ASPD bubble radiology a4c s4c cardiac effusion alternans pericarditis ami saline doubleshunt

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Double Shunt on Echocardiogram
What do you see on this saline contrast study, in a patient with

Early transit of bubbles ... stretched PFO or ASD ... PVeins (extra-cardiac ... DavidWienerMD #DoubleShunt ... clinical #pocus #a4c

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