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TITLE:

CONTRAST ECHOCARDIOGRAPHY: AN OVERVIEW OF ITS CLINICAL APPLICATIONS AND ADVANTAGES OVER THE LIMITATIONS OF NATIVE ECHOCARDIOGRAPHY AND COMPARISON OF CONTRAST ECHOCARDIOGRAPHY WITH CARDIAC MAGNETIC RESONANCE IMAGING

AUTHORS:

Dr Rizwan Rabbani, Dr Martin Goldman, Dr Rabia Sikandar

ABSTRACT:

In less than half a century echocardiography has revolutionized cardiovascular medicine. After EKG and CXR it is the most frequently performed cardiovascular exam through which information regarding cardiac morphology, function and hemodynamics can be obtained non-invasively. This technique has rapidly developed and evolved through M-mode, 2D, Doppler, stress, TE, intraoperative, contrast, digital, 3D and intra-cardiac and is being considered as a mainstay technology of clinical medicine. In 1953, Dr. Inge Elder and Dr. Helmet Hertz collaborated and began to use a commercial ultrasonoscope to examine the heart. This collaboration is accepted as the discovery of echocardiography, which was called cardiac ultrasound at that time(UCG).[1] It was in 1963,when Dr. Harvey Feigenbaum became interested in this subject and used an echoencephalography, a machine to record images of the heart rather than its original intent to record images of the brain. In 1968,Feigenbaum collaborated with Dodge at university of Alabama on the development of M-mode technology for the measurement of left ventricular diameter, and it was at this time when echocardiography was named and recognized clinically as an acceptable technique in the field of cardiology. [2] Though Transthoracic echocardiography (TEE) is the most widely and commonly performed cardiac ultrasound and has the potential to comprehensively evaluate left and right ventricular diastolic\ systolic functions, regional wall motion, valvular diseases and pericardial diseases, experts have come to realize the limitations of this technique no matter how skillful the sonographer is. Some of these limitations can be overcome using contrast agents. Contrast echocardiography is very useful when an accurate assessment of left ventricular (LV) function is required under a few circumstances like to assess LV function in patients in the intensive care, to help guide treatment decisions in heart failure patients, to keep follow up of patients with moderate valvular diseases and decision for surgical treatment, selection and monitoring of patients undergoing chemotherapy with cardio toxic drugs. Keywords: cardiovascular medicine, cardiac morphology, echocardiography, chemotherapy.

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