Bubble Echocardiogram

A bubble echocardiogram is a non-invasive diagnostic test used to identify a “hole in the heart.”

Overview

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What is a bubble echocardiogram?

A bubble echocardiogram (echo), also called a bubble saline contrast echo or bubble study, is a non-invasive test that looks at your heart.

Unlike a normal echocardiogram (heart ultrasound), a bubble echo uses an injection of saline (mixed with your blood to form small bubbles) to identify a hole in the heart called a patent foramen ovale (PFO).

Why is a bubble echocardiogram done?

Normally, the right and left sides of the heart do not communicate, but in people with an ASD (Atrial Septal Defect) or PFO, blood can flow from left to right, causing strain on the right heart, or right to left, possibly carrying clots with it, that might lead to stroke.

A PFO  is a congenital defect where the flap valve that separates the chambers of the heart stays open after birth rather than closing spontaneously. It is present in 25% of the population.

You may need to have a bubble echo if your doctor suspects you have a hole in your heart. Or, the test may also be done if you’ve had an unexpected stroke or heart attack, to identify whether an ASD or PFO could be to blame.

What does a bubble echocardiogram involve?

A bubble echo is a straightforward test which is performed by a trained physiologist.

To begin the test, you’ll have a cannula (thin plastic tube) inserted into a vein in the back of your hand. A small amount of sterile saline with microscopic bubbles will then be injected. The bubble are best created by mixing the saline with a drop of your own blood. The protein in the blood holds the bubbles in the mixture. You’ll be asked to lie down on your left side with your left arm above your head.

As the bubbles from the injection flows through your bloodstream and into your heart, your physiologist will track them using an echocardiogram. If your heart is normal, the bubbles will only be visible in the right side. If bubbles appear in the left side of your heart, this indicates the valve is still open and you have an ASD or PFO. You will be asked to do certain manoeuvres to see if bubbles cross from right to left- sniffing, and Valsalva, straining down as if pushing hard.

A bubble echo usually takes around 30 to 45 minutes.

Preparing for a bubble echocardiogram

Before having a bubble echo, you’ll have an appointment with your consultant cardiologist who will explain the test to you and answer any questions you may have.

You should continue to take any medications as normal and there is no need to fast before the test. It’s helpful to drink plenty of fluids and keep yourself warm before your test as this can help will blood flow making it easier to find a vein for cannula insertion.

Recovering from a bubble echocardiogram

Once the test is complete you can continue with your normal activities and you’ll be safe to drive.

Your consultant may share your results with you straight away, or you may be asked to book a follow-up appointment.

If a hole in your heart has been identified, your consultant will talk you through the next steps and most suitable treatment options.

Risks of a bubble echocardiogram

A bubble echo is a very safe test and associated risks are very low when performed by a specialist. The bubbles that are injected are extremely small and will be filtered out by your lungs so will not cause you any harm.

Very occasionally, if you have severe migraine, it might cause a headache.

Pricing for a bubble echocardiogram?

Please contact the centre to discuss pricing.

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Bubble Echocardiogram

Average time of test

30 to 45 minutes

Preparation

Drink plenty of fluids beforehand

Risks

Risks very low, headache could occur

Pricing

Ccontact the centre to discuss pricing

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Health Insurance

This service or treatment is generally covered by most health insurance policies. You are responsible for checking your insurance policy cover, and you may need a referral letter. Check which insurance companies are covered.

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Doctor Referral Only

You will generally need to get a referral letter from your NHS GP, Private GP, or other doctor to access this service or treatment. Find out more including how we can assist you

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Self-Pay Available

This treatment is available for self-paying users. If you would like to see more information on pricing visit our pricing and payments page.

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Fixed Price Package

For peace of mind, this service or treatment is available for an all-inclusive fixed price package.

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Same Day Availability

We usually have same-day appointments available for this service. Please call us to book.

Jason's story

Jason is a diver, and after 1,000 dives, he wondered what he had done differently. Was there something he had done wrong? He wondered if his body was trying to warn him of something more serious. Jason visited us to have a bubble echocardiogram; a non-invasive diagnostic test used to identify the hole in his heart. Read his story about his experience.

Read Jason's Story

Bubble Echocardiogram specialists

The consultants at OneWelbeck Heart Health have been assembled based on their hard-earned international reputations and expertise. Together, they cover the major London teaching hospitals and leading cardiac services, making up the largest independent cardiology group in the UK.

Earliest availability 29 Apr
Bookings are avaliable

Dr Iqbal Malik

Consultant Cardiologist

Specialist expertise: Coronary Artery Disease, Structural Heart Disease including PFO, ASD and the TAVI procedure, Cardiology, Interventional Cardiology, Breathlessness, Chest Pain, Blood Pressure, Type 1 & 2 Diabetes, Stroke, Heart Health, Valve Disease, Angina, Para-Valvular Leak Closure.

Earliest availability 06 May
Bookings are avaliable

Dr Amit Bhan

Consultant Cardiologist

Specialist expertise: Catheter-based treatment of Congenital Heart Disease (including ASD and PFO closures), Cardiology, Heart Health, Interventional Cardiology, Cardiopulmonary Exercise Test (CPET), Breathlessness, Minimally Invasive Interventional Procedures for Structural Heart Disease including PFO, ASD, Coarctation of the aorta.

Dr Aaisha Opel

Consultant Cardiologist and Electrophysiologist

Specialist expertise: Cardiac Electrophysiology, Cardiology, Electrophysiology, Heart Rhythm Disturbances including Atrial Fibrillation, Pacing and Syncope, Breathlessness, Long COVID, Palpitations, Atrial Fibrillation Ablation, Dizziness, Chest Pain, Blood Pressure, Cholesterol Disorders, Pacemakers, Syncope, Arrhythmias.

Professor Charlotte Manisty

Consultant Cardiologist

Specialist expertise: Cardiology, Radiology, Management of heart failure and advanced non-invasive cardiac imaging, Heart Rhythm Disorders, Breathlessness, Chest Pain, Blood Pressure, Palpitations, Echocardiography.

Professor Riyaz Patel

Consultant Cardiologist

Specialist expertise: Coronary Artery Disease, Chest Pain, Breathlessness, Palpitations, Preventative Cardiology, Cardiovascular Genetics, Familial Hypercholesterolaemia, Cholesterol Disorders, Blood Pressure, Cardiac CT Angiography, Stress Echocardiography, Cardiology.