Echocardiogram & Bubble Study

Contrast echocardiography is a type of ultrasound to visualize the heart. By adding a “contrast agent”, a cardiac echo has better resolution. The additional, clearer resolution allows doctors to watch blood flow through the heart.

Patient receiving an echocardiogram

The contrast given is most commonly a saline solution injected through an IV placed in the arm. The saline solution is gently agitated to create “microbubbles” and then injected into the IV. During the cardiac echo, the bubbles reflect the sound waves, which make them appear opaque. Unlike the red blood cells, these bubbles allow doctors to monitor the volume and the exact flow of blood in and out of the heart.

This fluid circulates up to the right side of your heart and shows up on the echocardiogram image. You may be asked to cough, which briefly increases the pressure in the heart’s right side.

Normally, your lungs will simply filter out the bubbles. But if you have a tiny opening between your heart’s upper chambers (the right and left atria), some bubbles will move through that hole and appear on the left side of the heart.

This opening is called a patent foramen ovale (PFO). About one in four people have this finding, which occurs when the hole—which is present in everyone before birth as a normal part of development—fails to close fully

Most people with a PFO remain healthy without any problems. But some evidence suggests that PFOs might be responsible for certain rare strokes when no other cause can be found.

Normally, the network of blood vessels in your lungs trap any tiny blood clots before blood recirculates through the heart and body. But if a clot bypasses the lungs by taking a shortcut through a PFO, it can travel to the arteries that supply the entire body. If a clot lodges in a blood vessel to the brain, it can cause a stroke.

A doctor may suspect a PFO if you’re relatively young and had a stroke but don’t have other obvious risk factors, such as high blood pressure or atrial fibrillation. But for the most part, carefully done studies show that there is no clear benefit to closing PFOs routinely, as it is very difficult to determine if a stroke is truly caused by a PFO. As a result, clot-preventing drugs are the main treatment for stroke prevention.

A bubble study may also show a different type of opening in the wall between the atria. Known as an atrial septal defect, these are usually discovered and repaired in childhood but may go unnoticed until later in life. Depending on the size of the hole, these defects may need to be closed to prevent strain on the heart and heart failure over time.

How do I get started?

Contact San Tan Cardiovascular Center today to make an appointment with one of our healthcare providers.

At this appointment:

  • we will review your medical history, discuss your symptoms and perform a non-invasive, diagnostic test to further determine your medical condition,
  • any pertinent testing that needs to be done beforehand will also be ordered at this time.

Our billing department will then contact your health insurance company to obtain prior authorization.  Upon receiving insurance authorization, the test will be scheduled.