Cardiologists use many tools to diagnose, manage and treat heart conditions in patients, one of which is a bubble echo. But what is this procedure and why might a cardiologist suggest this as the best course of action for a patient?
What is a bubble contrast echocardiogram?
It is a non-invasive procedure, often just called ‘echo’, which produces an image of your heart. It uses ultrasound to create this image; the process of using high-frequency sound which we can’t hear. Cardiologists use bubble echoes to gain information about the health, structure and function of the heart muscles, as well as the chambers and valves within it. It is a painless procedure.
Why would this test be recommended?
If your cardiologist recommends this procedure, he or she suspects you may have a hole in the heart. The heart is a strong muscle. Made up of four chambers, the chambers on the right-hand side of the heart receive the blood back when it has flowed around the body. This is the low-pressure side of the heart. The left side pumps the oxygen-rich blood out and around the body.
Normally, there is no ‘communication’ or exchange of blood between the left and right side of the heart. But if there is a hole or a small defect in the inter-atrial septum or the heart wall, it can lead to symptoms such as shortness of breath, heart murmur, abnormal heart rhythm and so on.
Most ‘holes in the heart’ are detected in childhood but for some people, they may not become prevalent until adulthood. Detection of small holes or defects may not always be obvious nor easily detected on a normal echocardiogram.
With this kind of ultrasound, the cardiologists will be looking to determine if there is a hole in the heart, known as Atrial Septal defect or ASD, or a small channel which behaves like a trap door, referred to as Patent Foramen Ovale or PFO.
The best way to detect PFO or ASD is by using a bubble study.
How is a bubble study carried out?
The test takes around 40 minutes in total. Completely painless, there are no side effects, but the results are a step closer to a diagnosis and effective treatment.
To start with, a normal transthoracic Echocardiogram is performed. This is an ultrasound of your heart and the surrounding area. After this, a small needle will be placed in a vein on the back of your hand.
A small amount of sterile saline solution is drawn into the syringe to create small bubbles. There are then agitated, followed by a quick injection into the vein. The bubbles will travel to the right-hand side of your heart, something that can be seen on the ultrasound image.
The bubbles are highly visible and should not travel from the right-hand side of the heart to the left. If they do, this is a positive test, with a strong suggestion that there is a presence of a hole in the heart.
What happens next?
What happens next very much depends on a patient by patient basis. Further tests may be carried out, along with medication or possibly surgery.
There is a much better understanding of the process of closing holes in the heart both in adults and children. As well as blood thinning medication, heart surgery is now much less invasive and is possibly an option.
Bubble studies are now considered to be a routine procedure and one that many people undergo without any discomfort or side effects. Your cardiologists will talk you through the procedure and any concerns you may have.