Afecțiuni cardiovasculare
29-10-2025
The bubble test: what it is, when it’s done, and why it’s important in cardiology
Data publicării: 07-11-2025
Actualizare la: 14-11-2025
Subiect: Afecțiuni cardiovasculare
Durată de citire estimată: 1 min.
Editor și traducător
Viktoryia Luhakova
Editor și traducător
Nisserine BousselhameThe bubble test, also known as contrast echocardiography with microbubbles, is a cornerstone of modern cardiology.
It is a quick, simple, and safe examination that offers highly valuable diagnostic insight, allowing clinicians to detect subtle but clinically important cardiac abnormalities that might otherwise go unnoticed.
This technique is a clear example of how contemporary cardiology is moving toward personalized and preventive diagnostics, providing patients with more accurate evaluations and tailored care.
We discussed it with Dr. Francesca D’Auria, cardiac surgeon and cardiologist at Smart Clinic Varedo, Smart Clinic Cinque Giornate, and Smart Clinic Certosa.
How the bubble test works and how it differs from a standard echocardiogram
The bubble test, or contrast-enhanced echocardiogram, is a specific variant of the transthoracic echocardiogram (TTE), an ultrasound-based imaging test performed on the chest to visualize the heart.
The key difference lies in the addition of a contrast agent made of microbubbles suspended in saline solution, which is administered intravenously. It’s important to emphasize that this contrast agent does not contain iodine, unlike those used in radiology, and therefore poses no risk of allergic reactions.
This is a non-invasive procedure, apart from a small needle prick used to inject the saline solution containing microbubbles. The test is relatively quick, well tolerated, and can easily be performed on an outpatient basis.
When this test is recommended
The bubble test is primarily performed when there is a suspicion of abnormal communication between the cardiac chambers.
It is especially indicated in cases such as:
- Suspected patent foramen ovale (PFO), a small opening between the right and left atria that persists after birth in some individuals.
- Diagnostic evaluation following a cryptogenic stroke or transient ischemic attack (TIA), when the cause of the event cannot be determined through other tests.
In these situations, the bubble test helps identify whether there is an abnormal passage of blood between the atria, which could have contributed to the embolic event.
Who should undergo the test
The bubble test is especially recommended for scuba divers and freedivers. In these sports, the presence of a cardiac shunt, even a small one, may increase the risk of embolic events during diving or ascent due to changes in pressure and circulation.
In such cases, the bubble test serves as an important and strongly recommended preventive screening tool, ensuring both safety and cardiovascular health for individuals engaging in these activities.