#JADEL Quick survey: How would you interpret this bubble study? A. Normal - no PFO B. Equivocal - cannot exclude PFO C. Abnormal- probable PFO D. Other- please explain American Society of Echocardiography CV Case Journal

@ASE360 @CASEfromASE b ASA mostly bulging to the right, so insufficient Valsalva

@ASE360 @CASEfromASE D. Is there a negative contrast effect? L -> R?

@ASE360 @CASEfromASE The septum appears aneurysmal is continuously bowing towards RA so can't tell if RAP ever exceeded the LAP@

@ASE360 @CASEfromASE ASA with negative bubbles

@ASE360 @CASEfromASE Sonographer: slowing frames down I “think” I saw about 5-10 Bubbles move r to l … the RV and RA don’t look impressive in size however IAS appears to bow to towards RA ( elevated LAP) and might be Aneurysmal … maybe saw some negative contrast in LA later. Cannot r/o tiny pfo

@ASE360 @CASEfromASE c

@ASE360 @CASEfromASE B

@ASE360 @CASEfromASE No pfo

@ASE360 @CASEfromASE A

@ASE360 @CASEfromASE A