Basics of Contrast Enhanced Echocardiography

Intravenously administered contrast agents are classified according their ability to pass the capillaries of the lung: the first part of the chapter deals with the right heart contrast agents which do not pass the pulmonary capillaries. Following the preparation of right heart contrast agents, practical advice is given on how to diagnose a patent foramen ovale and how to enhance Doppler signals of the tricuspid valve. The second part of the chapter provides the characteristics of the approved transpulmonary (‘left heart’) contrast agents. Recommendations are provided for safe application and appropriate imaging modalities like very low mechanical index multi-pulse techniques. This chapter is aligned to the EACVI core syllabus edition 2013, the Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017 and the 2018 American Society of Echocardiography Focused Update Regarding Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography.