A Positive Microbubble Study in Ventricular Septal Defect Patient Without Pulmonary Hypertension

Abstract

A stroke patient with supracristal ventricular septal defect accompanying suspected patent foramen ovale underwent transthoracic and transesophageal echocardiography with agitated saline microbubble study, a positive trans-ventricular microbubble jet after Valsalva maneuver provocation was detected, indicating instantaneous transient paradoxical right-to-left shunt at late diastole might be the etiology of embolic events. (Level of Difficulty: Intermediate.)

Keywords

• embolism
• microbubble study
• Valsalva maneuver
• ventricular septal defect