Field study bubble scores as detected by transthoracic saline contrast echocardiography (TTSCE) in subjects performing cycle ergometer exercise at sea level (A) and within 48 h of arrival at 5,260 m (B). *P < 0.05 compared with 5,260 m. Max, highest workload [watts (W)] achieved within subject and corresponding bubble score. ○, Normobaric; ●, hypobaric.