In patients with suboptimal images
- To enable improved endocardial visualization and assessment of LV structure and function when two or more contiguous
- segments are NOTseen on non-contrast images
- To have accurate and repeatable measurements of LV volumes, and ejection fraction by 2D Echo
- To increase confidence of the interpreting physician in the LV function, structure and volume assessments
- To confirm or exclude the echocardiographic diagnosis of the following LV structural abnormalities, when non-enhanced images are suboptimal for definitive diagnosis:
- apical hypertrophic cardiomyopathy
- ventricular non-compaction
- apical thrombus
- ventricular pseudoaneurysm
Clinical Case 1
60year old male. Hypertensive, diabetic, overweight. Referred for echocardiography to investigate breathlessness. Sub-optimal apical image quality, then was contrast used for image optimisation.
Clinical Case 2
45 year old male, 164 cm/155 kg – Body mass index 57.6, Past AMI and established heart failure: EF 40 % (2000), Drug abuse in the past, Admitted due to shortness of breath, Not taken “some medications”
Clinical Case 3
80 year old male, Smoker, Admitted due to suspected Heart Failure November 2007, Echo : Severely decreased systolic LV function, EF 15%, Normal angiogram (Non-ischemic dilated cardiomyopathy), Numerous runs of non-sustained VT : Scheduled for ICD, Medication led to a clinical improvement; NYHA IIIb & II, No remaining VT episodes during mobilisation
Clinical Case 4
54 year old male teacher. Seen in Cardiology Outpatients for assessment due to fatigue and shortness of breath. Heart failure symptoms and signs, referred for echocardiography.
Clinical Case 5
70 year old female, Referral for echocardiogram due to fatigue and shortness of breath.
- There is evidence to support the use of contrast agents in enhancing 2D echo stuides for superior assessment of LV structure and function.
- Particular benefits are seen with:
- Endocardial definition for ejection fraction
- Apical thrombus assessment
- Structural defects such as apical HCM or non-compaction cardiomyopathy