Contrast Echocardiography in the Cardiac Care Unit

  • Eyal HerzogEmail author
  • Seyed Hamed Hosseini Dehkordi
  • Edgar Argulian


Suboptimal echocardiograms are common in critically ill patients. The obstacles that interfere with optimal echocardiographic imaging in cardiac care unit patients include suboptimal positioning, obesity, hyperinflated lungs due to mechanical ventilation, lung disease, subcutaneous emphysema, surgical incisions, chest tubes, bandages, and crowded quarters. It is well known that use of contrast in echocardiography significantly improves the image quality, but despite that, contrast echocardiography is widely underused. The current chapter outlines the basics of contrast echocardiography as it applies to critical care.


Contrast echocardiography Myocardial infarction Thrombus 


  1. 1.
    Shaw LJ. Impact of contrast echocardiography on diagnostic algorithms: pharmacoeconomic implications. Clin Cardiol. 1997;20(suppl 1):I-39–48.CrossRefGoogle Scholar
  2. 2.
    Critical Care Statics. Accessed Jan 2018.
  3. 3.
    Orde S, Slama M, Hilton A, Yastrebov K, Mclean A. Pearls and pitfalls in comprehensive critical care echocardiography. Crit Care. 2017;21(1):279.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kurt M, Shaikh KA, Peterson L, et al. Impact of contrast echocardiography on evaluation of ventricular function and clinical management in a large prospective cohort. J Am Coll Cardiol. 2009;53(9):802–10.CrossRefPubMedGoogle Scholar
  5. 5.
    Mulvagh SL, Rakowski H, Vannan MA, Abdelmoneim SS, Becher H, Bierig SM, et al. American Society of Echocardiography Consensus Statement on the clinical applications of ultrasonic contrast agents in echocardiography. J Am Soc Echocardiogr. 2008;21(11):1179–201.CrossRefPubMedGoogle Scholar
  6. 6.
    IAC Standards and Guidelines for Adult Echocardiography Accreditation. Accessed on Jan 2018.
  7. 7.
    The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Http:// Accessed Jan 2018.
  8. 8.
    Szebeni J. Complement activation-related pseudoallergy: a new class of drug-induced acute immune toxicity. Toxicology. 2005;216:106–21. Scholar
  9. 9.
    Main ML, Hibberd MG, Ryan A, Lowe TJ, Miller P, Bhat G. Acute mortality in critically ill patients undergoing echocardiography with or without an ultrasound contrast agent. JACC Cardiovasc Imaging. 2014;7(1):40–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Weled BJ, Adzhigirey LA, Hodgman TM, et al. Critical care delivery: the importance of process of care and ICU structure to improved outcomes: an update from the American College of Critical Care Medicine Task Force on Models of Critical Care. Crit Care Med. 2015;43(7):1520–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Eyal Herzog
    • 1
    Email author
  • Seyed Hamed Hosseini Dehkordi
    • 1
  • Edgar Argulian
    • 1
  1. 1.Mount Sinai St. Luke’s HospitalNew YorkUSA

Personalised recommendations