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Updated: Feb 7, 2026

Transthoracic Echocardiography in Mice
Published on: May 28, 2010
Bubbles in the Brain: A Rare Complication Following Transthoracic Echocardiography
Andrew Y Powers1, Vijairam Selvaraj2
1medical student at the Warren Alpert Medical School of Brown University, Providence, RI.
Insights
A routine echocardiogram bubble study caused a stroke in an 89-year-old woman. This case highlights the rare but serious risk of cerebral air embolism during this common diagnostic procedure.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Ischemic stroke is a leading cause of death in the US, with nearly 30% originating from embolism.
- Echocardiography is crucial for diagnosing, preventing, and treating cardiac sources of embolism.
- Contrast-enhanced echocardiography uses microbubbles to visualize shunting, commonly called a "bubble study."
Abstract:
With nearly 700,000 cases every year, ischemic stroke represents the third leading cause of death in the United States.1,2 Nearly thirty percent of all ischemic strokes are due to embolism.3 A standard component of every stroke work-up at most institutions, echocardiography is vital not only for diagnosis but also for prevention and treatment of cardiac sources of embolism. Visualization of right-to-left shunting is often contrast-enhanced with micro bubbles created by mixing saline with air, a so-called "bubble study." We present a case of an 89-year-old woman who suffered cerebral air embolism and massive infarction following a routine bubble Transthoracic Echocardiogram.
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Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...