“Bubble echocardiogram?”
I am 38 years old and healthy. I had a TIA in 2018 with no deficit. My primary sent me to a cardiologist, who has ordered a bubble echocardiogram. My question is if this is necessary and safe. EKG done recently was also normal.
Male | 38 years old
3 Answers
A Bubble Study is an injection of agitated normal physiological solution into patient’s venous circulation in order to look for a shunt (a hole) between the right and left side of the heart.
If there is evidence of the shunt, meaning if bubbles cross from the right to the left side of the heart, that could explain why some people could have TIAs or strokes, by blood clots crossing through the hole inside their hearts.
If the shunt is large in size, and doctors believe that it is big enough to cause TIA or stroke, it could be closed via skin and peripheral veins by implanting a small occluder (a device) inside the heart, without a need to cut the chest open as we used to do it years ago.
Injecting bubbles is safe in patients who don’t have a very large holes in their hearts which can be diagnosed without injecting any “bubbles.” However, those smaller ones that can be easily missed without help of “bubbles” pose no risk to patients.
If there is evidence of the shunt, meaning if bubbles cross from the right to the left side of the heart, that could explain why some people could have TIAs or strokes, by blood clots crossing through the hole inside their hearts.
If the shunt is large in size, and doctors believe that it is big enough to cause TIA or stroke, it could be closed via skin and peripheral veins by implanting a small occluder (a device) inside the heart, without a need to cut the chest open as we used to do it years ago.
Injecting bubbles is safe in patients who don’t have a very large holes in their hearts which can be diagnosed without injecting any “bubbles.” However, those smaller ones that can be easily missed without help of “bubbles” pose no risk to patients.
An echocardiogram with a bubble study is absolutely standard of care for evaluation of stroke and stroke-like syndromes in people your age. Your doctors need to look for a possible persistent shunt in the heart that would allow blood and clots to pass from the right side of the heart to the left side of the heart. This is called a PFO and about 20-25% of people retain this into adulthood. It is not dangerous, but a bubble study can trigger a migraine if you have a PFO and it allows bubbles to pass from right to left.
This can be a very helpful test. This can prove if there is a shunt in the heart. That means that there could be a hole in the heart that would allow a clot that could form in the right side of the heart to travel to the left side of the heart and cause a stroke. This is a simple test in which an iv is started and saline is injected when an echocardiogram is being done. The bubbles that form in the right side can pass to the left side and indicate that there is a hole present.
