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Value of the cough maneuver for detecting right‐to‐left shunt during contrast transthoracic echocardiography
Author(s) -
Wang Ping,
Chen ShaSha,
Li Ying,
Zhang XiaoYong
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14289
Subject(s) - medicine , right to left shunt , cardiology , valsalva maneuver , sphygmomanometer , blood pressure , patent foramen ovale , migraine
Aim To explore the value of cough maneuver ( CM ) in detecting right‐to‐left ( RLS ) during contrast transthoracic echocardiography ( cTTE ) and its mechanism. Method We enrolled 196 patients with a high level of clinical suspicion of RLS underwent cTTE for RLS detection. Valsalva maneuver ( VM ) (blowing into a face mask connected to a sphygmomanometer at 40 mm Hg for 10 seconds) and CM were performed to provoke RLS , respectively. A comparison of the two provocative maneuvers in terms of the RLS ‐detection rate, the degree of RLS , the mobility of septum primum was done. Results The detection rates of RLS for CM were significantly higher than that for VM (38.3% vs 32.1%), ( P < 0.001). There was no significant difference between VM and CM in terms of detecting moderate‐ or severe‐extent RLS ( P > 0.05), however, CM was significantly better than VM in detecting mild‐extent RLS ( P = 0.004). CM caused a greater mobility of septum primum than VM (20.1 ± 0.2 mm vs 6.3 ± 0.1 mm), ( P < 0.001). Conclusion Cough maneuver had a higher detection rate for RLS than VM during cTTE , maybe due to its greater mobility of septum primum than VM caused.