title: A sinus venosus atrial septal defect is diagnosed by echocardiography with an unusual bubble study.
abstract: A 68-year-old man underwent echocardiogram with agitated saline for a presumed diagnosis of primary pulmonary hypertension. Surprisingly, the bubbles from the agitated saline enter the left heart before filling the right side, leading to a diagnosis of Eisenmeger's syndrome from a sinus venosus atrial septal defect. Because of high right-sided pressure, the bubbles preferentially travel from the superior vena cava through the defect to the right superior pulmonary vein and left atrium, rather than the right side. This diagnosis was later confirmed on cardiac MRI.
authors.affiliation: Division of Cardiology, School of Medicine, University of Colorado Denver, Aurora, Colorado 80045, USA. Jennifer.Dorosz@ucdenver.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Dorosz
authors.forename: Brian M
authors.initials: BM
authors.lastname: Fonseca
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Kay
authors.forename: Brian B
authors.initials: BB
authors.lastname: Graham
authors.forename: Ernesto E
authors.initials: EE
authors.lastname: Salcedo
authors.forename: Robert A
authors.initials: RA
authors.lastname: Quaife
mesh_terms: D000368:Aged; D004452:Echocardiography / Q000379:methods*; D004541:Eisenmenger Complex / Q000000981:diagnostic imaging*; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D045423:Microbubbles; D012965:Sodium Chloride
chemical_list: D012965:Sodium Chloride
keywords: Eisenmeger's syndrome; contrast echocardiography; sinus venosus atrial septal defect