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Contrast echocardiography 

Contrast echocardiography
Chapter:
Contrast echocardiography
Author(s):

L. Galiuto

, R. Senior

, and H. Becher

DOI:
10.1093/med/9780199599639.003.0007
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date: 22 August 2019

Contrast echocardiography is a non-invasive, well tolerated echocardiographic technique which employs ultrasound contrast agent in order to improve the quality of echocardiographic images, by enhancing blood flow signal.

Clinical usefulness of this echocardiographic imaging modality resides in the possibility of providing better acoustic signal in cases of poor quality images, with additional important information related to assessment of myocardial perfusion. Indeed, about one-third of echocardiographic images are affected by poor quality due to high acoustic impedance of the chest wall of the patients secondary to obesity or pulmonary diseases, not allowing detection of left ventricular endocardial border. Moreover, in patients with low ejection fraction and apical left ventricular aneurysm, intraventricular thrombus could be undetectable with standard echocardiography. Furthermore, coronary microcirculation cannot be assessed by standard echocardiography. Contrast echocardiography can be performed in all such conditions to improve diagnostic power of echocardiography.

The adjunctive role of contrast echocardiography is well defined in both rest and stress echocardiography in order to detect the endocardial border and intraventricular thrombi, to accurately measure ejection fraction, wall motion, and to assess myocardial perfusion.

The purpose of this chapter is to explain basic principles, feasibility, safety, major clinical applications, current indications, and further developments of contrast echocardiography.

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