{"id":12655,"date":"2014-07-26T16:03:19","date_gmt":"2014-07-26T16:03:19","guid":{"rendered":"http:\/\/cardiophile.org\/?p=12655"},"modified":"2023-03-11T12:25:37","modified_gmt":"2023-03-11T06:55:37","slug":"pfo-detection-by-saline-contrast-echocardiography","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/pfo-detection-by-saline-contrast-echocardiography\/","title":{"rendered":"PFO Detection by Saline Contrast Echocardiography"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/uvumvvfb9k8\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">PFO detection by saline contrast echocardiography<\/span><\/h2>\n<p>Patent foramen ovale can cause paradoxical embolism and stroke. Hence in every case of stroke, it is necessary to look for a PFO. <span style=\"color: #0000ff;\">PFO typically shunts right to left at the end of a Valsalva maneuver<\/span>.<\/p>\n<figure id=\"attachment_58846\" aria-describedby=\"caption-attachment-58846\" style=\"width: 864px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-58846 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2014\/07\/PFO-Detection-by-Saline-Contrast-Echocardiography-2-e1678516628202.jpg\" alt=\"PFO Detection by Saline Contrast Echocardiography\" width=\"864\" height=\"692\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2014\/07\/PFO-Detection-by-Saline-Contrast-Echocardiography-2-e1678516628202.jpg 864w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2014\/07\/PFO-Detection-by-Saline-Contrast-Echocardiography-2-e1678516628202-300x240.jpg 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2014\/07\/PFO-Detection-by-Saline-Contrast-Echocardiography-2-e1678516628202-768x615.jpg 768w\" sizes=\"auto, (max-width: 864px) 100vw, 864px\" \/><figcaption id=\"caption-attachment-58846\" class=\"wp-caption-text\"><strong><span style=\"color: #ff00ff;\">PFO Detection by Saline Contrast Echocardiography<\/span><\/strong><\/figcaption><\/figure>\n<ol>\n<li>Hence injection of an agitated saline bolus at the end of a Valsalva maneuver and detection of the microbubbles in the left atrium within three cardiac cycles from the right atrial appearance would suggest presence of a PFO. This is called the &#8220;3 beat rule&#8221; to discriminate patent foramen ovale mediated right-to-left shunt from intrapulmonary right to left shunt using saline contrast transthoracic echocardiography [1].<\/li>\n<li>Delayed appearance would indicate a pulmonary arteriovenous fistula.<\/li>\n<li>Sometimes injection from the lower limb is needed to detect a PFO because of the preferential streaming of the inferior vena caval blood towards the PFO as in fetal life.<\/li>\n<li>This is more likely if there is an associated Eustachian valve.<\/li>\n<li>Transesophageal echocardiography may be able to detect PFO better than transthoracic echocardiography.<\/li>\n<\/ol>\n<p><strong><span style=\"color: #0000ff;\">Reference<\/span><\/strong><\/p>\n<ol>\n<li>Brett E Fenster, Douglas Curran-Everett, Andrew M Freeman, Howard D Weinberger, J Kern Buckner, John D Carroll. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24138568\/\">Saline Contrast Echocardiography for the Detection of Patent Foramen Ovale in Hypoxia: A Validation Study Using Intracardiac Echocardiography<\/a>. Echocardiography. 2014 Apr;31(4):420-7.<\/li>\n<\/ol>\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>PFO detection by saline contrast echocardiography Patent foramen ovale can cause paradoxical embolism and stroke. Hence in every case of stroke, it is necessary to look for a PFO. PFO typically shunts right to left at the end of a Valsalva maneuver. Hence injection of an agitated saline bolus at the end of a Valsalva [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":58846,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[157,1414,2356,2800,2871,2872,2989,3117,3373,3477,3730,3852,3977,3981,4053,4112],"class_list":["post-12655","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","tag-agitated-saline-bolus","tag-eustachian-valve","tag-microbubbles","tag-patent-foramen-ovale","tag-pfo","tag-pfo-detection","tag-preferential-streaming-of-the-inferior-vena-caval-blood","tag-pulmonary-arteriovenous-fistula","tag-right-to-left-shunt","tag-saline-contrast-echocardiography","tag-stroke-evaluation","tag-tee","tag-trans-esophageal-echocardiography","tag-trans-thoracic-echocardiography","tag-tte","tag-valsalva-maneuver"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>PFO Detection by Saline Contrast Echocardiography - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"description\" content=\"PFO detection by saline contrast echocardiography: PFO typically shunts right to left at the end of a Valsalva maneuver. 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