Atrial septal defect contrast echocardiography

Atrial Septal Defect Microchapters
Home
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
MRI
Echocardiography
Transesophageal Echocardiography
Transthoracic Echocardiography
Contrast Echocardiography
M-Mode
Doppler
Transcranial Doppler Ultrasound
Cardiac Catheterization
Exercise Testing
ACC/AHA Guidelines for Evaluation of Unoperated Patients
Treatment
Medical Therapy
Surgery
Indications for Surgical Repair
Surgical Closure
Minimally Invasive Repair
Robotic ASD Repair
Percutaneous Closure
Post-Surgical Follow Up
Special Scenarios
Pregnancy
Diving and Decompression Sickness
Paradoxical Emboli
Pulmonary Hypertension
Eisenmenger's Syndrome
Atmospheric Pressure
Case Studies
Case #1
Atrial septal defect contrast echocardiography On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Atrial septal defect contrast echocardiography All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Atrial septal defect contrast echocardiography
CDC on Atrial septal defect contrast echocardiography
Atrial septal defect contrast echocardiography in the news
Blogs on Atrial septal defect contrast echocardiography
Directions to Hospitals Treating Type page name here
Risk calculators and risk factors for Atrial septal defect contrast echocardiography

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]

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
• Agitated saline is commonly used as the contrast material.

• 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