Contrast Echocardiography

SonoVue (sulfur hexafluoride) is indicated for use with ultrasound imaging to enhance the echogenicity of the blood, which results in an improved signal-to noise ratio. SonoVue should only be used in patients where examination without contrast enhancement is inconclusive.

• Suboptimal exam where 2 or more segments of the heart in an apical view are not well seen
• To improve endocardial border delineation
• To assist in the detection and correct classification of intracardiac masses (tumors, thrombi)
• To confirm or exclude the echocardiographic diagnosis of the following LV structural abnormalities, when non-contrast images are suboptimal:
  a. Apical variant of hypertrophic cardiomyopathy
  b. LV noncompaction
  c. Apical thrombus
  d. Complications of myocardial infarction: LV aneurysm, pseudoaneurysm, and myocardial rupture
  e. Apical wall motion abnormalities (akinesis/dyskinesis)

• Known allergy to echocardiographic contrast, or its components
• Known right to left cardiac shunts (bubbles can bypass filtering by the lung and directly enter the arterial circulation)
• Patients with known severe pulmonary hypertension (Pulmonary artery > 90 mmHg), uncontrolled systemic hypertension, adult respiratory distress syndrome
• Patients taking dobutamine with conditions suggesting cardiovascular instability
• Refer to Bracco product monograph for updated contraindications
• There is no evidence that contrast crosses the placenta, however, SonoVue should not be used routinely in pregnancy patients