case_images: PMC9149543_01
case_images: Image from the patient's TTE during cough maneuver demonstrating opacified RA and RV, and lack of bubbles in the LV, ruling out an intracardiac shunt. RA, right atrium; RV, right ventricle; LV, left ventricle.
case_images: cro-0015-0399-g01.jpg
case_images: PMC9149543_01_cro-0015-0399-g01.jpg
case_images: F1
case_images: Transthoracic echocardiogram (TTE) with saline contrast and bubble study revealed lack of bubbles in the left ventricle after cough and the presence of bubbles after 7 heartbeats, suggestive of a transpulmonary shunt (as shown in Fig. 1, 2).
case_images: Image from the patient's TTE after 7 beats during cough maneuver demonstrating the presence of bubbles in the LV, suggestive of an intrathoracic shunt.
case_images: cro-0015-0399-g02.jpg
case_images: PMC9149543_01_cro-0015-0399-g02.jpg
case_images: F2
case_images: Transthoracic echocardiogram (TTE) with saline contrast and bubble study revealed lack of bubbles in the left ventricle after cough and the presence of bubbles after 7 heartbeats, suggestive of a transpulmonary shunt (as shown in Fig. 1, 2).