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Hepatopulmonary Syndrome on Echocardiogram (A4C)
Hepatopulmonary Syndrome: Intrapulmonary shunting is most commonly demonstrated by contrast TTE when

Echocardiogram (A4C ... Intrapulmonary shunting ... with intracardiac shunt ... Echocardiogram #A4C ... #bubble #shunting

Atrial Septal Defect (ASD) with Shunting on Echocardiogram with Contrast (a4c)

An elderly patient with dyspnea -

Defect (ASD) with Shunting ... with Contrast (a4c ... Echocardiogram #Contrast #a4c ... clinical #pocus #bubble ... #Shunting

PFO with shunting on Contrast Echocardiogram (a4c)
74 yo presents with CVA. RoPE score of 4.

PFO with shunting ... Echocardiogram (a4c ... DrShemisa #PFO #shunting ... Echocardiogram #a4c ... cardiology #pocus #bubble

Hypoxemia Differential Diagnosis Algorithm by A-a Gradient

Normal A-a Gradient:
• ↓ Atmospheric pressure
• Hypoventilation: CNS

Differential Diagnosis Algorithm ... Right-to-Left Shunt ... ↓Ventilation (↑Shunting ... Differential #Diagnosis #Algorithm ... #pulmonary #Aa

ASD on Bubble Contrast Echocardiogram (a4c)
A patient with an anterior STEMI (take a look at the

ASD on Bubble Contrast ... Echocardiogram (a4c ... #defect #ASD #Bubble ... Echocardiogram #a4c ... cardiology #pocus #shunting

Hepatopulmonary Syndrome - Echocardiogram (A4c) with bubble study showing delayed right-to-left shunt consistent with intrapulmonary shunt
68M

Echocardiogram (A4c ... ) with bubble study ... Echocardiogram #bubble ... #shunting #intrapulmonary ... pocus #hepatology #a4c

Right to Left Shunt on POCUS Echocardiogram (S4C)

Dr. Ashley Miller @icmteaching

#Shunt #POCUS #Echocardiogram #S4C #clinical #cardiology

Right to Left Shunt ... Echocardiogram (S4C ... icmteaching #Shunt ... Echocardiogram #S4C ... clinical #cardiology #bubble

Negative Contrast Effect in Right Atrium - Differential Diagnosis
1. Small secundum ASD or PFO with left

left to right shunt ... echocardiogram #s4c ... #pocus #bubble

Preoperative Risk Evaluation

Major Pre-Op Questions:
1. Does the patient have any modifiable risk factors that could be

event, follow ACC ... algorithm to determine ... indication of AC ... Recent PCI/stenting

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

Double Shunt on ... Early transit of bubbles ... pressure and R➡️L shunt ... (extra-cardiac shunt ... clinical #pocus #a4c

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