Ascites pocus radiology abdominal s4c atrial pericardial contrast bubble shunting saline hepatopulmonary septal washout 2

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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 ... #2 c/w hepatopulmonary ... as RAP>LAP as atrial ... septum shifts left ... #cardiology #saline

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