Microchapters

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Patient Information

Overview

Anatomy

Classification

Ostium Secundum Atrial Septal Defect
Ostium Primum Atrial Septal Defect
Sinus Venosus Atrial Septal Defect
Coronary Sinus
Patent Foramen Ovale
Common or Single Atrium

Pathophysiology

Epidemiology and Demographics

Risk Factors

Natural History and Prognosis

Complications

Diagnosis

History and Symptoms

Physical Examination

Electrocardiogram

Chest X Ray

CT

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Echocardiography

Transesophageal Echocardiography
Transthoracic Echocardiography
Contrast Echocardiography
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Transcranial Doppler Ultrasound

Cardiac Catheterization

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Special Scenarios

Pregnancy
Diving and Decompression Sickness
Paradoxical Emboli
Pulmonary Hypertension
Eisenmenger's Syndrome
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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]

For a full discussion on the usage of echocardiography for atrial septal defect diagnosis click here.

Overview

Echocardiography is the preferred diagnostic tool in the evaluation of an atrial septal defect. Contrast echocardiography is an effective modality that can be performed in individuals with a suspected atrial septal defect which is not visualized definitively on transthoracic imaging.

Contrast echocardiography

  • Used to determine the presence of intercardiac shunting often seen in the apical four chamber view
  • Commonly referred to as a Bubble study
  • Agitated saline is commonly used as the contrast material.
  • Saline contrast can visualize heart function, problems in the left ventricle, and problems in the surrounding valves.
  • Injected into a peripheral vein during echocardiography, small air bubbles can be seen on the imaging.
  • It may be possible to see bubbles travel across an atrial septal defect either at rest or during a cough.
  • Bubbles will only flow from right atrium to left atrium if the RA pressure is greater than LA

Common Findings

  • A right-to-left interatrial shunt can be seen:
  • When an atrial septal defect with accompanying pulmonary hypertension, resulting in a left-to-right reversal.
  • Any time a patent foramen ovale defect is present.
  • When an uncomplicated atrial septal defect has an imbalance in right-sided pressure, such as from coughing or the Valsalva maneuver.
  • When an uncomplicated atrial septal defect has a momentary onset of left ventricular contraction.

Sensitivity

  • Not recommended for:
  • Left-to-right interatrial shunt diagnosis
  • Pregnant patients
  • Patients with severe pulmonary hypertension

Disadvantages

  • False positives in the setting of a pulmonary arteriovenous malformation
  • Difficulty in quantifying the size of the shunt

References

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