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Figure 3 Example of a patient with a PFO and an atrial right to left shunt detected only by SHI. Transthoracic echocardiograms (left and mid-left panel) showing an apical four-chamber view with FI (left panel) and SHI (mid-left panel) as well as transesophageal echocardiograms (mid-right and right panels) showing image planes at 0° and 112° rotation. Intense opacification of the right heart chambers is seen with all imaging modalities. However, contrast bubbles in the left heart chambers are only detected with SHI.