Detecting intrapulmonary right to left shunt with contrast echocardiography. Observations in a patient with diffuse pulmonary arteriovenous fistulas

Contrast echocardiography has been useful in detecting intracardiac right to left shunts. In a patient with hereditary hemorrhagic telangiectasia and diffuse pulmonary arteriovenous fistulas, we have demonstrated the feasibility of detecting intrapulmonary right to left shunting using this technique. After venous injection of indocyanine green dye, the characteristic contrast flow pattern consisted of a markedly delayed appearance of echoes in the left ventricle.