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Senior R, Becher H, Monaghan M, Agati L, Zamorano J, Vanoverschelde JL, Nihoyannopoulos P, Edvardsen T, Lancellotti P. Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017. Eur Heart J Cardiovasc Imaging 2018; 18:1205-1205af. [PMID: 28950366 DOI: 10.1093/ehjci/jex182] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 12/16/2022] Open
Abstract
Contrast echocardiography is widely used in cardiology. It is applied to improve image quality, reader confidence and reproducibility both for assessing left ventricular (LV) structure and function at rest and for assessing global and regional function in stress echocardiography. The use of contrast in echocardiography has now extended beyond cardiac structure and function assessment to evaluation of perfusion both of the myocardium and of the intracardiac structures. Safety of contrast agents have now been addressed in large patient population and these studies clearly established its excellent safety profile. This document, based on clinical trials, randomized and multicentre studies and published clinical experience, has established clear recommendations for the use of contrast in various clinical conditions with evidence-based protocols.
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Affiliation(s)
- Roxy Senior
- Department of Cardiology, Royal Brompton Hospital, Imperial College, Sydney Street, London SW3 6NP, UK
| | | | | | | | - Jose Zamorano
- CIBERCV, University Hospital Ramón y Cajal, Madrid, Spain
| | | | | | | | - Patrizio Lancellotti
- University of Liege Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liege, Belgium
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Katz JS, Heching M, Hoffman DM, Danilov T, Tranbaugh RF. Echocardiography and Cardiac Rupture: Is Contrast Extravasation an Indication for Surgery? Echocardiography 2015; 33:150-3. [PMID: 26299914 DOI: 10.1111/echo.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Contrast echocardiography demonstrating microbubbles in the pericardial space has often been cited as evidence of ventricular rupture requiring emergent surgical intervention. We report a case where no myocardial perforation was found during post-myocardial infarction surgery despite prior echocardiographic evidence of contrast extravasation into the pericardial effusion. Clinical decision making requires balancing imaging evidence with clinical circumstances to determine the optimal timing for surgical intervention.
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Affiliation(s)
- Jonathan S Katz
- Department of Cardiology, Mount Sinai Beth Israel, New York, New York
| | - Moshe Heching
- Department of Medicine, Mount Sinai Beth Israel, New York City, NY
| | - Darryl M Hoffman
- Department of Cardiothoracic Surgery, Mount Sinai Beth Israel, New York, New York
| | - Tatyana Danilov
- Department of Cardiology, Mount Sinai Beth Israel, New York, New York
| | - Robert F Tranbaugh
- Department of Cardiothoracic Surgery, Mount Sinai Beth Israel, New York, New York
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Cosyns B, Roossens B, Hernot S, El Haddad P, Lignian H, Pierard L, Lancellotti P. Use of contrast echocardiography in intensive care and at the emergency room. Curr Cardiol Rev 2013; 7:157-62. [PMID: 22758614 PMCID: PMC3263480 DOI: 10.2174/157340311798220467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 03/04/2011] [Accepted: 04/07/2011] [Indexed: 12/13/2022] Open
Abstract
Bedside echocardiography in emergency room (ER) or in intensive care unit (ICU) is an important tool for managing critically ill patients, to obtain a timely accurate diagnosis and to immediately stratify the risk to the patient’s life. It may also render invasive monitoring unnecessary. In these patients, contrast echocardiography may improve quality of imaging and also may provide additional information, especially regarding myocardial perfusion in those with suspected coronary artery disease. This article focuses on the principle of contrast echocardiography and the clinical information that can be obtained according to the most frequent presentations in ER and ICU.
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Affiliation(s)
- Bernard Cosyns
- UZ Brussel, Cardiology, Free University of Brussels, Belgium.
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Fukuda M, Tanaka N, Fujii A, Fukuta S, Oda T, Nakao F, Fujii T, Suzuki K, Tsuboi H. A case of cardiac rupture subsequent to myocardial infarction diagnosed in emergency room. J Echocardiogr 2011; 9:73-4. [PMID: 27276883 DOI: 10.1007/s12574-010-0068-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 08/25/2010] [Accepted: 08/26/2010] [Indexed: 11/28/2022]
Abstract
A 72-year-old woman was transferred to the emergency room because of left anterior chest pain with cold sweating. Electrocardiography revealed recent anterior myocardial infarction. Echocardiography showed akinesis of the mid-ventricular septum to the apex by apical view, a small amount of pericardial effusion and collapse of the right ventricular wall, indicating cardiac tamponade, by subcostal view. These echocardiographic findings strongly suggested cardiac rupture subsequent to the myocardial infarction. Emergent operation was successfully performed to repair the ruptured left ventricle.
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Affiliation(s)
- Masakazu Fukuda
- Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan
| | - Nobuaki Tanaka
- Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan.
| | - Akihisa Fujii
- Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan
| | - Seiko Fukuta
- Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan
| | - Tetsuro Oda
- Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan
| | - Fumiaki Nakao
- Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan
| | - Takashi Fujii
- Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan
| | - Kazuhiro Suzuki
- Department of Cardiovascular Surgery, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan
| | - Hidetoshi Tsuboi
- Department of Cardiovascular Surgery, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan
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Grayburn PA. Product safety compromises patient safety (an unjustified black box warning on ultrasound contrast agents by the Food and Drug Administration). Am J Cardiol 2008; 101:892-3. [PMID: 18328861 DOI: 10.1016/j.amjcard.2007.11.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 11/28/2007] [Accepted: 11/28/2007] [Indexed: 10/22/2022]
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