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<p>Contrast echocardiography encompasses two forms of ultrasound contrast agents. This article focuses on agitated saline (AS-C) contrast, commonly called ‘bubble’ contrast. Its main application is in identifying the presence of a right to left shunt in a number of clinical syndromes, often associated with a patent foramen ovale (PFO). Dependant on the clinical presentation, the presence of a PFO with a likelihood of a causal role may be considered for percutaneous PFO closure. This guideline outlines a structured approach to performing an AS-C transthoracic echocardiogram, including the indications, protocols, and potential pitfalls for performing AS-C transthoracic echocardiography (TTE). It also addresses when to proceed to more advanced imaging modalities and highlights clinical decision-making frameworks such as the RoPE score.</p>

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Agitated Saline Contrast Echocardiography in the diagnosis of right to left shunts: Guidance and recommendations from the British Society of Echocardiography

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月1日

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  • Bushra Rana,
  • Shaun Robinson,
  • Liam Ring,
  • Dave Oxborough,
  • Mark Belham,
  • Jim Newton,
  • Alfa Ali,
  • Nilesh Sutaria,
  • Nina Bual,
  • Martin Swaans,
  • Nina Wunderlich,
  • Victoria Delgado,
  • David Northridge,
  • Dave Hildick-Smith,
  • Neil Ruparelia,
  • Mark Turner,
  • Michael Mullen,
  • Chris Baker,
  • Brian Clapp,
  • Mark Spence,
  • Horst Sievert,
  • Iqbal Malik,
  • Roxy Senior,
  • Anjana Siva

摘要

Contrast echocardiography encompasses two forms of ultrasound contrast agents. This article focuses on agitated saline (AS-C) contrast, commonly called ‘bubble’ contrast. Its main application is in identifying the presence of a right to left shunt in a number of clinical syndromes, often associated with a patent foramen ovale (PFO). Dependant on the clinical presentation, the presence of a PFO with a likelihood of a causal role may be considered for percutaneous PFO closure. This guideline outlines a structured approach to performing an AS-C transthoracic echocardiogram, including the indications, protocols, and potential pitfalls for performing AS-C transthoracic echocardiography (TTE). It also addresses when to proceed to more advanced imaging modalities and highlights clinical decision-making frameworks such as the RoPE score.