Artefacts or excessive ultrasound ‘noise’ can prevent accurate assessment of the left ventricular apex and also of overall cardiac geometry in patients with sub-optimal image quality. Contrast is a quick, cheap and highly effective way of diagnosing ventricular thrombus [17], apical hypertrophic cardiomyopathy [18], left ventricular non-compaction [19], myocardial abscess [20] and pseudo-aneurysms [21]. Other imaging modalities are also available, such as cardiac MRI, but the widespread availability of echocardiography and the considerably lower cost make contrast echocardiography the first-line imaging modality in such patients.
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