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Large atrial septal defect on cardiac POCUS with an oddly satisfying bubble study.

Eric Abrams, MD @eabramsMD

#Bubble
Large atrial septal ... defect on cardiac ... #Study #ASD #Atrial ... Echocardiogram #A4C ... #Large
ASD on Bubble Contrast Echocardiogram (a4c)
A patient with an anterior STEMI (take a look at the
ASD on Bubble Contrast ... Ivan_Echocardio #atrial ... #septal #defect ... #ASD #Bubble #Contrast ... #clinical #cardiology
Negative contrast effect = a washout of the contrast (agitated saline) in the right atrium in
Negative contrast ... ) in the right atrium ... atrial #septal # ... defect #a4c #Echocardiogram ... #clinical #cardiology
Large Atrial Septal Defect and clearly not a PFO. I want to personally thank all the
Large Atrial Septal ... Defect and clearly ... #Clinical #Cardiology ... Echocardiogram #A4C ... #ASD #Large #SeptalDefect
Atrial septal defect

An ECG may show the “crochetage” pattern (92% specific)—a notch near the apex of
Atrial septal defect ... notches signify a larger ... shunt #ECG #EKG ... #Cardiology #Crochetage ... #Sign #ASD
Abnormal Jugular Venous Pressure Waveforms - Differential Diagnosis
 - Absent a wave - Atrial fibrillation, sinus
fibrillation, sinus ... enlarged a waves - Large ... septal defect ... Absent y descent - Cardiac ... #PhysicalExam #cardiology
Negative Contrast Effect in Right Atrium - Differential Diagnosis
1. Small secundum ASD or PFO with left
Negative Contrast ... Atrium - Differential ... Small secundum ASD ... echocardiogram #s4c ... #pocus #bubble
Endocarditis Summary

Who?
Infectious:
• Pre-existing valvular disease
• Prosthetic valve
• Congenital heart disease
• IV substance use
• IV catheter
• Recent
Libman Sacks) • Atrial ... • Coagulase-negative ... Glomerulonephritis Septic ... Paradoxical emboli via ASD ... ↑ ESR, CRP • EKG
Double Shunt on Echocardiogram
What do you see on this saline contrast study, in a patient with
Early transit of bubbles ... as RAP>LAP as atrial ... septum shifts left ... PVeins (extra-cardiac ... clinical #pocus #a4c
Endocarditis - Overview and Differential Diagnosis Framework

Who?
Infectious:
• Pre-existing valvular disease
• Prosthetic valve
• Congenital heart disease
• IV
Libman Sacks) • Atrial ... aureus, Coagulase-negative ... staphylococci Culture Negative ... tumor embolism Septic ... ↑ ESR, CRP • EKG