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Microbubble testing is a specialised medical scanning procedure that our consultants use when diagnosing various heart conditions. The test itself involves the use of tiny gas-filled bubbles, called microbubbles, to improve the clarity of ultrasound imaging.
The procedure is particularly useful in detecting issues related to the heart's structure and function, especially in cases where traditional imaging methods may not provide sufficient detail.
The microbubbles are injected into your bloodstream, and when the ultrasound is performed, the microbubbles create a clear contrast between the blood and surrounding tissues, allowing our consultants to observe the flow of blood through the heart and other blood vessels more accurately.
This test is particularly useful in visualising the upper chambers of the heart (the atria) and identifying abnormal connections or blood flow patterns that might not be visible with standard ultrasound imaging.
PFO is a small, flap-like opening between the upper chambers of the heart (the left and right atria). This opening is normal before birth, allowing blood to bypass the lungs while the foetus develops, and typically closes soon after birth.
However, in some people, the PFO remains open, which can allow blood clots or other particles to pass from the right side to the left side of the heart, potentially leading to a stroke or other complications.
As well as detecting PFO, microbubble testing can also diagnose a range of different heart conditions, including atrial septal defects (ASD), which are similar to PFO but involve a larger hole between the heart's upper chambers.
The test can also help identify abnormal blood flow patterns, evaluate the function of heart valves, and assess the presence of blood clots within the heart.
Once injected, the microbubbles travel through the bloodstream and reach your heart within seconds.
As the ultrasound probe is placed on the chest, it emits high-frequency sound waves that bounce off the microbubbles and are detected by the probe. These reflected sound waves create an image on the ultrasound screen, allowing your consultant to visualise the heart's structure and blood flow in real-time.
Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.
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Patients with certain heart conditions, such as atrial septal defects or valve disorders, may also benefit from microbubble testing. The test is useful for anyone who has symptoms or a medical history that includes any suspicion of heart abnormality or blood flow that might not be detectable through other imaging techniques.
Another benefit is that microbubble testing is not very invasive. There’s only a small injection followed by a straightforward ultrasound scan, making it safer and less uncomfortable for patients compared to more invasive procedures.
Microbubble testing is also very effective at detecting conditions like PFO, which can be tricky to diagnose with standard ultrasound techniques. Early detection of these kinds of conditions can be crucial in preventing strokes and other complications.
While there is no special preparation required for microbubble testing in most cases, the consultant may advise you to avoid eating or drinking for a few hours before the test, especially if the test is being performed as part of a larger cardiac evaluation.
If you’re taking any medications, let the medical team know, as some drugs may need to be temporarily paused before the test.
Once the IV is in place, the ultrasound technician will apply a special gel to your chest. This gel helps the ultrasound probe make better contact with your skin, which makes images clearer. The probe will then be placed on your chest, and the technician will begin taking ultrasound images of your heart.
As the microbubbles are injected into your bloodstream, the technician will monitor the ultrasound screen to observe how the microbubbles move through your heart. During the test, you may be asked to perform certain breathing exercises, such as holding your breath or coughing, to help the consultant see how the bubbles move through the heart.
The whole test usually takes about 30 to 60 minutes. You will be awake and able to communicate with the medical staff throughout the test.
Your consultant will review the ultrasound images and discuss the results with you either on the day, or at a follow-up appointment. In some cases, additional tests may be needed if the microbubble test reveals any abnormalities that require further investigation.
As well as PFAs and TIAs, microbubble tests can also find and assess:
A larger hole in the heart's upper chambers that can lead to heart failure or other complications if left untreated.
Any conditions that affect the function of the heart's valves, leading to abnormal blood flow.
These are defined as abnormal connections between the heart chambers that allow blood to flow in the wrong direction.
Any abnormal connections between blood vessels in the lungs can lead to low oxygen levels and other complications.
If you have any concerns or questions about the test, be sure to discuss them with your consultant beforehand. Understanding what to expect can help ease any anxiety you may have about the tests.
In some cases, some individuals may experience mild discomfort at the injection site or a temporary rash. These symptoms usually resolve on their own without the need for any extra medical attention.
If the test reveals a PFO, ASD, or other condition, your doctor will discuss the findings with you and recommend appropriate treatment options. In some cases, additional tests may be needed to confirm the diagnosis or to plan for treatment.
For most people, microbubble testing provides valuable information that can help guide decisions about their heart health. Whether the results show a need for further treatment or simply provide reassurance, the test is an important tool to make sure any potential heart issues are identified and addressed promptly.
Content reviewed by Circle in-house team in January 2025. Next review due January 2027.