A cardiologist may recommend performing the following tests to diagnose an open oval window.
The most common echocardiography is called transthoracic echocardiography. In this study, ultrasound waves directed to your heart from a stick-shaped device (sensor) located on your chest create video images of your heart in motion. The doctor can use echocardiography to detect an open oval window and other problems in the heart.
Different versions of this procedure can be used to detect an open oval window, such as:
When an ultrasound wave bounces off blood cells passing through the heart, it changes the frequency and wavelength. These characteristic changes (Doppler signals) and computer-processed color of these signals help the doctor assess the speed and direction of blood flow in your heart.
If you have an open oval window, the color Doppler flow will be visible on the echocardiogram between the right and left Atria.
Test with contrast-saline solution (Bubble test)
In this method, a sterile saline solution is shaken until tiny bubbles form, and then injected into a vein. The bubbles move to the right atrium and appear on an echocardiogram in the right chambers of the heart.
If there is no opening between the left and right Atria, the bubbles simply pass into the lungs and are exhaled. If you have an open oval window, bubbles appear in the left chambers of the heart and can be seen on the echocardiogram. However, the presence of an open oval window is often difficult to confirm with transthoracic echocardiography.
The doctor can perform another version of echocardiography, called transesophageal echocardiography, to get a closer look at the heart and its flows. During this examination, a small sensor is attached to the end of a tube inserted through the mouth into the esophagus. This method is considered the most accurate available test to see an open oval window in combination with color dopplerography or bubble analysis.
The doctor can perform a simple method called transcranial dopplerography. During this examination, the sensor is placed on the temple and you can see blood flows passing in the cerebral arteries, the study is performed with a bubble sample. After the passage of air bubbles through the oval window, they enter the left atrium and then the left ventricle. The left ventricle throws out blood along with the vesicles and they can easily be seen in the cerebral arteries with the help of a sensor.
This method does not allow you to tell exactly where the hole in the heart is, so it is always supplemented with transesophageal echocardiography
Your doctor may recommend that you take additional tests if you have an open, oval hole and have had a stroke. You may also need to consult a neurologist and a hematologist for additional diagnosis