Echocardiography has now reached its maturity and plays a key role in the clinical assessment of cardiac function however its ability to assess myocardial perfusion remains a clinical challenge myocardial contrast echocardiography is a technique that uses microbubbles. Contrast opacification of the left ventricular cavity enhances endocardial border definition fig 2 2 and has been shown to increase diagnostic accuracy in suboptimal studies at rest 9 and during stress 10 this is the major clinical use of left heart contrast echocardiography at present table 2 2. Contrast echocardiography in daily clinical practice contrast echocardiography is also used as an adjunctive technique when unenhanced echocardiography falls short in the differentiation of . Clinical impact of the use of contrast during echocardiography on patient management in a variety of inpatient and outpatient settings the data do not reflect total impact because lack of any change in management does not necessarily indicate lack of impact. Contrast echocardiography using second generation microbubble contrast agents has been used in clinical echocardiographic practice for several years in many centres outside australia echo contrast agents dramatically improve endocardial definition in both resting echocardiography and stress echocardiography the improvement in the
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