knee radiology msk sign pocus clinical labeled a4c atrial septal s4c myxoma constrictive bubble 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 ... as RAP>LAP as atrial ... septum shifts left ... Echocardiogram #clinical ... #pocus #a4c #intrapulmonary

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