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

Suqin Jin; Siyu Zhao; Xiaoyu Wan; Mei Zhang; Mingjun Xu

doi:10.1016/j.jaccas.2023.101782

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

JACC Case Rep. 2023 Feb 15:11:101782. doi: 10.1016/j.jaccas.2023.101782. eCollection 2023 Apr 5.

Authors

Suqin Jin¹, Siyu Zhao¹, Xiaoyu Wan², Mei Zhang², Mingjun Xu²

Affiliations

¹ Department of Neurology, The Second Hospital of Shandong University, Jinan, China.
² The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.

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: Valsalva maneuver; embolism; microbubble study; ventricular septal defect.