Contrast echo

Question 1

How to perform contrast echo

Answer 1

Microbubble study
* Injection of saline with micro bubbles in peripheral vein

Question 2

Path of bubbles

Answer 2

• Contrast enter CrVC or CaVC → RA → RV → PA
• If normal, bubbles will be eliminated by pulmonary circulation

Question 3

ASD/VSD L to R shunt

Answer 3

o Negative contrast effect → no contrast in LA/LV
o Washout phenomenon on RA/RV side

Question 4

ASD/VSD R to L shunt

Answer 4

o Positive contrast effect → contrast present in LA/LV
 Bubbles passing from RA → LA OR RV → LV
 Valsalva maneuver can be performed to ↑RAP → ↑ PG btw atria

Question 5

TOF

Answer 5

• Depending on PS severity → if shunting is R to L or L to R

Question 6

PDA

Answer 6

EXTRACARDIAC shunt
o Need to confirm absence of intracardiac shunting
o Microbubbles present in abdominal Ao