Articles Vol. 67 No. 2 02/03/2026

THE ROLE OF CONTRAST ECHOCARDIOGRAPHY IN THE DIAGNOSIS OF PATENT FORAMEN OVALE IN PATIENTS WITH ISCHEMIC STROKE

Thang Vu Manh1,2, Hung Nguyen Minh1,2, Ton Mai Duy3,4,5,6,7,8, Hoai Nguyen Thi Thu1,2, Nguyet Giap Thi Minh1,2, Dao Luu Thi Bich1,2, Hung Pham Manh9,10
1 Vietnam National Heart Institute, Bach Mai Hospital
2 Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai
3 Stroke Center, Bach Mai Hospital
4 Hanoi Medical University
5 University of Medicine and Pharmacy, Vietnam National University, Hanoi
6 Trung tâm Đột Qụy, Bệnh viện Bạch Mai
7 Đại học Y Hà Nội
8 Đại học Y Dược, Đại học Quốc Gia Hà Nội
9 Department of Cardiology, Hanoi Medical University
10 Bộ môn Tim mạch, trường Đại học Y Hà Nội
DOI: 10.52163/yhc.v67i2.4344
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Abstract

Objective: To evaluate the role of contrast transthoracic echocardiography (cTTE) using self-prepared contrast compared with contrast transesophageal echocardiography (cTEE) in the diagnosis of right-to-left shunt caused by patent foramen ovale (PFO).

Methods: A cross-sectional descriptive study was conducted on 51 patients admitted with ischemic stroke. All patients underwent both cTTE and cTEE using self-prepared contrast agents.

Results: PFO was detected in 17 patients (33.3%) by cTTE compared with 18 patients (35%) by cTEE (χ² = 0.5; p ≈ 1), with no statistically significant difference between the two methods. Compared with cTEE, cTTE identified 94.4% of PFO cases, indicating a high level of agreement between the two modalities (Kappa = 0.9). Moreover, cTTE showed superiority in assessing the degree of right-to-left shunt through PFO, particularly in detecting large shunts, when compared with cTEE (Z = –2.053, p = 0.04). No adverse reactions were observed during either cTTE or cTEE using self-prepared contrast.

Conclusion: cTTE with self-prepared contrast is a simple, non-invasive, and cost-effective method suitable for detecting and diagnosing PFO.

Keywords
contrast echocardiography, patent foramen ovale, ischemic stroke
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