Figure. Contrast echocardiography with agitated saline performed in PYNEH in a young gentleman with sudden oxygen desaturation to exclude inter-atrial shunting. No patent foramen ovale was present. The cardiac function at that time was so poor that the agitated saline contrast remained in the right cardiac chambers for several minutes, and was only dispersed by further saline flushing. He died of septic shock few hours after this echocardiogram from necrotising fasciitis, despite limb amputation. Culture showed Vibrio vulnificus.
Which of the following in incorrect about the above test?
A. The accepted echocardiographic standard for differentiating a patent foramen ovale (PFO) from pulmonary arteriovenous malformation (PAVM) relies on a delay of three to eight cardiac cycles or 2 to 5 s of agitated saline bubbles to arrive in the left atrium after right atrial opacification. Earlier opacification would indicate an intracardiac shunt.
B. PFO occurs in 2.5% to 3% of all adults.
C. PFO is frequently associated with exaggerated mobility of the atrial septum and, in the extreme form, an atrial septal aneurysm.
D. Shunting between the atria may sometimes also be demonstrated by colour flow imaging.
Answer: B
PFO occurs in 25% to 30% of all adults.
Reference
Feigenbaum’s echocardiography. Authors: Harvey Feigenbaum, William F. Armstrong, Thomas Ryan