Bubble Echocardiogram
A bubble echocardiogram is a specialised ultrasound scan of the heart which uses harmless micro-bubbles to show any unusual blood flow between the heart’s chambers. It helps to detect conditions such as a small hole in the heart or an abnormal connection between heart chambers.
At a glance
- Doctor referral only
- Same Day Availability
- Fixed Price Package
- Health insurance
- Self-Pay Available
What is a bubble echocardiogram?
A bubble echocardiogram (sometimes called a bubble study or bubble saline contrast echo) is a specialist ultrasound scan of the heart. It works like a standard echocardiogram, but includes a small injection of saline (salt water) mixed with a tiny amount of your own blood to create harmless micro-bubbles. These bubbles act as a contrast agent, allowing your cardiologist to see whether any blood is passing abnormally between the chambers of the heart.
This test is often used to detect a small hole in the heart, such as a patent foramen ovale (PFO) or an atrial septal defect (ASD). In a healthy heart, the right and left sides are separate, but in people with one of these openings, a small amount of blood can move between them. In rare cases, this can allow tiny clots to pass through and potentially increase the risk of stroke or migraine.
Your doctor may recommend a bubble echocardiogram if they suspect a hole in your heart or if you’ve had an unexplained stroke, transient ischaemic attack (TIA), or heart attack. The test helps confirm or rule out a PFO or ASD and guides the next steps in your care.
At Welbeck, bubble echocardiograms are performed by our expert physiologists in our dedicated Heart Health Centre. Using advanced imaging technology in a calm, comfortable environment, we provide accurate results and a clear explanation of your findings — all in one visit. If further treatment or assessment is required, we can coordinate this seamlessly within our specialist network, ensuring you receive expert care every step of the way.
More information
Before your test begins, your physiologist will explain each step, answer any questions you have, and make sure you’re comfortable.
You’ll be asked to remove any clothing from your upper half and will be given a gown that opens at the front. Small stickers (electrodes) will be placed on your chest to monitor your heart rate and rhythm.
During the test:
a small cannula (thin plastic tube) will be placed into a vein in the back of your hand
a small amount of sterile saline, mixed with a drop of your own blood to create tiny bubbles, is then injected through the cannula
you’ll be asked to lie on your left side
your physiologist will place a little ultrasound gel on your chest and move a handheld probe across the skin to capture live pictures of your heart
as the bubbles travel through your bloodstream and into your heart, their movement will be tracked on the echocardiogram images
you may be asked to perform simple breathing or straining manoeuvres — such as sniffing or gently bearing down (the Valsalva manoeuvre)
once the scan is finished, the gel will be wiped off, and the cannula and stickers will be removed
In a normal heart, the bubbles appear only on the right side. If they appear on the left, this can indicate a small connection between the chambers, such as a PFO or ASD.
A bubble echocardiogram usually takes 30 to 45 minutes and is completely painless.
A bubble echocardiogram is a very safe test, and the associated risks are very low when performed by a specialist. The bubbles that are injected are extremely small and will be filtered out by your lungs, so they won’t cause you any harm.
Very occasionally, if you suffer from migraines, the test might cause a headache.
Before having a bubble echo, you’ll have an appointment with your consultant cardiologist, who’ll explain what you should do to prepare.
You should continue to take any medications as normal, and there’s no need to fast before the test. It’s helpful to drink plenty of fluids and keep yourself warm before your test, as this can help blood flow, making it easier to find a vein for cannula insertion.
Once the test is complete, you can continue with your normal activities, and you’ll be safe to drive home.
Your consultant may share your results with you straight away, or you may be asked to book a follow-up appointment. If a hole in your heart has been identified, your consultant will talk you through the next steps and the most suitable treatment options.
Please contact our Heart Health centre for pricing.
At Welbeck, our cardiologists are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
To book a bubble echocardiogram, you must be referred by either your GP or a cardiologist following a consultation with them. Self-referrals are not accepted for this test.
If you would like to schedule a consultation with a cardiologist, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
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Frequently asked questions
If a patent foramen ovale (PFO) or atrial septal defect (ASD) is identified, your cardiologist will explain how significant the finding is and what it means for you. Many small openings don’t require any treatment and are simply monitored over time. If the connection is larger or linked to symptoms — such as a stroke, migraine with aura, or breathlessness — your consultant may recommend further assessment or closure. If closure is advised, this is usually done with a minimally invasive keyhole procedure through a vein in the leg rather than open-heart surgery. Your cardiologist will discuss the safest and most appropriate plan for you and coordinate any next steps within the Welbeck network.
Sometimes, yes. If your diagnosis was many years ago, or if your symptoms have changed, your cardiologist may repeat the bubble echocardiogram to see whether the opening has altered in size or flow direction. This updated information helps guide whether any follow-up or closure is needed.
A bubble echocardiogram focuses mainly on detecting small holes or abnormal connections in the heart, but the ultrasound can also provide useful information about your heart valves, chamber size, and overall heart function. If anything unexpected is seen, your cardiologist will explain this clearly and may suggest a full echocardiogram or further investigations for a more detailed assessment.
A bubble echocardiogram is a highly sensitive and reliable test for detecting even the smallest openings between the heart’s chambers. When performed by an experienced cardiac physiologist, it can identify abnormal blood flow that may not be visible on a standard echocardiogram. If results are unclear or if further detail is needed, your consultant may recommend an additional imaging test such as a transoesophageal echocardiogram (TOE) or cardiac MRI for confirmation.