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Southwest Pulmonary and Critical Care Fellowships
Monday
Aug042014

Ultrasound For Critical Care Physicians: Where Did the Bubbles Go? 

A 35-year-old woman with factor V Leiden deficiency on chronic anticoagulation therapy and a history of multiple deep vein thrombosis, pulmonary embolism and transient ischemic attacks presented for an evaluation of dyspnea. An echocardiogram with agitated saline contrast (bubble study) was performed (Figure 1).

Figure 1. Apical 4 chamber video taken from bubble study.

What is the best explanation for the findings in the video?

Reference as: Natt B, Snyder L, Lax D. Ultrasound for critical care physicians: where did the bubbles go? Southwest J Pulm Crit Care. 2014;9(2):91-3. doi: http://dx.doi.org/10.13175/swjpcc100-14 PDF

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